Background

Food insecurity, an insufficient access to adequate food for a healthy lifestyle, is linked to numerous poor health outcomes. In the United States (US), 11.8% of households (15 million) were food insecure in 2017. While food insecurity and obesity share many common risk factors, the rates of food insecurity among patients in weight management and bariatric surgery programs are not established.

Methods

We surveyed patients (N=298) who resided with a child (2-18 years old) and romantic partner from two US centers offering medical weight management and bariatric surgery. Food insecurity was assessed using the 2-item Hunger Vital Sign. We used multivariate logistic regression to assess correlates of food insecurity including sex, race, program type (weight management or surgery), income, education, number of children living at home, and body mass index (BMI) and stratified by sex.

Results

Food insecurity was present in 29.2% of patients, and reported among patients of all income ranges and education levels. There was increased odds of food insecurity in patients with lower incomes; patients with incomes of <$20,000 (OR 13.3 [95% CI: 3.12-57], $20-39,999 (10.8 [3.70-31.5], $40-59,999 (5.31 [1.81-15.54], and $60-99,999 (2.07 [0.80-5.35]) had increased odds of being food insecure compared to patients making 100,000 or more. Participants with 3 or more children living at home (vs one) had 3.33 times the odds of food insecurity (1.36-8.15). There was no association with sex, race, program type, education, or BMI. Results were similar when stratified by sex.

Conclusions

Food insecurity is highly prevalent among patients in weight management and bariatric surgery programs. Specifically, food insecurity was more common among low-income households and households with 3 or more children, however, it was present among all income levels and education backgrounds. Food insecurity screening in weight management and surgery programs is needed to address this potential barrier to a healthy lifestyle.