Cost of Living, Food Insecurity, and Eating Disorders

As the cost of living continues to rise across Aotearoa, many households are struggling to make ends meet. Grocery prices have increased significantly, and for some, skipping meals or stretching food further is a matter of financial necessity.

What’s not often talked about (or understood) is how this can create the perfect conditions for disordered eating to emerge. Research indicates 17% of individuals experiencing severe food insecurity meet the criteria for a clinical eating disorder (Becker et al., 2017; 2019). It can also undermine recovery for those already struggling.

I 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 a clinical risk factor.

At its core, the body does not distinguish between reasons why food is scarce. Whether restriction comes from weight and shape concerns, a need for control, trauma, or financial pressure, the effects of not getting enough energy are strikingly similar. The body and brain respond to deprivation in predictable ways; physically, psychologically, and socially.

One of the clearest demonstrations of this comes from the Minnesota Starvation Studyin the 1940s. Healthy young men, with no history of mental illness, were placed on a semi-starvation diet. Over time, they became preoccupied with food, anxious, depressed, socially withdrawn, and obsessive. Food dominated their thoughts. Some developed rituals around eating; others experienced episodes of loss of control. These weren’t signs of underlying pathology, they were the direct result of not getting enough to eat. Once adequately re-nourished, many of the men’s symptoms resolved.

We see similar patterns in historical accounts of people who endured extreme food scarcity, including during World War II. Behaviours like binge eating, hoarding food, or feeling unable to stop once food is available are not unusual in that context. They are adaptive responses to deprivation.

When Survival Responses Become Something More

For people living with ongoing food insecurity, these survival responses can become part of daily life.

Someone might restrict their intake to make food last, only to find themselves overeating or binge eating when food becomes available again; for example, around payday. This “feast or famine” pattern isn’t a lack of discipline; it’s the body responding to inconsistent access to energy.

Over time, what begins as a situational response can start to take on a life of its own. Skipping meals may no longer feel like a financial decision alone. Eating patterns can become more rigid or chaotic. Thoughts about food can intensify. For some, this is the point at which a clinical eating disorder begins to emerge or an existing one becomes more entrenched.

Recovery itself can become financially out of reach. For someone working towards recovery, eating regularly and adequately often means increasing both the volume and variety of food, and that comes at a cost. Weight restoration in particular can require a significant and sustained increase in energy intake. For people already under financial strain, this can feel impossible.

I’ve worked with clients who are trying to follow recovery recommendations while also worrying about their grocery bill, or feeling like they have to give up the few areas of life that bring them joy in order to afford food. Others find themselves pulled back into restriction simply because they cannot consistently afford to eat enough. In this context, what might look like a “lack of progress” may be a valid reflection of financial constraint.

Who Gets Missed

Eating disorders affect people across all body sizes, cultures, genders, and socioeconomic backgrounds. This includes Māori and Pasifika communities, people in larger bodies, transgender and gender diverse people, and those living in poverty.

Marginalised communities are disproportionately impacted by financial insecurity and, consequently, food insecurity. That matters, because it means some of the people at greatest risk of developing disordered eating patterns are also navigating the very conditions that can trigger and maintain them: inconsistent access to food, financial stress, and limited access to support. Yet, they are often the least likely to be recognised as struggling.

Part of the problem is that stereotypes still shape how eating disorders are identified. If someone doesn’t “look” unwell in a way that fits the cultural script, their distress can be overlooked by others, and sometimes by themselves. Restriction may be misread as discipline and binge eating may be dismissed as a lack of willpower. The broader context of food insecurity is often missed entirely.

Layer onto this the financial barriers to accessing care, long waitlists in public services, and a lack of culturally responsive support, and it becomes clear why so many people fall through the cracks. Those most at risk are often the least likely to receive help; not because they are less unwell, but because their experiences don’t fit the mould of what we expect an eating disorder to look like.

The Impact on Children and Young People

Food insecurity doesn’t just affect adults. When children don’t have consistent access to enough food, they may struggle to concentrate at school, become irritable or anxious, show more aggression, and find it harder to learn and engage.

There are well-researched academic and behavioural impacts of hunger , and these can be long-lasting; shaping a young person’s future and potential. This is why school lunch programmes are so vital for our tamariki. Furthermore, early experiences of food scarcity can shape a child’s relationship with food in lasting ways. Patterns of restriction, urgency around eating, or anxiety about food availability can carry into adolescence and adulthood. Over time, this increases the risk of both mental health difficulties and physical health complications.

What Needs to Change

Responding to eating disorders in the context of rising inequality requires more than individual-level solutions. It requires us to support whole communities. This means ensuring people have reliable access to enough food; not just as a matter of welfare, but as a matter of public health. When people are adequately nourished, we see benefits across the board: improved mental health, better educational outcomes, and reduced strain on healthcare systems over time. There is also evidence that reducing poverty and food insecurity can contribute to lower rates of crime, as financial stress and deprivation ease.

In that sense, supporting people to eat enough is not just compassionate; it’s economically and socially sensible.

This includes initiatives like universal school meals, more accessible healthcare, and systems that recognise food insecurity as a legitimate risk factor for illness. It also means challenging the tendency to place responsibility solely on individuals, when the conditions shaping their behaviour are often structural and outside of their control.

People are often doing the best they can with the resources available to them. 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 income.