How Food Insecurity Makes It Harder to Manage Weight

A new study found that adults who followed high-intensity, lifestyle-based weight-loss interventions were successful at managing their weight. However, that intervention was less effective in people experiencing food insecurity. 

“Food insecurity and obesity often exist side by side for several reasons," Cheryl Mussatto, MS, RD, LD, clinical dietitian and the author of The Nourished Brain, tells Verywell. "A steady diet of high-fat, high-sugar, energy-dense foods keep your stomach full, are affordable, easily available, require little to no preparation, and taste good. Then, when people are unsure where their next meal will come from, they may overeat when food or money is available.”

What Is Food Insecurity?

Being food insecure means that a person experiences a disruption of food intake or eating patterns because of lack of money, access, or other barriers. A person who is experiencing food insecurity may choose less nutritious food because of its cost, availability, or convenience. 

Food insecurity can lead to excess body weight, which in turn raises a person’s risk for developing numerous health conditions like diabetes, hypertension, cardiovascular disease, and depression.

Zoey Thill, MD, MPH, MPP, a family medicine physician based in New York, tells Verywell that the new study's findings would be in line with what any primary care physician will tell you: purely clinical interventions are often not enough to improve people's health. "This study implies that structural interventions must complement clinical interventions," Thill says.

Food Insecurity Is a Barrier to Weight Loss

The March study, which was published in the New England Journal of Medicine, found that people experiencing food insecurity have higher body weights compared to people who are not food insecure.  

So the researchers set out to explore whether food insecurity plays a role in the results people see when participating in a structured weight-loss intervention program.   

The researchers used past data from the Promoting Successful Weight Loss in Primary Care in Louisiana (PROPEL) trial, in which 452 individuals participated in an intensive lifestyle intervention and 351 individuals received their usual care.

The data was collected over two years from 18 clinics in Louisiana. The subjects who were included in the study were considered to be overweight or obese at the beginning of the trial. 

Participants in the intensive lifestyle intervention group attended weekly meetings with health professionals for 6 months, followed by monthly meetings. The people in the usual care group received newsletters containing wellness-related information. 

Those in the intensive lifestyle intervention group lost more weight than the usual care group at the end of the study; however, the people who were food insecure lost less weight than the people who were food-secure.

How to Manage Health While Experiencing Food Insecurity

The current data highlights how food insecurity negatively impacts weight, even when a person is participating in a weight-loss program. The authors of the study suggest healthcare providers proactively identify food-insecure patients and refer them to support services that can provide resources. The authors also highlight the need for weight-loss methods that address obesity and food insecurity together.

Mussatto adds that “assessing food security, cooking skills, frequency of eating out and of skipping meals” can help identify people who are most in need of lifestyle interventions to address obesity rates in food-insecure populations. 

Tips for Eating a Balanced Diet on a Budget

Lainey Younkin, MS, RDN, LD, a Boston-based registered dietitian, tells Verywell people experiencing food insecurity who are trying to manage their weight can improve their diet by:

• Adding fiber to your diet. Many high-fiber foods like whole-wheat pasta, potatoes, beans, and lentils are inexpensive and can often be purchased in bulk.
• Don't underestimate the role stress plays in weight management. Stress makes the hormone cortisol rise, which in turn can increase cravings for carbohydrates. Cortisol also drives the storage of belly fat. Look for ways to cut down on stress, such as walking, journaling, or meditating. It's also important to get enough quality sleep.
• Eat balanced meals. Aim to eat something with protein, fiber, and fat every three to four hours instead of snacking. 
• Find someone to keep you accountable. Having someone to help you navigate food choices, especially if you have limited options, can be beneficial. Ask your healthcare provider about working with a dietitian and/or therapist (if you have insurance, these sessions might be covered).

Stock up on Affordable, Nutrient-Dense Products

Mackenzie Burgess, RDN, registered dietitian nutritionist and recipe developer at Cheerful Choice, suggests that people make use of shelf-stable items. “Eating healthfully and achieving a desired weight doesn't have to be expensive,” Burgess tells Verywell. “Canned fruits and vegetables may be a more affordable option to increase your intake of nutrient-dense foods that are low in calories."

Lower-cost but still nutritious and tasty items can also form the basis for many meals.

"Other pantry ingredients like lentils, grains, and beans are packed with fiber and protein to keep you fuller for longer," Burgess says. "You can even make your own protein-packed dry soup mix with these ingredients."