Food assistance programs do not promote obesity in children

There is no pattern of evidence that federal food assistance programs such as school meals and grocery benefits promote unhealthy weight in children, according to a comprehensive analysis by researchers at Washington University in St. Louis’ School of Public Health and the Brown School. On the contrary, when such programs use evidence-based nutritional standards, they can support healthy weight outcomes for children. 

The systematic review focused on scientific journals with published research on federal food assistance programs and children’s weight — a total of 75 studies spanning more than four decades. The findings should put to rest long-standing questions about whether food assistance programs — designed to combat hunger and malnutrition — are unintentionally worsening the obesity epidemic.  

“We found that participating in a food assistance program does not have any direct relationship to whether a person is obese or not,” said co-author Sarah Moreland-Russell, MPH, PhD, an associate professor at WashU Public Health. “We don’t see any evidence that these programs are doing harm, and it’s important to ensure that kids and their families receive food because we know that is fundamental to quality of life, to health, to performance, to everything.”

Federal food assistance for children comes in the form of school-based programs such as the National School Lunch Program and the School Breakfast Program, as well as direct-support programs such as the Supplemental Nutrition Assistance Program (SNAP; formerly known as food stamps), which provides money to buy groceries; and Women, Infants and Children (WIC), which delivers nutritious food to children up to age 5, and pregnant and breastfeeding women. 

Since the first food assistance programs were established in the mid-20^th century, they have proven remarkably effective at accomplishing not just their primary goal of reducing food insecurity, but also at alleviating poverty, improving health and reducing health-care costs. As these programs have expanded, the American health landscape has been changing, with overweight and obesity becoming increasingly serious public health issues. When SNAP started in 1961, 13% of U.S. adults and 6% of children had obesity; today, those numbers have tripled to 40% of adults and 19% of children. Unlike in previous eras, when poverty was associated with underweight, in modern times low-income people are more likely to have problems with overweight and obesity than people in higher income brackets. 

“There’s this paradox where we see rising rates of food insecurity and obesity simultaneously, and people wanted to know why it was happening and what they could do about it,” said lead author Dan Ferris, PhD, an associate professor of practice at the Brown School. “A few studies pointing to things like school meals, WIC and SNAP as having adverse impacts on weight, particularly in childhood and adolescence, got a lot of attention in the media and in policy debates.”

Faced with a seemingly unstoppable rise in national obesity rates, some policymakers have argued that food assistance programs should be pared down because they do more harm than good to the public health. 

To resolve the question of whether providing food assistance puts people at risk of obesity, Ferris, Moreland-Russell and colleagues — including Amanda Gilbert, PhD, a postdoctoral researcher, and Tyler Frank, a PhD candidate in public health sciences, both at the School of Public Health — conducted a rigorous, systematic analysis of available evidence. They combed through scientific literature for peer-reviewed studies with data on federal food assistance programs and children’s weight, screening over 30,000 to find 75 that met their criteria. They focused on children because of the lifelong impact on health of childhood weight and obesity issues. 

The studies dated back to 1977 and ran the gamut, covering a range of ages (newborns to 20-year-olds), study designs (experimental or observational), data sources (directly collected, administrative data, health records and more), sizes (40 to 860,000 children participating), and programs (five federal programs were included, individually or in combination). Individual studies came down on all sides of the debate — beneficial, adverse, mixed and no effects on children’s weight — but taken all together, there was no evidence of any consistent pattern that federal food assistance programs promote obesity. 

“Research has consistently documented that these programs have profound benefits for addressing food insecurity, hunger and malnutrition,” Ferris said. “There has been this idea that there’s a policy trade-off between food security and weight. The evidence doesn’t support pulling back on these programs because of concerns around overweight and obesity. If anything, we should expand these programs and keep strengthening nutrition standards.”

Eighteen of the studies evaluated the effects of policy changes to bring programs more in line with the latest evidence and nutritional science, such as the Healthy Hunger-Free Kids Act of 2010, which updated standards for school meals to increase fruits, vegetables and whole grains, and to limit calories, fat and sodium. All 18 studies found mixed or beneficial effects of such policy changes on children’s weight; none reported adverse effects.

These findings are timely since SNAP is changing again. Starting this year, Missouri and 17 other states will block people from purchasing candy, soda and other junk food with their SNAP benefits. Critics have pointed to the fact that SNAP benefits can be used to purchase foods with limited nutritional value as evidence that the program may contribute to poor health. But the research tells a different story: Program participation itself does not drive obesity, and there is no consistent evidence that families use their SNAP benefits in ways that harm their children’s health. 

“Since limiting what’s available in SNAP is a more recent policy phenomenon, our review did not include any studies looking at those changes,” Ferris said. “We have seen beneficial effects of updating the nutritional standards of school meals and WIC, but in those cases the evidence and the science were already there, and the policy changes just brought the programs more into alignment with them. The impact of individual restrictions is still very much up in the air.”

As anyone who has ever made a resolution to eat better knows, eating habits are hard to change. People who use SNAP benefits may respond to the restrictions by buying and eating more nutritious foods, as policymakers hope. But they also may buy healthy food and then not eat it, and find other ways to obtain their preferred foods. Those who live in food deserts where nutritious food is limited may not be able to use their benefits fully. All of this could undermine the program’s primary goal of reducing food insecurity, the researchers said.  

“Food assistance programs are implemented within a complex system,” Moreland-Russell said. “In some areas, it’s hard enough for recipients to access food as it is, and if you start to restrict the options people have, it will disrupt that system and likely decrease the amount of food they are able to access, at least in the short term. You don’t want to increase food insecurity or disincentivize people from participating in the program; there are decades of evidence of the many positive outcomes of making sure that families can access the food they need.”

Ferris D, Davison G, Frank T, Gilbert A, Thomas F, Rothman S, Lipsey K, Moreland-Russell S. “Nutrition assistance programs and pediatric weight outcomes: a systematic review.” Nutrients. January 25, 2026. DOI: 10.3390/nu18030394

This research received no external funding.