Article| Volume 30, ISSUE 5, e11-e15, September 2016

Addressing Food Insecurity in a Pediatric Weight Management Clinic: A Pilot Intervention



      Our objectives were to (a) identify rates of food insecurity among patients seen in a pediatric weight management clinic and (b) test a pilot intervention to address food insecurity in the identified patients.


      All new patients seen in the clinic were screened for food insecurity and Supplemental Nutrition Assistance Program (SNAP) benefit status. Families with food insecurity and no SNAP benefits were asked if they wanted SNAP enrollment assistance from a partnering food bank. Those agreeing to assistance were connected to the food bank.


      A total of 116 new patients were evaluated in the clinic during the intervention; 28 (24%) endorsed food insecurity, and 40 (34%) were eligible for SNAP enrollment assistance. Three (8%) of the eligible patients completed the SNAP enrollment process.


      Food insecurity in this pediatric weight management clinic was common. However, even when given direct access to SNAP enrollment assistance, only a small minority of patients matriculated into this program.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric Health Care
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bruening M.
        • MacLehose R.
        • Loth K.
        • Story M.
        • Neumark-Sztainer D.
        Feeding a family in a recession: Food insecurity among Minnesota parents.
        American Journal of Public Health. 2012; 102: 520-526
        • Cook J.T.
        • Frank D.A.
        • Berkowitz C.
        • Black M.M.
        • Casey P.H.
        • Cutts D.B.
        • Heeren T.
        Welfare reform and the health of young children: A sentinel survey in 6 US cities.
        Archives of Pediatrics & Adolescent Medicine. 2002; 156: 678-684
        • Dietz W.H.
        Does hunger cause obesity?.
        Pediatrics. 1995; 95: 766-767
        • Dinour L.M.
        • Bergen D.
        • Yeh M.C.
        The food insecurity-obesity paradox: A review of the literature and the role food stamps may play.
        Journal of the American Dietetic Association. 2007; 107: 1952-1961
        • Ettinger De Cuba S.
        • Weiss I.
        • Pasquariello J.
        • Schiffmiller A.
        • Frank D.A.
        • Coleman S.
        • Breen A.
        • Cook J.
        The SNAP Vaccine: Boosting Children's Health.
        Children's Health Watch, Boston, MA2012 (Retrieved from)
        • Gilbert D.
        • Nanda J.
        • Paige D.
        Securing the safety net: Concurrent participation in income eligible assistance programs.
        Maternal and Child Health Journal. 2014; 18: 604-612
        • Goldman N.
        • Ettinger de Cuba S.
        • Sheward R.
        • Cutts D.
        • Coleman S.
        Food security protects Minnesota children's health.
        Children's Health Watch, Boston, MA2014 (Retrieved from)
        • Hager E.R.
        • Quigg A.M.
        • Black M.M.
        • Coleman S.M.
        • Heeren T.
        • Rose-Jacobs R.
        • Frank D.A.
        Development and validity of a 2-item screen to identify families at risk for food insecurity.
        Pediatrics. 2010; 126: e26-32
        • Jasik C.B.
        • King E.C.
        • Rhodes E.
        • Sweeney B.
        • Mietus-Snyder M.
        • Grow H.M.
        • Kirk S.
        Characteristics of youth presenting for weight management: Retrospective national data from the POWER Study Group.
        Childhood Obesity. 2015; 11: 630-637
        • Jones S.J.
        • Jahns L.
        • Laraia B.A.
        • Haughton B.
        Lower risk of overweight in school-aged food insecure girls who participate in food assistance: Results from the Panel Study of Income Dynamics Child Development Supplement.
        Archives of Pediatrics & Adolescent Medicine. 2003; 157: 780-784
        • Jyoti D.F.
        • Frongillo E.A.
        • Jones S.J.
        Food insecurity affects school children's academic performance, weight gain, and social skills.
        The Journal of Nutrition. 2005; 135: 2831-2839
        • Larson N.I.
        • Story M.T.
        Food insecurity and weight status among U.S. children and families: A review of the literature.
        American Journal of Preventive Medicine. 2011; 40: 166-173
        • Mabli J.
        • Ohls J.
        Supplemental Nutrition Assistance Program participation is associated with an increase in household food security in a national evaluation.
        The Journal of Nutrition. 2015; 145: 344-351
        • Ogden C.L.
        • Lamb M.M.
        • Carroll M.D.
        • Flegal K.M.
        Obesity and socioeconomic status in children: United States 1988–1994 and 2005–2008. National Center for Health Statistics, Data Brief. No. 51.
        Centers for Disease Control and Prevention, Atlanta, GA2010 (Retrieved from)
        • Olson C.M.
        • Bove C.F.
        • Miller E.O.
        Growing up poor: Long-term implications for eating patterns and body weight.
        Appetite. 2007; 49: 198-207
        • Stuber J.
        • Schlesinger M.
        Sources of stigma for means-tested government programs.
        Social Science & Medicine (1982). 2006; 63: 933-945
        • U.S. Department of Agriculture, Economic Research Service
        USDA ERS: Food security in the U.S.: Definitions of food security.
        Author, Washington, DC2014 (Retrieved from)
        • U.S. Department of Agriculture, Food and Nutrition Service
        Supplemental Nutrition Assistance Program (SNAP).
        Author, Alexandria, VA2014 (Retrieved from)
        • Widome R.
        • Neumark-Sztainer D.
        • Hannan P.J.
        • Haines J.
        • Story M.
        Eating when there is not enough to eat: Eating behaviors and perceptions of food among food-insecure youths.
        American Journal of Public Health. 2009; 99: 822-828


      Claudia K. Fox, Assistant Professor, Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Minnesota, Minneapolis, MN.


      Nicole Cairns, Research Assistant, School of Medicine, University of Minnesota, Minneapolis, MN.


      Muna Sunni, Assistant Professor, Division of Endocrinology, Department of Pediatrics, University of Minnesota, Minneapolis, MN.


      Gail L. Turnberg, Pediatric Nurse Practitioner, Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Minnesota, Minneapolis, MN.


      Amy C. Gross, Assistant Professor, Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, Minneapolis, MN.