The lived experience of Co-occurring food insecurity and food addiction: A qualitative study

Household food insecurity affects 13.5% of US households and is associated with short and long-term negative health outcomes. Food addiction, which posits that highly processed (HP) foods may trigger addictive responses akin to substance use disorders (SUD), occurs in approximately 15% of adults. Food addiction is measured using the Yale Food Addiction Scale 2.0, which is based on the SUD criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Although recent research suggests food insecurity and food addiction are associated among low-income adults, the lived experience of adults experiencing food insecurity and food addiction requires further study. Qualitative interviews were conducted with adults (n = 23) with food insecurity and food addiction to investigate their lived experience and how food insecurity impacted participants' experiences of food addiction, whether to facilitate or intensify food addiction symptoms, or contribute to other experiences inconsistent with food addiction. Overall, participant descriptions of each symptom mirrored descriptions from more general samples of adults with food addiction. For example, themes included compulsive HP food consumption despite negative consequences and intense craving for HP food. Although most participants did not explicitly connect their experiences of food insecurity and food addiction, several themes emerged related to food insecurity contributing to food addiction symptoms, including a tendency to overeat HP foods when they became available, overeating to avoid food waste, and withdrawal symptoms emerging when financial constraints limited access to HP food. In sum, individuals experiencing food insecurity described their food addiction experiences in ways consistent with more general samples of adults with food addiction and highlighted how food insecurity contributed to several food addiction symptoms.