Experiencing food insecurity — a lack of access to enough nutritious foods for a healthy and active lifestyle, usually due to being low-income — makes it more difficult to lose weight, even when you’re taking part in the same structured weight-loss program as people without food insecurity, according to a study published in the journal Annals of Internal Medicine.
Nutrition experts and researchers have known for a long time that people with food insecurity in the United States are at greater risk for being overweight or obese, potentially due to a number of factors including stress, lack of access to healthy foods that don’t encourage weight gain, or limited knowledge about the effects of nutrition on body weight. But there hasn’t been much research on what happens when people with food insecurity are placed in a structured weight-loss program with other people who are similarly overweight or obese, but don’t experience food insecurity.
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Effects of food insecurity on weight loss
In the latest findings, researchers looked at participants in a weight-loss study conducted at 18 different locations — primary care doctor’s offices — throughout Louisiana. The study lasted two years, and participants were randomly assigned either to a structured weight-loss intervention — following the same format at all locations — or to receive their usual care, which means they got no special care or instructions (other than receiving a health newsletter) but had their outcomes measured as part of the study. The total number or participants was 803, with 452 taking part in the weight-loss program. The body-mass index (BMI, a measure of body weight that takes height into account) of participants ranged from 32.2 to 42.8, putting all of them in the category of obese (BMI of 30 or above).
As noted in a Healio article on the study, members of the weight-intervention group met with trained health professionals once each week for the first six months of the study, followed by monthly sessions for the remaining 18 months. Overall, study participants reported a significant degree of food insecurity, with 31% qualifying based on their responses to a questionnaire. Over 65% of participants had an annual income less than $40,000, and 26% were enrollees in the state’s Medicaid program for health insurance.
After two years, members of the weight-intervention group lost more weight than the control group that didn’t take part in the program — but the benefits were much greater among participants who didn’t experience food insecurity. While the average difference in body weight between the intervention and control groups was 5.2 kilograms (11.5 pounds) for people without food insecurity, it was only 2.7 kilograms (6.0 pounds) among the 247 participants who reported food insecurity.
The researchers concluded that these results have “implications for physicians and healthcare practitioners working to address the growing obesity epidemic among U.S. adults,“ especially women, minority groups and people with a lower income. Without meaningful access to affordable nutritious foods, they wrote, any actions that healthcare providers take may be met with limited success — even if those actions involve a sustained weight-loss program.
The next step in their research, they wrote, is to better determine what specific factors led to more limited weight loss in people who experienced food insecurity, so that healthcare providers, policymakers and others may be able to take steps to address these challenges and help people who want to lose weight achieve this goal.
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