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Updated: Oct 3, 2025

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Food Insecurity Influences Weight Trajectory in Children with Obesity
June M Tester1,2, Lan Xiao3, Lydia Tinajero-Deck1,2
1UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA.
Insights
Food insecurity in low-income children with obesity was linked to a slower weight gain trajectory. This suggests household food insecurity may influence weight management outcomes in pediatric obesity care.
Area of Science:
- Pediatric obesity research
- Social determinants of health
- Longitudinal health studies
Background:
- Social disadvantage is linked to childhood obesity risk.
- Limited understanding exists regarding social disadvantage's impact on pediatric weight trajectories.
- Food insecurity is a key aspect of social disadvantage affecting child health.
Purpose of the Study:
- To analyze the association between food insecurity and weight change over time in low-income children.
- To investigate how food insecurity influences the weight trajectory of children attending a weight management clinic.
Main Methods:
- Longitudinal analysis of 794 low-income children (household income <$60k/year) from 2008-2016.
- Mixed-effects growth curve modeling to assess weight trajectory (%BMIp95) based on baseline food security status.
- Examined interactions between food insecurity and time elapsed since the initial visit.
Main Results:
- 30% of patients were food-insecure at baseline, with a mean %BMIp95 of 129% (severe obesity).
- Food-insecure children showed a significantly smaller monthly increase in %BMIp95 compared to food-secure peers.
- While food-secure children showed a significant 12-month decrease in %BMIp95, food-insecure children did not exhibit a significant change.
Conclusions:
- Household food insecurity is associated with a less optimal weight trajectory in children with obesity.
- Findings highlight the complex interplay between socioeconomic factors and pediatric weight management.
- Further research is needed to understand the mechanisms driving these weight trajectory differences.
Abstract:
Social disadvantage is associated with children's risk of being overweight or obese, but little is known about how it impacts weight trajectory. This longitudinal analysis examines food insecurity and weight change over time among low-income children in a multidisciplinary weight management clinic. Food insecurity was assessed between 2008 and 2016 among 794 low-income patients (household income <$60k/year) who attended 3234 visits. Mixed-effects growth curve modeling was used to examine the association between baseline food security status and weight trajectory, using percentage of the 95th percentile for BMI (%BMIp95). Random effects (each child's growth curve) and fixed effects (food insecurity, starting age and %BMIp95, demographics, and months since the initial visit) were modeled, and interactions between food insecurity and elapsed time estimated the influence of food insecurity on weight trajectory. Mean %BMIp95 was 129% (SD 24%), corresponding to severe obesity. Thirty percent of patients were food-insecure at baseline. After adjusting for other factors, monthly change in %BMIp95 was significantly smaller for food-insecure children compared to food-secure peers (difference in the coefficients for slope: 0.13, SE 0.05, p = 0.009). The modeled 12-month change in %BMIp95 was significant for food-secure children (-2.28, SE 0.76, p = 0.0026), but not for food-insecure children (-1.54, SE 1.22, p = 0.21). Household food insecurity was associated with a less optimal weight trajectory among children with obesity.
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