title: Disordered eating behaviours and food insecurity: A qualitative study about children with obesity in low-income households.
abstract: 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.
authors.affiliation: UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA(1). Electronic address: jtester@chori.org.
authors.forename: June M
authors.initials: JM
authors.lastname: Tester
authors.affiliation: UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA(1).
authors.forename: Tess C
authors.initials: TC
authors.lastname: Lang
authors.affiliation: University of California, Berkeley, School of Public Health, Berkeley, CA, USA.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Laraia
mesh_terms: D002032:Bulimia / Q000150:complications / Q000523:psychology*; D019872:Chief Cells, Gastric; D002648:Child; D003430:Cross-Sectional Studies; D005247:Feeding Behavior; D001068:Feeding and Eating Disorders / Q000150:complications / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D005523:Food Supply; D006801:Humans; D008297:Male; D009042:Motivation; D063766:Pediatric Obesity / Q000150:complications / Q000523:psychology*; D011203:Poverty / Q000523:psychology*
keywords: Disordered eating; Focus groups; Food hiding; Food insecurity; Paediatric obesity