Eating Behaviors 50 (2023) 101757

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Eating Behaviors
journal homepage: www.elsevier.com/locate/eatbeh

The role of sexual orientation in the relationships among food insecurity,

food literacy, and disordered eating
Jenessa Canen, Kendra Rigney, Amy Brausch *
Department of Psychological Sciences, Western Kentucky University, 1906 College Heights Blvd, Bowling Green, KY 42101, United States of America

A R T I C L E I N F O A B S T R A C T

Keywords: LGBTQ young adults are at increased risk for food insecurity and disordered eating behaviors. Food literacy is a
Disordered eating related construct that may also impact disordered eating; however, research on these relationships is limited. It is
Food insecurity also not well understood if food security and food literacy relate to disordered eating behaviors differently for
Food literacy
LGBTQ and heterosexual individuals. The current study examined these constructs in a sample of college students
Sexual orientation
LGBTQ
(n = 572; 22 % LGBTQ), as well as examined sexual orientation as a moderator in the relationship between food
insecurity/food literacy and disordered eating outcomes. Results showed that LGBTQ individuals reported
greater dieting/restricting, bulimia symptoms, oral control, and binge eating symptoms than heterosexual peers.
LGBTQ students were also more likely to be food insecure and had significantly lower food literacy than het­
erosexual students. Sexual orientation significantly moderated the relationships between food insecurity and
overall disordered eating, and between food insecurity and dieting/restricting behaviors. These relationships
showed that very low food security was strongly related to disordered eating symptoms for LGBTQ individuals.
Sexual orientation did not moderate the relationship between food literacy and disordered eating outcomes.
These findings contribute to the overall literature on food insecurity and disordered eating for the LGBTQ
community through replicating past findings, and also provide new information about relationships between
food literacy, food insecurity, disordered eating, and the role of sexual orientation.

1. Introduction
LGBTQ individuals are consistently at greater risk for mental health
and healthcare challenges (Nagata et al., 2020; Ploderl & Tremblay,
2015). Disordered eating is one example of behavior that has higher
prevalence in LGBTQ communities compared to their heterosexual
peers, with up to 30 % reporting significant eating disorder symptoms
(Arikawa et al., 2021). LGBTQ individuals are also more likely to
experience food insecurity, particularly young adults who may not have
support from family members and/or are in college with limited re­
sources (Downing & Rosenthal, 2020; Willis, 2019). Food insecurity has
also been linked to more disordered eating behaviors, including binge-
eating, restricting food intake, and purging behaviors, in samples of
college students and adult food bank clients (Barry et al., 2021; Becker
et al., 2017, 2019). Furthermore, food literacy, which is knowledge
about nutrition and healthy eating, is also potentially linked to disor­
dered eating behaviors (Ferreira et al., 2021). LGBTQ individuals are
known to experience food insecurity and low food literacy, which may
increase their risk for disordered eating behavior (Downing &
Rosenthal, 2020; Willis, 2019). The current study examined differences
between LGBTQ and heterosexual young adults on food insecurity, food
literacy, and disordered eating behaviors, and if the relationships be­
tween food insecurity/literacy and disordered eating depended on sex­
ual orientation.
Research focusing on minority stress and health disparities has noted
that LGBTQ populations are at a greater risk for mental health and
health issues than their heterosexual peers due to unique stressors
related to their sexual orientation (Meyer, 2003). Among other issues,
nutrition is noted as one of the highest-ranking concerns for LGBTQ
individuals (Hoffman et al., 2009). This concern may be exacerbated by
the documented increased risk for poverty, housing instability, and
overall stress reported by LGBTQ individuals (James et al., 2016). As
noted, rates of disordered eating are also notably higher in LGBTQ in­
dividuals compared to their heterosexual counterparts (Calzo et al.,
2017), and it has been proposed that factors such as victimization,
discrimination, and internalized stigma increases overall stress and risk
for disordered eating behaviors in this community (Katz-Wise et al.,
2015). As LGBTQ individuals are more likely to encounter a number of

* Corresponding author.
E-mail addresses: Jenessa.canen120@topper.wku.edu (J. Canen), Kendra.rigney@wku.edu (K. Rigney), amy.brausch@wku.edu (A. Brausch).

https://doi.org/10.1016/j.eatbeh.2023.101757
Received 15 November 2022; Received in revised form 19 May 2023; Accepted 25 May 2023
Available online 31 May 2023
1471-0153/© 2023 Elsevier Ltd. All rights reserved.
J. Canen et al.
everyday stressors, previous research has documented that they expe­
rience food insecurity and low food literacy more so than their hetero­
sexual peers. Existing research has not yet focused on how sexual
orientation may affect the relationships between food security, food
literacy, and disordered eating behaviors.
Food security is known to be related to overall eating behaviors, and
consists of four pillars: availability (having sufficient food), access
(physical and financial), utilization (making food into meals), and sta­
bility (consistent access to food; Begley et al., 2019). Existing research
on these pillars indicates that greater food insecurity associates with
more disordered eating behaviors (Darling et al., 2017). For example,
low food security was associated with a greater likelihood of scoring
high on an eating disorder screening measure in college students (Barry
et al., 2021). In a series of studies, Becker et al. (2017, 2019) examined
food insecurity, eating disorder pathology, and dietary restraint in
samples of adults who frequented food banks. Both studies found
increased proportions of eating disorder pathology and dietary restraint
across the spectrum of food insecurity, with symptoms worsening as
food insecurity was more severe. Interestingly, reasons for restricting
food intake were rarely related to weight and shape concerns, but
instead were related to stretching food to last longer or not being able to
purchase food (Middlemass et al., 2021).
While both food insecurity and sexual orientation are known to play
a role in disordered eating, little existing research examines the three
constructs together. Available research suggests that food insecurity
may be observed at higher rates among individuals experiencing poverty
and/or insecure housing (Coleman-Jensen et al., 2020). LGBTQ people,
specifically youth, report increased rates of homelessness compared to
their heterosexual counterparts (Corliss et al., 2011; Wilson et al., 2020).
Similarly, food insecurity is more prevalent in households with at least
one lesbian or gay adult (Cho, 2022). These increased rates of food and
housing insecurity could be due to several factors, such as being dis­
placed from one's childhood home due to rejection from parents for their
identity (Pearson et al., 2017), or facing economic and employment
disadvantages due to their minoritized status (Cho, 2022). Additionally,
LGBTQ adults are significantly more likely to experience food and
housing insecurity than their heterosexual peers (Downing & Rosenthal,
2020), over half (54 %) of LGBTQ young adults have reported food
insecurity, and up to one-third score above clinical cut-offs on eating
disorder screeners (Arikawa et al., 2021). Given the additional strain of
minority stress, it is likely that the relationship between food insecurity
and disordered eating may be stronger for LGBTQ vs. heterosexual
individuals.
Another factor associated with food insecurity is food literacy, which
may also impact disordered eating behavior; however, there is currently
minimal literature on this relationship. Most existing studies have
focused on food and health literacy as they relate to healthy eating
habits. For example, within a sample of Portuguese students, lower food
literacy was associated with more negative eating patterns (e.g.,
consuming fewer daily meals, eating fewer fruits and vegetables daily,
and eating more fast food; Ferreira et al., 2021). Food literacy was
associated with healthy eating habits in a sample of Korean young adults
(Lee et al., 2022). Low health literacy, which includes both food and
exercise knowledge, relates to a higher probability of eating disorder
symptoms (Boberova & Husarova, 2021). These existing studies show
that food literacy does associate with eating habits, but none have
directly studied food literacy and disordered eating behaviors, nor have
they examined differences by sexual orientation. Research on relation­
ships between food security, food literacy, and disordered eating be­
haviors in LGBTQ people are lacking, but existing research suggests that
this population may have increased vulnerability for several reasons.
First, due to increased likelihood of food and housing insecurity, LGBTQ
individuals may lack the resources to engage with food literacy educa­
tion (Morton et al., 2018). Additionally, due to stigma, LGBTQ in­
dividuals may be more likely to have negative experiences with health
care (Elliott et al., 2015); thus, having less opportunity to acquire food
2
Eating Behaviors 50 (2023) 101757
literacy from family members or healthcare professionals. However, no
research to our knowledge has directly examined food security and food
literacy may differentially relate to disordered eating behavior among
LGBTQ and heterosexual young adults. It is important to understand
how common stressors such as food insecurity and food literacy may
impact LGBTQ individuals since feeding oneself is a basic need that
needs to be met. If discrepancies exist, this information could also
inform development of interventions aimed at improving both food se­
curity and food literacy in LGBTQ populations. In the current study, it
was hypothesized that LGBTQ individuals would report significantly
greater disordered eating symptoms, greater food insecurity, and less
food literacy than heterosexual individuals. It was further hypothesized
that sexual orientation status would moderate the relationship between
both food security and food literacy and all disordered eating outcome
measures, such that the relationships would be stronger for LGBTQ
individuals.
2. Method
2.1. Participants
Data were collected from 596 young adults enrolled at a mid-sized
university in the south-central United States. Participants were
excluded for short completion time (<5 min; n = 1), failing at least 2 out
of 4 attention checks (n = 20), and not reporting sexual orientation (n =
3). Attention checks included prompts such as “Please type the number
63 in the box below,” “If you are reading this, select the number 30,”
after which four responses were presented. The final sample included
572 young adults with a mean age of 19.75. The majority were female
(76.7 %), with 20.2 % identifying as male, and 3.1 % identifying as trans
or non-binary. All trans and non-binary individuals also identified as
lesbian, gay, bisexual, etc. and were thus included in the LGBTQ group.
The majority identified as white (75.8 %); most identified as hetero­
sexual (78.3 %) and 22 % (n = 123) identified as gay/lesbian, bisexual,
pansexual, asexual, questioning or other. Most reported living on-
campus (60 %), with 31.3 % living off-campus, and 8.7 % reporting
other housing. Most participants had never been diagnosed with an
eating disorder (92.3 %); 44 participants reported being previously
diagnosed with Anorexia Nervosa (n = 17), Bulimia Nervosa (n = 8),
Binge Eating Disorder (n = 5), and EDNOS (n = 14). About half of those
with diagnoses reported never receiving treatment (45.5 %). Within the
whole sample, most reported family incomes of less than $60-80 K (54.4
%), 32 % reported receiving Pell grants, and 12.3 % reporting receiving
SNAP benefits within the last 5 years. For Food Secure individuals, 60 %
reported family income of $60-80 K or greater; for Food Insecure in­
dividuals, 43 % reported family income greater than $60-80 K. It is
notable that family income may not reflect a student's actual income and
financial resources while at college. See Table 1 for full demographic
information for heterosexual and LGBTQ groups.
2.2. Measures
2.2.1. Eating Attitudes Test – 26 (EAT-26; Garner et al., 1982)
The EAT-26 assesses symptoms of disordered eating behaviors across
three subscales: Dieting, Bulimia, Food Preoccupation, and Oral Control.
The measure yields an overall total score, as well as subscale scores.
Responses are on a 6-point scale, but are weighted from 0 to 3, with
greater scores indicating greater disordered eating patterns. The EAT-26
has a clinical cut-off score of 20; scores above this threshold are
considered to be in the clinically significant range (20 % in the current
sample). The EAT-26 has shown strong test-retest reliability (0.84;
Garfinkel & Newman, 2001). Internal consistencies in the current sam­
ple were good: total score (α = 0.89), Bulimia and Food Preoccupation
(α = 0.80), Dieting (α = 0.87), and Oral Control (α = 0.70).
J. Canen et al.
Table 1
Sample demographics and comparisons of heterosexual and LGBTQ groups.
Variable
Gender
Female
Male
Trans woman
Trans man
Trans – not specified
Gender fluid
Unsure
Other
Race/ethnicity
White
Black/African American
Hispanic/Latino(a/e)
Indigenous/Native American
Asian
Multi-ethnic
Other
Note. Scores for binge-eating symptoms, food security, and food literacy come from the BES, HFSSM, and SFLQ, respectively.
*
p < .05.
**
p < .01.
2.2.2. Binge-Eating Scale (BES; Gormally et al., 1982)
The BES is a 16-item measure that assesses binge-eating thoughts,
emotions, and behaviors. There are eight items that assess behaviors,
and eight that assess thoughts and emotions. Responses are scored on a
4-point scale ranging from 0 to 3 with lower scores indicating no/few
binge-eating symptoms and higher numbers indicating greater binge-
eating symptoms. Items are summed for a total score, ranging from
0 to 43. Cutoff-points are as follows: <17 = minimal binge eating
problems (77.7 % of current sample), 18–26 = moderate binge eating
problems (16 %), and >27 = severe binge eating problems (6.3 %)
(Escrivá-Martínez et al., 2019). This measure has shown strong internal
consistency (α = 0.85; Gormally et al., 1982); it was also strong in the
current sample (α = 0.91).
2.2.3. U.S. Household Food Security Survey Module – Adult (HFSSM;
Bickel et al., 2000)
The HFSSM-Adult is a 10-item self-report questionnaire that asks
participants to indicate their level of food access by measuring avail­
ability of funds to buy more food when needed, occurrences of skipping
or cutting down meals due to lack of food in the household, and
assessing the length of time missing meals. Responses are scored either a
0 (negative) or 1 (affirmative) based on the response to each item. Re­
sponses of “yes,” “often,” “sometimes,” “almost every month,” and
“some months but not every month” are coded as a 1 (affirmative). Items
are summed for a total score, which fall into four categories: Score
0 (“High Food Security”), Score 1–2 (“Marginal Food Security”), Score
3–5 (“Low Food Security”), and Score 6–10 (“Very Low Food Security”).
High and Marginal Food Security are considered to be “Food Secure,”
while Low and Very Low Food Security are considered to be “Food
Insecure.” Within this study, participants were asked to complete this
measure twice; once for food access in their last full year living at home
and once for current food access while in college. Since all participants
were current students, scores from their food access at college were
used. In the current sample, 75 % were Food Secure (Marginal [19.4 %]
and High [55.6 %] Security), and 25 % were Food Insecure (Low [13.4
%] and Very Low [11.6 %] Security). The HFSSM was found to be valid
when compared with general household income (Gulliford et al., 2006).
In the current sample, internal consistency was also good (α = 0.88 for at
college).
2.2.4. Short Food Literacy Questionnaire (SFLQ; Gréa Krause et al., 2018)
The SFLQ is a 12-item self-report questionnaire assessing food lit­
eracy/knowledge based on knowledge of healthy nutrition, ease of
judgment of food related commercials, and general knowledge of how to
Eating Behaviors 50 (2023) 101757
Heterosexual (n = 449) LGBTQ (n = 123) t/χ2
% % χ2 = 74.459**
77.1 74.8
22.9 9.8
0 0.8
0 1.6
0 5.7
0 2.4
0 1.6
0 2.4
% % χ2 = 18.808*
77.5 69.9
10.5 17.9
4.9 4.1
0 1.6
3.3 4.1
3.6 0.8
0.2 1.6
read a nutrition label. Responses to these items are scored on a 0 to 4
scale, with 0 indicating “I do not make use of this kind of information,”
and 1 (“Disagree strongly” or “Very hard”) to 4 scale (“Agree strongly”
or “Very easy”), depending on the wording of the item. Items are sum­
med for a total score, with greater scores indicating greater food literacy.
The SFLQ was modified for the purpose of this study to remove the word
“Swiss” on items 3–5. This measure has demonstrated strong internal
consistency (α = 0.85; Gréa Krause et al., 2018), which was also good in
the current sample (α = 0.86). This measure has also demonstrated
convergent validity with other measures of health literacy (Durmus
et al., 2019).
2.3. Procedure
The current study was reviewed and approved by the Institutional
Review Board at the authors' university. The study was posted to the
university's Study Board and made available to all students enrolled in
psychology courses. Participants completed the full study online
through a secure Qualtrics survey link and received course credit for
participating. After providing informed consent, participants completed
demographic items including age, gender, ethnicity, sexual orientation,
parental SES (income, occupation, level of education), Pell Grant
Receipt Status, and SNAP benefits. All remaining measures were
administered in a randomized order; the food security measure
(HFSSM), food literacy (SFLQ), disordered eating symptoms (EAT-26),
and binge eating disorder symptoms (BES). Four attention checks were
included at regular intervals in the research protocol. At the end of the
study, participants were presented with a debriefing page that included
resources for mental health, eating disorder services, and campus food
pantries.
2.4. Data analysis plan
Descriptive statistics were run for all variables, as well as kurtosis
and skew. All variables met criteria for normality. Missing data was
minimal; most variables had <1 % of missing total scores, with the EAT-
26 total score having the most at 5 %. Bi-variate correlations were
calculated between all variables. MANOVA was used to compare mean
scores on all variables between heterosexual and sexual minority par­
ticipants. To test the moderation hypotheses, the PROCESS Macro for
SPSS was used. A series of moderation analyses were run. The first series
included food security as the independent variable (entered as an
ordinal variable with four levels: Very Low, Low, Marginal, and High),
sexual orientation as the moderator (heterosexual vs. LGBTQ, coded as
3
J. Canen et al. Eating Behaviors 50 (2023) 101757

0 and 1, respectively), and the following variables as dependent vari­ Table 3

ables in separate models: total disordered eating (EAT-26 score), EAT-26 Means, standard deviations, and comparisons of food security, food literacy, and
Dieting subscale, EAT-26 Bulimia and Food Preoccupation subscale, disordered eating in heterosexual and LGBTQ young adults.
EAT-26 Oral Control subscale, and total binge eating symptoms (BES Measure Heterosexual LGBTQ F/χ 2 p-
score). The second series included food literacy as the independent M SD M SD
Value
variable, sexual orientation as the moderator, and the same disordered
EAT - Total Score 11.74 11.50 15.57 13.02 9.43* .002
eating scores as dependent variables in separate models. Based on rec­
EAT - Dieting 7.70 7.78 9.61 8.30 5.56* .019
ommendations from Hayes et al. (2012) to encourage accurate inter­ EAT - Bulimia 1.42 2.78 2.31 3.30 8.99* .003
pretation of moderation results, only the interaction results are reported. EAT – Oral Control 2.64 3.26 3.43 3.74 5.00* .026
Binge Eating 11.03 9.06 14.49 9.21 13.73** <.001
3. Results Food Literacy 46.30 10.44 43.08 10.78 8.72* 0.003
Food Insecurity at 21 % 39 % 17.17** <.001
College
Means, standard deviations, and score ranges for all variables are
*
shown in Table 2. For bi-variate correlations, all scores were signifi­ p < .05.
**
p < .01.
cantly correlated in the expected direction (e.g., more disordered eating
symptoms, food insecurity, and less food literacy correlated with LGBTQ
status). Food literacy was not correlated with any of the EAT-26 sub­ literacy and disordered eating outcomes (see Table 4). Sexual orienta­
scales, and the Oral Control subscale of the EAT-26 was also not corre­ tion was not found to be a significant moderator in the relationship
lated with the Binge Eating Scale total score. All correlations are between food literacy and overall disordered eating symptoms (EAT-26
presented in Table 2. total score); moderation analyses with EAT-25 subscales as outcome
MANOVA results found that LGBTQ individuals scored significantly variables were also not significant. There was no significant moderation
higher on total disordered eating symptoms, dieting symptoms, bulimia in the relationship between food literacy and binge eating symptoms
and food preoccupation, oral control, and binge eating disorder symp­ (BES total score).
toms, compared to heterosexual individuals. LGBTQ individuals also
reported significantly lower food literacy, and a chi-square analysis 4. Discussion
found that this group was significantly more likely to be Food Insecure
(see Table 3). The current study aimed to examine differences in food security,
The first series of moderation analyses tested the hypothesis that food literacy, and disordered eating symptoms in heterosexual and
sexual orientation would moderate the relationship between food se­ LGBTQ young adults, as well as examine sexual orientation as a
curity and overall disordered eating symptoms (see Table 4). The overall moderator in these relationships. Our hypotheses were partially sup­
model was significant, F (7, 524) = 4.56, p < .001, and accounted for 5.7 ported, with results clearly showing group differences on these con­
% of the overall variance. The interaction between sexual orientation structs, but not significant moderation for all relationships. Our first
and food security was significant, and analyses showed that the rela­ hypothesis, that LGBTQ individuals would be more likely to experience
tionship between very low food security and overall disordered eating food insecurity and report more disordered eating symptoms, and report
symptoms was significantly stronger for LGBTQ individuals compared to lower food literacy than heterosexual individuals, was fully supported.
heterosexual individuals. The relationship between high food security LGBTQ students were significantly more likely to be currently food
and disordered eating symptoms was similar for heterosexual and insecure, reported more dieting, bulimia, oral control, and binge-eating
LGBTQ individuals (see Fig. 1). behaviors, and reported lower scores on food literacy. These results
Moderation analyses were also run with individual EAT-26 sub­ suggest that LGBTQ college students are more likely to experience
scales. Only the model with Dieting as the dependent variable showed stressors such as food insecurity, in addition to less healthy eating be­
significant moderation; overall model, F(7, 541) = 3.72, p < .001, R2 = haviors. These findings are in line with previous research that found
0.046 (see Table 4). Within this model, the interaction between sexual food insecurity and disordered eating occur at higher rates among
orientation and food security was significant. Interaction analyses LGBQT individuals (Arikawa et al., 2021; Downing & Rosenthal, 2020).
showed the same pattern as for the total EAT-26 score. As shown in Additionally, our data adds to the literature by demonstrating that
Fig. 2, the relationship between very low food security and dieting LGBTQ students report less food literacy than their heterosexual peers.
symptoms was stronger for LGBTQ individuals compared to heterosex­ One reason for this disparity may be differences in access to services that
ual individuals, and the relationship between high food security and provide food literacy education, which may be limited due to negative
dieting was similar for heterosexual and LGBTQ individuals. The models experiences with medical professionals (Elliott et al., 2015), or due not
including Bulimia and Oral Control subscales as dependent variables did having instruction about food literacy from family members. Previous
not show significant moderation. studies show that LGBTQ youth who were kicked out of their home or
The second series of moderation analyses tested the hypothesis that ran away report less educational attainment and more dangerous health
sexual orientation would moderate the relationship between food behaviors than those who lived with family members (Pearson et al.,

Table 2
Correlations among quantitative study variables (n = 572).
Variable M (SD) Range 1 2 3 4 5 6 7 8

1. Sexuality 1
2. EAT total 12.45 (11.74) 0–78 0.137** 1
3. EAT Dieting 8.07 (7.86) 0–39 0.103* 0.947** 1
4. EAT Bulimia 1.59 (2.89) 0–18 0.130** 0.784** 0.672** 1
5. EAT Oral Control 2.79 (3.32) 0–21 0.100* 0.599** 0.373** 0.284** 1
6. Binge-Eating 11.75 (9.19) 0–48 0.155** 0.613** 0.619** 0.675** 0.067 1
7. Food Security 1.66 (2.54) 0–10 − 0.209** − 0.168** − 0.148** − 0.156** − 0.085* − 0.258** 1
8. Food Literacy 45.61 (10.56) 0–72 − 0.125** 0.015 0.054 − 0.050 0.003 − 0.133** 0.186** 1
*
p < .05.
**
p < .01.

4
J. Canen et al. Eating Behaviors 50 (2023) 101757

Table 4 25
Results of analyses testing sexual orientation as a moderator between food se­
curity and food literacy and disordered eating outcomes.
20
Total F B t
R2

EAT-26 Total Scores

Food Security 15
Outcome variable: EAT total 0.057 4.56**
Sexual Orientation × Low Food − 7.83 − 2.22* Heterosexual
Security 10
LGBTQ
Sexual Orientation × Marginal Food − 4.32 0.27
Security
Sexual Orientation × High Food − 6.63 − 1.56 5
Security
Outcome variable: Dieting 0.046 3.72**
Sexual Orientation × Low Food − 5.30 − 2.24* 0
Security Very Low Low Marginal High
Sexual Orientation × Marginal Food − 2.78 − 1.07 Food Security
Security
Sexual Orientation × High Food − 4.72 2.78 Fig. 1. Sexual orientation as a moderator in the relationship between food
Security security and the EAT-26 total score.
Outcome variable: Bulimia 0.038 3.02**
Sexual Orientation × Low Food − 0.71 − 0.83
Security
Sexual Orientation × Marginal Food 0.17 0.18
16

Security
14
Sexual Orientation × High Food − 0.19 − 0.19

EAT-26 Dieting Subscale Scores

Security
12
Outcome variable: Oral Control 0.023 1.88
Sexual Orientation × Low Food − 0.86 − 0.87
10
Security
Sexual Orientation × Marginal Food − 1.13 − 1.03
8
Security Heterosexual
Sexual Orientation × High Food − 0.66 − 0.56 6 LGBTQ
Security
Outcome variable: Binge Eating 0.086 7.42** 4
Sexual Orientation × Low Food − 1.03 − 0.38
Security 2
Sexual Orientation × Marginal Food 1.96 0.66
Security 0
Sexual Orientation × High Food 1.56 0.49 Very Low Low Marginal High
Security
Food Security

Food Literacy Fig. 2. Sexual orientation as a moderator in the relationship between food
Outcome variable: EAT total 0.02 4.40* security and the dieting subscale of the EAT-26.
Sexual Orientation × Food Literacy − 0.0011 − 0.01
Outcome variable: Dieting 0.18 3.31*
Sexual Orientation × Food Literacy 0.0005 0.007 preoccupation, or oral control. Our results align with past research that
Outcome variable: Bulimia 0.02 4.50* has documented significant relationships between food insecurity and
Sexual Orientation × Food Literacy − 0.01 − 0.01 disordered eating in both college students and adult food bank clients
Outcome variable: Oral control 0.015 2.69*
(Barry et al., 2021; Becker et al., 2019; Darling et al., 2017). The current
Sexual Orientation × Food Literacy 0.0244 0.76
Outcome variable: Binge eating 0.042 7.91** study adds to this literature by demonstrating that these relationships
Sexual Orientation × Food Literacy 0.12 1.33 seem to be more prominent among LGBTQ individuals. Notably, the
relationship between dieting/restricting and food insecurity was only
Note. Moderation analyses were also run including perceived SES, receipt of Pell
grant, and receipt of SNAP benefits anytime in the past 5 years as co-variates.
significant among LGBTQ young adults. The stress of a minoritized
Results did not change when covariates were included; results from analyses identity may contribute to increased vulnerability to experience events
without co-variates are reported. or circumstances that lead to food insecurity, such as job loss and
*
p < .05. insecure housing. Current laws do not protect LGBTQ people from job or
**
p < .01. housing discrimination in all states (Martino et al., 2021; State Equality
Index, 2022). Constantly managing the stress of job or housing loss due
2017). Future research should examine other possible reasons that to one's sexual identity may be one explanation for why food insecurity
LGBTQ individuals may not receive as much instruction about nutrition is related to restricted food intake (labeled as “dieting” on the measure
and healthy eating, and how this relates to other stressors and health used) in LGBTQ populations. Notably, within our sample, proportions of
outcomes. students across the four categories of food security were similar for those
Our second hypothesis was that sexual orientation would moderate with and without campus meal plans, and also for those who lived on or
the relationships between food literacy and food insecurity and disor­ off-campus. Also, proportions for LGBTQ and heterosexual students
dered eating behaviors, with stronger relationships for LGBTQ students. were similar when comparing on- or off-campus living and meal plan vs.
This hypothesis received partial support, since significant moderation not. Therefore, it does appear that other factors are impacting eating
was found for food insecurity, but not for food literacy. Food insecurity behaviors of LGBTQ individuals. Studies have identified themes within
was strongly associated with overall disordered eating symptoms and the LGBTQ community on perceptions of body image, health eating, and
dieting/restricting behaviors for LGBTQ individuals, but not hetero­ physical activity (VanKim et al., 2016); perceptions seem to vary by
sexual individuals. No significant moderation was observed for the re­ gender identity and sexual orientation, and have also been mixed. For
lationships between food insecurity and binge-eating, bulimia and food example, lesbian and bisexual women noted that they feel their sexual

5
J. Canen et al.
orientation has a positive effect on their body image, but they also felt
pressure to engage in healthy eating. Conversely, gay men reported
feeling pressured to maintain a fit appearance and “bulk up,” but also
consume high-calorie alcoholic drinks and non-nutritious food at social
events (VanKim et al., 2016). Future research should continue to
examine minority stressors and social expectations as they relate to food
insecurity, which may be reflective of disordered eating and/or the re­
ality of their situation.
As noted, sexual orientation did not significantly moderate the
relationship between food literacy and disordered eating outcomes, but
greater food literacy was associated with less binge-eating symptoms. To
our knowledge, the relationship between food literacy and disordered
eating behavior has not been extensively studied. Two previous studies
using general population samples of adults suggest that misinformation
about healthy eating (lower food literacy) is associated with less healthy
eating patterns such as not eating regular meals and eating fast food
more frequently (Ferreira et al., 2021; Lai et al., 2021). There is little to
no research on how sexual orientation may impact the relationship be­
tween food literacy and disordered eating behaviors, and our results add
to this literature. LGBTQ individuals may be more likely to turn to
maladaptive coping strategies such as eating (Sornberger et al., 2013),
and binge-eating associates with eating to alleviate negative emotions
(Boggiano et al., 2014). Our study's measure of food literacy focused on
knowledge of nutrition and healthy eating, and did not assess emotion or
coping-focused functions of eating. It may be that these factors would be
significantly moderated by sexual orientation as they relate to disor­
dered eating behaviors; a potential focus of future research. These re­
sults may also imply that food literacy could associate with lack of
awareness of food portions or overall calories consumed, making binge
eating more likely. Thus, the relationship between food literacy and
binge eating may exist regardless of sexual orientation.
The current study has limitations which should be noted. The first is
the use of a university study board, which could have sampling bias.
Future studies should consider platforms such as Amazon's Mechanical
Turk or Prolific to collect more diverse samples. Relatedly, the use of a
college sample is another limitation since factors like food security and
food literacy may differ in samples of young adults who are living
independently or not currently full-time college students. Our sample
also had limited representation of LGBTQ individuals (22 %), and did
not allow for more in-depth analyses of study factors across orientations
(e.g., gay/lesbian, bisexual, pansexual). A larger and more diverse
sample would also allow for analysis of differences in food security, food
literacy, and disordered eating behaviors for intersecting identities (e.g.,
gender identity, ethnicity, sexual orientation). Due to low representa­
tion of males and non-binary/gender fluid individuals in the sample, we
were also not able to test hypotheses by gender. Future research should
explore these relationships in all genders across both heterosexual and
LGBTQ identities. Another limitation may be the overall family income
reported by the majority of the participants, which was $60-80 K or
greater. Samples of independent young adults or those not enrolled in
college would likely show a different distribution of overall income that
could affect results, particularly for food insecurity. Lastly, results may
be influenced by the COVID-19 pandemic, which may have affected
family and personal income, housing stability, and food security for this
sample of college students.
In conclusion, this study provides important information about food
insecurity vulnerability in the sexual minority community, and how that
relates to disordered eating, that future research can expand upon. Re­
sults regarding food literacy are novel within the field of disordered
eating, and also provide a launching point for future research on how
this construct relates to eating disorder risk. Study findings highlight
that food insecurity associates with disordered eating behavior, specif­
ically dieting/food restriction, in sexual minority individuals. Clinicians
and researchers alike should be aware of this link, but also further
inquire about the motivations for behaviors like food restriction. Clini­
cians should be aware that LGBTQ clients are more likely to be food
6
Eating Behaviors 50 (2023) 101757
insecure, and may need to be connected with resources. Mental health
professionals may also consider routinely screening for disordered
eating symptoms in LGBTQ populations since they may be at higher risk.
Future research on how food insecurity affects eating behaviors and
eating disorder symptoms will help clarify these relationships.
Funding
This research did not receive any specific grant from funding
agencies in the public, commercial, or not-for-profit sectors.
CRediT authorship contribution statement
Author Rigney designed the study, collected and analyzed pre­
liminary data, assisted with data analysis, and assisted in drafting the
manuscript. Author Canen designed the specific study hypotheses,
assisted with data analysis, and assisted in drafting the manuscript.
Author Brausch assisted with study design and data collection, con­
ducted final data analyses, and assisted in drafting the manuscript. All
authors contributed to and have approved the final manuscript.
Declaration of competing interest
The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influence
the work reported in this paper.
Data availability
Data will be made available on request.
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