Household Food Insecurity across Childhood and Weight Change Attempts in Early Adolescence: Findings from a Nationally Representative Cohort of United States Youth

<h2>Abstract</h2><h3>Background</h3> Youth with food insecurity may have a disproportionately high risk of experiencing body image concerns and unhealthy weight control behaviors, but these associations remain poorly understood. Understanding how food insecurity across childhood relates to adolescent weight change attempts may inform important strategies for addressing body image concerns and preventing risky weight control behaviors among youth. <h3>Objective</h3> To understand how food insecurity across childhood relates to weight change attempts in early adolescence. <h3>Methods</h3> Children (n=7,115) participated in the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99, a nationally representative cohort of U.S. youth. Parents reported household food insecurity (exposure) at four timepoints: when children were in kindergarten, grade 3, grade 5, and grade 8. In grade 8, children self-reported trying to lose or gain weight (outcomes). Associations were tested using adjusted Poisson regression models. <h3>Results</h3> Compared to children who remained food secure from grade 5 to grade 8, those who recently became food insecure were more likely to attempt weight loss in grade 8 (Prevalence Ratio [PR] = 1.25, 95% CI: 1.03, 1.52). Children with food insecurity during 3-4 (vs. 0) total timepoints were also more likely to attempt weight loss in grade 8 (PR = 1.24, 95% CI: 1.04, 1.47). Associations with weight gain attempts were statistically non-significant. <h3>Conclusions</h3> Both transient and persistent experiences of household food insecurity during childhood were associated with greater likelihood of attempting weight loss in early adolescence. These findings emphasize the need for long-lasting food insecurity prevention strategies and development of programs to promote healthy body image and eating patterns among children with food insecurity.