From the Plate to the Mirror: A New View on Food Insecurity and Its Relationship With Body Image and Eating Behavior in Brazilian Adolescents

Objectives: To analyze the relationship between body image and eating behavior in food-insecure adolescents in the metropolitan region of São Paulo, Brazil. Methods: This was a cross-sectional study of adolescents from public schools in São Paulo, Brazil in 2022. The silhouette and body esteem scales were used to assess body image perception. Eating practices were analyzed using food consumption markers, while eating behavior was observed using the Three-Factor Eating Questionnaire-R21. Food insecurity was assessed using the Brazilian Food Insecurity Measurement Scale (EBIA). The association between food insecurity and the variables was assessed using the chi-square test, and multiple associations were assessed using Poisson regression. A significance level of 5% and a 95% confidence interval were adopted for all statistical tests. Results: Of the 114 adolescents, 74.6% were female. The predominant age group was 16 years old (48.2%). Of these adolescents, 20.2% were overweight, and 30.7% were dissatisfied with their excess weight. With regard to eating habits, 85.1% of young people tended to eat their meals while watching television, with a higher intake of sugary drinks (71.1%) and sweets (71.9%) than fruit consumption (42.1%), and vegetables (58.8%). Pearson's chi-square test showed a significant association between cognitive restriction behavior (p< 0.005) and emotional eating (p< 0.014). Poisson regression showed a significant association between adolescents with perceived dissatisfaction with excess weight and food restriction behavior PR: 3.90; 95%CI: 1.17-12.98; p= 0.026. Conclusions: Intermittent food insecurity, characterized by cycles of abundance and scarcity, has adverse effects on physical and psychological health, inducing harmful eating behaviors, especially the excessive consumption of poorly nutritious foods. These patterns, evidenced in adolescents in São Paulo, reinforce the need for comprehensive interventions and public policies, considering the psychological and dietary dimensions, to promote a positive body image and bring benefits to the physical and mental well-being of this already vulnerable population. Funding Sources: None.