Relationship Between Hunger and Obesity
While food insecurity and obesity can co-exist in the same individual, family, or community, the research on whether there is a statistically significant relationship provides mixed results. Overall, based on several reviews of the literature, the strongest and most consistent evidence is for a higher risk of obesity among food insecure women.
The extent of research on food insecurity and obesity has grown considerably since 1995, when a leading pediatrician published a medical case report that proposed a relationship between hunger and obesity (Dietz, 1995). At first, the relationship between food insecurity and obesity was considered counterintuitive and labeled a paradox. This was due, in part, to our limited understanding of the causes and consequences of food insecurity. But now, with a more extensive research base and comprehensive conceptual framework, researchers conclude that the “coexistence of food insecurity and obesity is expected given that both are consequences of economic and social disadvantage” (Frongillo & Bernal, 2014).
While food insecurity and obesity can co-exist in the same individual, family, or community, the research on whether there is a statistically significant relationship provides mixed results (Dinour et al., 2007; Eisenmann et al., 2011; Franklin et al., 2012; Larson & Story, 2011). A number of research studies in the U.S. and abroad have found positive associations between food insecurity and overweight or obesity. Other studies have found no relationship, or even a lower risk of overweight or obesity with food insecurity. Associations, or lack thereof, often differ by gender, age, and/or race-ethnicity. Making comparisons across studies is further complicated by differences in study design, measures of weight and food security status, and sample size and characteristics. Overall, based on several reviews of the literature, the strongest and most consistent evidence is for a higher risk of obesity among food insecure women.
A selection of recent U.S. studies is provided below that demonstrate the mixed findings on the relationship between food insecurity and obesity. The majority of these studies control for socioeconomic factors (e.g., income, education) as well as demographic characteristics (e.g., age, gender, race-ethnicity). Explanations for this relationship are available in the section on Why Low-Income and Food Insecure People are Vulnerable to Obesity.
Research Examining Food Insecurity and Obesity among Adults
- A study of more than 7,930 U.S. adults found that household food insecurity was associated with being overweight or obese among mothers, but not among fathers, child-free women, or child-free men (Martin & Lippert, 2012). (Researchers determined that this pattern among mothers was not attributable to pregnancy-related metabolic changes.)
- In a 12-state study of 66,553 adults, those who were food insecure had 32 percent greater odds of being obese compared with those who were food secure (Pan et al., 2012). Obesity was significantly associated with food insecurity among the following five population sub-groups: women (but not men); those with some college education or who graduated from college; and those with no children or two children in the household.
- Food insecurity was associated with increased body mass index (BMI) among young women, but not young men, in a national study of more than 13,700 young adults 24 to 32 years of age (Gooding et al., 2012).
- Food insecurity was associated with a greater increase in BMI in a longitudinal study of more than 2,400 patients at a Massachusetts community health center (Chen Cheung et al., 2015).
- Female baby boomers and older adults who were food insecure were 1.4 times more likely to have a higher BMI than those females who were food secure, based on a study set in an eight-county region of central Texas with 2,985 participants (Ahn et al., 2014). No association between food insecurity and BMI was observed among male participants.
- In a study of 810 pregnant women in North Carolina with incomes less than or equal to 400 percent of the income/poverty ratio, living in a food insecure household was associated with being severely obese before pregnancy and with experiencing greater weight gain during pregnancy (Laraia et al., 2010). Additional studies have found links between food insecurity during pregnancy and greater postpartum weight and BMI, particularly among women who were obese before or during pregnancy (Laraia et al., 2015; Olson & Strawderman, 2008).
Research Examining Food Insecurity and Obesity among Children and Adolescents
The following results for children and adolescents are less consistent than the studies for adults described above, which typically found a consistent relationship between obesity and food insecurity among adult women, but not men.
- Across five measures of obesity (i.e., BMI, waist circumference, triceps skinfold, trunk fat mass, and percentage of body fat), one study found no association between household food insecurity status and obesity among a national sample of 2,516 low-income children 8 to 17 years of age (Gundersen et al., 2009).
- Young people 12 to 18 years of age from marginally food secure, low food secure, and very low food secure households were 1.4 to 1.5 times more likely to have central obesity than those from high food secure households, based on national survey data from 7,435 participants (Holben & Taylor, 2015). Those from low food secure and marginally food secure households also were significantly more likely to be overweight than their counterparts from high food secure households.
- A three-city study (Boston, San Antonio, and Chicago) of 1,011 low-income adolescents found that maternal stress in combination with adolescent food insecurity significantly increased an adolescent’s probability of being overweight or obese (Lohman et al., 2009).
- According to a longitudinal study of more than 28,000 low-income children in the Massachusetts WIC program, persistent household food insecurity without hunger during infancy and early childhood was associated with 22 percent greater odds of child obesity at two to five years of age, in comparison to children from persistently food secure households (Metallinos-Katsaras et al., 2012). These odds varied with the mother’s pre-pregnancy weight status: children from households with persistent food insecurity without hunger were three times more likely to be obese if the mother was underweight and 34 percent more likely to be obese if the mother was overweight or obese, when compared to children from persistently food secure households; no association was found if the mother had a normal pre-pregnancy weight status.
- A smaller study of 222 young, predominantly Hispanic children whose caregivers were receiving WIC services found no association between overweight or obesity and household food security status (Trapp et al., 2015).