Background

In patients with obesity, the relationship between food insecurity (FI) and eating-related (ER) experiences is poorly described. We explored this relationship with the Body-Q Eating Scales, which consists of three scales - ER behavior (eating habits, snacking frequency), ER distress (emotions after eating), and ER symptoms (nausea, vomiting, pain associated with eating).

Methods

All patients who presented to a major academic institution for evaluation for medical or surgical weight loss were given the Body-Q Eating Scales and the two-question FI screen. Body-Q Eating Scale scores were summed, and individual questions of each Body-Q domain were dichotomized between presence and absence of scale item. FI was dichotomized as presence or absence of FI over the prior 12 months. Pearson's correlation was used to evaluate the relationship between FI and Body-Q.

Results

Overall, 761 patients completed both Body-Q and FI with an 83% compliance rate. Twenty percent of the cohort reported FI. The baseline demographics of those with and without presence of FI did not significantly differ in age or BMI (Table). Those with FI had significantly worse ER symptoms (p<0.001) and ER distress (p<0.001), but not ER behavior (Figure).

Conclusions

In patients being evaluated for obesity treatment, 20% suffer from FI, which is associated with worse ER symptoms and ER distress, but not worse ER behavior. These findings suggest that FI is an important screening tool to identify patients with high risk of poor eating-related symptoms and emotional distress. Pre-emptive diet-related interventions may be indicated for high-risk patients.