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 and disproportionately impacts students who are
low-income, first generation, or from minoritized racial and ethnic groups 4–6. In addition to exacerbating
existing health disparities, including 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.