Testing a Dual-Process Mechanistic Model Linking Food Insecurity and Loss-of-Control Eating - PROJECT SUMMARY/ABSTRACT Food insecurity (FI) - a household-level economic and social condition of limited or uncertain access to adequate food 1- is a serious public health problem that affects 37% of undergraduate students 2. FI is more prevalent among students than in the general population 3. In addition to exacerbating physical and mental health problems, FI is consistently associated with an increased risk for eating disorder (ED) pathology. As many as 38-52% of university students with FI meet criteria for an eating disorder 7,8 with many more students reporting subclinical symptoms. This is an urgent problem because EDs are associated with increased mortality and morbidity, reduced quality of life, and high economic burden for individuals and healthcare systems. However, the specific mechanisms linking the experience of FI to eating behaviors remain largely unknown. One possibility is that feedback loops driven by 1) financial concerns related to FI and 2) “traditional” ED pathways of shape/weight concerns may perpetuate problem eating behaviors; however, there is yet to be a study examining within-person experiences of these two pathways in undergraduate students and their impact on academic functioning. Without understanding how these processes contribute to ED symptoms, it is likely that the efficacy of interventions for EDs in undergraduate students with FI will be limited. Our scientific premise is that mechanistic knowledge is critically needed to develop targeted interventions for undergraduate students with FI and EDs, as both FI 9–16 and untreated EDs 17–20 are associated with lower academic functioning, which may have profound impacts on educational attainment. For this R16 application, we have the following specific aims: 1) Evaluate a positive feedback loop of dietary restriction due to FI and loss-of-control eating; 2) Evaluate a positive feedback loop of loss-of-control eating, compensatory dietary restriction due to shape/weight concerns, and dietary restriction due to FI; and 3) Test how academic performance metrics are associated with FI and ED behaviors on the daily and cross-sectional levels. The proposed study is innovative and significant because it will evaluate potential mechanisms linking FI, EDs, and academic functioning. The majority of studies examining these constructs have been cross-sectional, predictive, or retrospective using between-subjects designs. There have been relatively few studies that have examined within-person associations between FI and ED symptoms and no studies that have explored how these daily experiences impact academic performance. Results from this study will support researchers, clinicians, and academic institutions in better addressing student needs. Data from this study will enable the modification of existing ED treatments to be more responsive to how ED pathology may be maintained by FI.
