Examination of Shame as a Mediator of the Relationship Between Food Insecurity and Disordered Eating

Background: An emerging literature has found associations between food insecurity and disordered eating behaviors. This study was two-fold. First, to replicate the existing literature that food insecurity is associated with disordered eating symptoms including loss of control over eating. Second, to expand the existing literature by examining stigma control theory, which purports that experiences related to food insecurity potentially induce stigma-related shame, with disordered eating behaviors used to cope with the shame. Further, to explore if emotion coping strategies moderate associations between shame and disordered eating. Method: This is a secondary analysis of a cross-sectional study of 582 adults with food insecurity. Participants completed a 20-minute online survey on food insecurity, shame related to food insecurity, coping strategies, and disordered eating behaviors. Analyses: Hierarchical regressions were computed where food insecurity, shame, and emotion focused coping were entered as predictor variables, followed by their interaction terms, and with disordered eating behaviors entered as outcome variables. Results: Regressions suggest that a) internalized shame partially mediated the relationship between food insecurity and global disordered eating, b) internalized shame did not mediate the relationship between food insecurity and loss of control, c) emotion focused coping did not moderate any relationship. Discussion: Internalized shame may be one mechanism in which disordered symptoms arise in food insecure populations, however emotion focused coping does not have any effect on this relationship. Results indicate that coping strategies alone may not reduce eating disorder symptoms, and internalized shame may be an important predictor of disordered eating in food insecure populations.