"We go hunting...too": Experiences of people living with obesity and food insecurity in an ethnically diverse community when shopping for supermarket foods

Background: The United Kingdom faces complex economic and structural challenges that have disrupted food pricing, contributing to widespread food insecurity. These fluctuations diminish the affordability and accessibility of healthy, nutrient-dense foods among vulnerable groups. In high-income countries, food insecurity is associated with higher levels of obesity, and in the UK specifically, the cost of living crisis, where the cost of food has increased quicker than wages, is likely to have exacerbated existing dietary inequalities. This qualitative paper explores insights of people living with obesity and food insecurity, in an ethnically diverse community, to develop further understanding on their food shopping experiences.Methods: A secondary analysis of qualitative data from four focus groups (8–11 participants per group; 92% female) was undertaken with participants who self-reported as living with obesity and food insecurity (n=39) and were attempting to reduce their weight. Results: Three themes and eight subthemes were generated using deductive and reflexive thematic analysis: (1) the Conscious Consumer, reflects the preparation and planning participants undertook by participants to maximise their limited resources. Subthemes include advanced meal planning, and price-comparison shopping. Despite these efforts, participants frequently encountered barriers to being able to purchase nutritionally balanced foods. (2) the Restricted Consumer highlights how structural and systemic limitations, including time pressures due to work or caregiving responsibilities, further constrained participants’ food purchasing choices. and (3) Mitigating the rising cost of food, describes the actions required to manage the challenges in purchasing foods with rising costs. Subthemes include substituting affordable, less-healthy products for costlier fresh produce and bulk buying of staple items. Conclusions: Findings challenge societal beliefs that people living on low incomes need to budget more carefully to afford a healthy diet. People living with obesity and food insecurity often report experiencing cognitive dissonance. In this context, participants faced difficult and emotive trade-offs, as they recognised the suboptimal nutritional value of their food purchases but felt compelled by necessity to buy unhealthier food that matched their budget. Findings provide further insights to support healthy, sustainable food purchasing, as part of transforming the UK food system.