Food insecurity may make losing weight more difficult, even with an intense intervention


Participants with obesity and food insecurity lost less weight than food secure participants with obesity over 24 months when following an intensive, lifestyle-based intervention for weight loss. These findings suggest that weight loss approaches that address both obesity and food insecurity are needed. Findings from a post hoc analysis of the PROPEL (Promoting Successful Weight Loss in Primary Care in Louisiana) study are published in Annals of Internal Medicine.

Food insecurity, or the lack of sufficient healthy food to sustain an active, healthy lifestyle, is associated with greater body weight in adults, especially in underserved populations. Researchers from Pennington Biomedical Research Center, Baton Rouge, La., used data from the PROPEL study, which randomly assigned participants to a high-intensity, lifestyle-based intervention or usual care for weight loss and tracked progress over 24 months, to determine if food insecurity had an effect on weight loss outcomes. Participants’ food insecurity was assessed using a brief questionnaire. Those with two or more affirmative responses were categorized as food insecure.

Over the course of the study period, the researchers assessed differences in body weight between food secure and food insecure patients, accounting for a variety of patient characteristics. At 24 months, participants randomly assigned to the intensive lifestyle intervention lost more weight than those in the usual care group regardless of food security status; however, the intervention seemed to be less effective among those who were food insecure. The mean absolute weight difference between the intervention and usual care groups was 5.2 kg among food secure patients and 2.7 kg among food insecure patients. The mean absolute weight difference between the intervention and usual care groups was 2.5 kg lower among food insecure patients than food secure patients.

According to the study authors, clinicians may want to screen patients with obesity for food insecurity. Effective weight loss programs will need to address this issue.