Cost of Living, Food Insecurity, and Eating Disorders

As the cost of living continues to rise across Aotearoa, many households are being pushed to the edge. For those already vulnerable to eating disorders, this economic strain can be devastating. And for others, it can create the perfect storm for disordered eating to emerge for the first time.

I recently shared my thoughts on this issue with journalist Rosa-Lee O’Reilly for her RNZ article, titled “It is the cost of living or an eating disorder?”. The article explores how the cost of living crisis is quietly fuelling and worsening eating disorder behaviours. This is a public health issue that goes far beyond hunger - it’s about the mental and physical health consequences of food insecurity in a country where getting adequate help is often difficult, delayed, or out of reach.

Food insecurity is more than a socioeconomic issue - it's a clinical risk factor.

Research tells us that around 17% of individuals experiencing severe food insecurity meet the criteria for a clinical eating disorder (Becker et al., 2017; 2019). That is a staggering number, especially when you consider how many more may be suffering in silence - undiagnosed, unrecognised, or simply unable to access the care they need.

People often think of eating disorders as illnesses of excess control or thinness, but in reality, they are deeply linked to scarcity, deprivation, and the emotional toll of living without enough. The feast or famine cycle many low-income individuals experience (surviving on very little for days or weeks until payday, then overeating out of necessity or relief) is not a character flaw. It’s a survival response. Over time, though, this pattern can shift from a situational adaptation to something more enduring, entrenched, and harmful.

Eating disorders do not just affect the thin, white, and wealthy.

It’s a dangerous myth that eating disorders only happen in certain bodies. Individuals from already marginalised groups - Māori and Pasifika communities, people in larger bodies, transgender folks, and those living in poverty - are all affected by eating disorders including atypical anorexia, bulimia nervosa, and binge eating disorder. Yet these conditions often go undetected, both by individuals themselves and by health professionals. Why? Because stereotypes still dominate. And because our systems are not set up to support the people most at risk.

Societal weight stigma, misconceptions about what eating disorders "look like," and the financial barriers to accessing a GP or psychologist all contribute to this invisibility. In fact, those who are most at risk are often the least likely to receive diagnosis or treatment.

Hunger affects everyone - but it can activate an eating disorder in some.

The effects of undernutrition and inconsistent food access aren’t just physical; they are psychological too. The Minnesota Starvation Study, conducted in the 1940s, demonstrated just how dramatically the human body and brain respond to inadequate food intake. Participants - healthy young men - became preoccupied with food, depressed, anxious, socially withdrawn, and obsessive. These effects weren’t signs of pre-existing mental illness; they were caused by starvation itself.

Now imagine what happens when a person experiencing those same effects also has a genetic, psychological, or social vulnerability to developing an eating disorder. For them, food insecurity isn't just distressing - it can be a direct pathway to a life-threatening illness.

Ending school lunch programmes is a cruel mistake.

In this context, the government’s decision to cut school lunch programmes feels not just short-sighted, but cruel. When children are hungry, they cannot concentrate. They become irritable, anxious, and struggle to learn. Research consistently shows that hunger is linked to poorer academic outcomes and more behavioural challenges - but there’s another risk we need to name: a disordered relationship with food that can carry into adolescence and adulthood. And with that comes increased mental health issues, physical health complications, and long-term cost to the public health system.

What we need is compassion, not judgment. Structural support, not blame.

Addressing eating disorders in a time of rising inequality means going beyond the clinic. It means advocating for accessible food, universal school meals, culturally competent care, and a public health response that recognises food insecurity as a risk factor - not just for hunger, but for illness.

I also want to acknowledge a tension here. I know that the cost of private eating disorder support, including my own services, can be out of reach for many people. I’ve worked in public health for over a decade, and I’ve seen first-hand how stretched our public systems are, with long waitlists and limited access. It’s something I hold a lot of discomfort about - we need better funded, more accessible services for everyone, not just those who can afford private care.

If you're struggling with disordered eating in the midst of financial stress, please know: it’s not your fault. Your body and brain are responding to the circumstances around you. And you deserve care, support, and nourishment - no matter your body size, income, or diagnosis status.