Abstract

Pediatric obesity puts children at risk for long-term, negative health outcomes and disproportionately impacts children from families with low income. Families with low income are also at increased risk for food insecurity. Consistent with the “scarcity mindset” theory of poverty, food insecurity is associated with increased discounting of delayed rewards and heighted present focus. It is also associated with increased food reinforcement, and decreased likelihood of meal planning. Despite the seriousness of this issue, little research has examined the role food insecurity, and its psychological correlates, play in behavioral treatments for pediatric obesity. This study examined food insecurity in 108 parent-child dyads enrolled in a pilot study seeking to adapt family-based treatment for pediatric obesity (FBT) for families with low income. It was found that compared to parents who were food-secure, parents with food insecurity were more likely to report income volatility (17.2% vs. 10.3%) and financial strain (82.8% vs. 43.6%) but were otherwise similar across sociodemographic, psychological, and behavioral characteristics including measures of scarcity mindset and meal planning. No statistically significant effect of food insecurity was observed with respect to parent or child weight outcomes, but a notable directional effect of food insecurity was observed in children such that, on average, children with food insecurity lost less weight (change in units of % overweight) than those who were food-secure (M=0.53 [SD=14.92] vs. M=-6.90 [SD=16.48]). Parents with longer financial planning horizons, and those who meal planned more, lost more weight (change in BMI kg/m2) during treatment (β=-0.05 [SE=0.015] and β =-0.030 [SE=0.014] respectively). No moderating effect of meal planning on the relationship between financial planning horizon and weight change was detected. The current study highlights the importance of measuring and addressing social determinants of health (SDOH) needs in clinical populations and raises important questions about the feeding and eating practices of parent-child dyads with low income enrolled in FBT.

Committee Chair

Denise Wilfley

Committee Members

Desiree White; Deanna Barch; Michael Strube; Richard Stein

Degree

Doctor of Philosophy (PhD)

Author's Department

Psychology

Author's School

Graduate School of Arts and Sciences

Document Type

Dissertation

Date of Award

5-30-2025

Language

English (en)

Author's ORCID

https://orcid.org/0009-0006-4696-9070

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Available for download on Thursday, June 18, 2026

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Psychology Commons

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