Coronavirus Chronicles — Food Insecurity, Just the Tip of the Iceberg

The one thing everyone knows about an iceberg is that most of its bulk lurks beneath the water’s surface, unseen, but ready to cause disaster.

Food insecurity, or uncertainty about where tomorrow’s or next week’s meals will come from, can have a strange and paradoxical effect on the human psyche. For some people, rather than inspiring them to be cautiously frugal, food insecurity cultivates irrational and harmful reactions within them. They develop clinically significant pathology around food.

We see such warnings as “Household food insecurity is associated with binge-eating disorder and obesity,” with reminders of potential difficulties like, “binge eating is associated with more severe mental and physical health problems than overeating or obesity alone.” BED, or Binge Eating Disorder, “includes eating an unusually large amount of food while feeling a concurrent sense of loss of control.”

Change gonna come

Unharvested food; food wasted because the supply chain is broken; empty supermarket shelves; food banks crushed by the demand; long lines of hungry Americans; empty shelves in home pantries… As if all these tragedies were not enough, another whole set of problems lurks beneath the visible surface. Many people are in fragile psychological condition, and many more are incubating emotional disorders that will haunt them for years, even after an appearance of normalcy in society is restored.

Eating disorders specialist Crystal Karges reminds us that people arrive in life with troubling biological and genetic influences, that may lie dormant, or may be aggravated by environmental and psychosocial factors. A physical body that is trying to preserve itself and survive can be ambushed by various mental and emotional tics that prompt a person to do the exact things that are inimical to health.

A food insecurity situation — real or perceived — can initiate a reactionary spiral that ends up with BED, anorexia nervosa, bulimia nervosa, and other disorders. Symptoms can show up in the present (provided there is any food to practice them on), or remain submerged like the larger and more dangerous portion of the iceberg. Karges names some possible symptoms:

— Stealing or hiding food
— Eating rapidly over a short period of time
— Consuming large quantities of food, even to the point of vomiting
— Storing or stashing food
— Becoming upset or emotional if food is limited, taken away or if forced to share with others
— Rigidity or anxiety surrounding food

All these problems require the assistance of mental health professionals, who (not surprisingly in a time of crisis) are in short supply.

As we have seen, the damage is not just mental and emotional. It is very apparent that obesity and its co-morbidities complicate the illness known as COVID-19 in myriad ways, from the sheer physical difficulty of moving a morbidly obese patient from gurney to bed, all the way down to the intricate interplay of chemicals within the hidden recesses of the body’s cells.

We have no way of knowing what the future holds for people who live through this period of food insecurity, however short or long it turns out to be. Surprisingly, analysis of the effects of starvation on the survivors of Nazi concentration camps does not seem to have reached any final consensus, even after all these decades.

It appears that the long-term effects on the children and grandchildren of the survivors may have been more severe than on the imprisoned individuals themselves. This hint of epigenetic consequences is troubling, and adds several thousand tons of ice to the submerged portion of the iceberg. So, what may happen as a result of the current food shortages caused by the pandemic is, at this point, anybody’s guess.

(To be continued…)

Your responses and feedback are welcome!

Source: “Household food insecurity is associated with binge-eating disorder and obesity,”, 12/19/18
Source: “Starvation, Trauma, and Food Hoarding,”, 05/07/15
Image by Dr. Roger Hewitt/(CC BY 2.0)

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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