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Obes Res Clin Pract. 2016 Sep - Oct;10(5):544-552. doi: 10.1016/j.orcp.2015.11.007. Epub 2015 Dec 12.

Disordered eating behaviours and food insecurity: A qualitative study about children with obesity in low-income households.

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UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA(1). Electronic address:
UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA(1).
University of California, Berkeley, School of Public Health, Berkeley, CA, USA.



While there is information in the literature describing the poor nutritional intake of food-insecure youth, eating behaviours among food-insecure children - particularly, obese children are less well-described. We conducted focus groups with family members of low-income children who were initiating care in a paediatric obesity clinic. Food hiding emerged as a theme, and generated the motivation for this analysis.


Between April 2012 and December 2013, a total of 7 focus groups were conducted (4 food-insecure groups and 3 food-secure). Based on recruitment from 37 index patients, the focus groups were attended by a total of 47 participants. Participant responses about eating behaviours were evaluated using a combination of inductive codes derived from the data and deductive codes informed by criteria for diagnosis of disordered eating.


While participants from food-secure and food-insecure households all had anecdotes about their children overeating, respondents in two of the food-insecure groups described episodes that resemble binge eating. The topic of hiding food emerged in the food-insecure groups, though was not endorsed in the food-secure groups despite probing. Night-time eating arose spontaneously in two of the food-insecure groups, but not in the food-secure groups.


This study highlights the presence of food hiding, binge eating, and night-time eating in food-insecure children with obesity. These factors would further compound their health burden, and the relationship between disordered eating and food insecurity in children with obesity warrants further study.


Disordered eating; Focus groups; Food hiding; Food insecurity; Paediatric obesity

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