Food insecurity may promote opportunistic eating through heightened satiety insecurity: A cross-sectional mega-analysis study.

Food insecurity promotes opportunistic eating (overeating when food is available), contributing to obesity. Opportunistic eating may persist after food security is restored; it is unclear why. Food insecurity may produce lasting worries about maintaining fullness between meals, which may motivate opportunistic eating independent of food access. We developed the novel Satiety Insecurity Scale (4-items), reflecting worries about maintaining fullness. We tested whether satiety insecurity contributes to food insecurity's relationship with opportunistic eating and higher BMI, and whether relationships were moderated by sex. We mega-analyzed six cross-sectional studies (n=1,240 from Singapore, United Kingdom, United States) that included measures of food insecurity, satiety insecurity, and virtual portion size selection. Mega-analyses tested the aggregated indirect effects of satiety insecurity on relationships of food insecurity with virtual portion sizes and BMI. One study included an experiment where participants selected ideal virtual dinner portions while expecting to consume a large or small hypothetical lunch. Higher food insecurity was associated with higher satiety insecurity, which was independently associated with selecting larger virtual portion sizes (Indirect effect = 6.82 kilocalories, 95%CI: 4.15, 9.50) and higher BMI (Indirect effect = 0.28, 95%CI: 0.14, 0.42). The association between food insecurity and satiety insecurity was stronger among males. However, the serial indirect effect of food insecurity on BMI through satiety insecurity and portion selection was only observed among females. Satiety insecurity was also associated with selecting larger virtual dinner portions only when expecting to consume a large virtual lunch, suggesting satiety insecurity may motivate eating when hunger is minimal. Satiety insecurity is an unexamined driver of overeating and partially explains why food insecurity motivates opportunistic eating and higher BMI (especially among females). Efforts to mitigate the lasting effects of food insecurity on obesogenic eating behaviors should both restore food access and target insecurities about maintaining satiety.