{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:38:46Z","timestamp":1790887126406,"version":"4.1.0"},"reference-count":79,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012228","name":"American Beverage Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012228","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004367","name":"Coca-Cola","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004367","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000354","name":"Food Standards Agency","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000354","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:p>Good health is viewed as essential to enable citizens to live fulfilling lives, shape communities, and drive economic growth. However, health is socially patterned. Low socioeconomic status is associated with an increased risk of non-communicable diseases, where poor dietary patterns and diet-related obesity are likely contributors. Food purchasing can be influenced by many factors, including cost and income. Most food purchased to be consumed at home is acquired from supermarkets, and any increase in food prices disproportionately impacts low-income households, contributing to food insecurity. This study explored the factors that helped and hindered people living with obesity and food insecurity in purchasing healthy, environmentally sustainable food from supermarkets. Semi-structured interviews (<jats:italic>n<\/jats:italic>\u202f=\u202f25) and focus groups (<jats:italic>n<\/jats:italic>\u202f=\u202f7) were conducted between June and December 2023 with adults living in Scotland and England who self-identified as living with obesity and food insecurity. Using thematic analysis, six main themes were identified: (1) <jats:italic>Supermarket deals<\/jats:italic>: perceptions surrounding <jats:italic>the good<\/jats:italic>, <jats:italic>the bad,<\/jats:italic> and <jats:italic>the ugly<\/jats:italic> side of supermarket offers and promotions; (2) <jats:italic>Skepticism about supermarkets and the wider food system<\/jats:italic>: questioning supermarket pricing motives but recognizing the role of the wider food system in food pricing; (3) <jats:italic>Other peoples\u2019 role in enhancing or undermining healthy diet intentions<\/jats:italic>: the impact of others in shaping food purchases; (4) <jats:italic>Financial restrictions facing non-UK nationals<\/jats:italic>: additional challenges faced by those with no recourse to public funds; (5) <jats:italic>The overwhelming in-store supermarket experience<\/jats:italic>: sensory overload and attempts to prevent unintended, impulse purchases; (6) <jats:italic>Unconscious, environmentally sustainable shopping practices<\/jats:italic>: cost saving practices that lead to environmentally sustainable purchasing patterns and behaviors as a unintentionally created outcome of budget maximizing strategies. However, such strategies, that is, limiting food waste and purchasing less meat, although beneficial for environmental sustainability, do not necessarily indicate that a healthier diet is being purchased or consumed. While views on some factors believed to help or hinder healthy, environmentally sustainable food purchases varied, there was general agreement amongst participants on the need for upstream changes, including having access to adequate benefits and wages.<\/jats:p>","DOI":"10.3389\/fnut.2025.1646056","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T04:18:09Z","timestamp":1759897089000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["The people behind the pounds: a qualitative exploration of factors that help or hinder healthy, sustainable food purchases for people living with obesity and food insecurity in the UK"],"prefix":"10.3389","volume":"12","author":[{"given":"Emma","family":"Hunter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra M.","family":"Johnstone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca A.","family":"Stone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah C.","family":"Greatwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte A.","family":"Hardman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Griffiths","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora","family":"Douglas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.puhe.2019.03.023","article-title":"Defining health and health inequalities","volume":"172","author":"McCartney","year":"2019","journal-title":"Public Health"},{"key":"ref2","year":"2024"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2478\/raon-2020-0008","article-title":"Socioeconomic inequalities in cancer incidence in Europe: a comprehensive review of population-based epidemiological studies","volume":"54","author":"Mihor","year":"2020","journal-title":"Radiol Oncol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12889-015-2227-y","article-title":"Socioeconomic inequalities in non-communicable diseases and their risk factors: an overview of systematic reviews","volume":"15","author":"Sommer","year":"2015","journal-title":"BMC Public Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1136\/bmj.n604","article-title":"Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease: two prospective cohort studies","author":"Zhang","year":"2021","journal-title":"BMJ"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1750","DOI":"10.1001\/jama.2016.4226","article-title":"The association between income and life expectancy in the United States, 2001-2014","volume":"315","author":"Chetty","year":"2016","journal-title":"JAMA"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1647","DOI":"10.1016\/S0140-6736(18)32207-4","article-title":"Changes in health in the countries of the UK and 150 English local authority areas 1990\u20132016: a systematic analysis for the global burden of disease study 2016","volume":"392","author":"Steel","year":"2018","journal-title":"Lancet"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1016\/S0140-6736(16)32380-7","article-title":"Socioeconomic status and the 25\u00d7 25 risk factors as determinants of premature mortality: a multicohort study and meta-analysis of 1\u00b7 7 million men and women","volume":"389","author":"Stringhini","year":"2017","journal-title":"Lancet"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1093\/nutrit\/nux012","article-title":"Possible role of diet in cancer: systematic review and multiple meta-analyses of dietary patterns, lifestyle factors, and cancer risk","volume":"75","author":"Grosso","year":"2017","journal-title":"Nutr Rev"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.jfca.2017.02.002","article-title":"Selected nutrient analyses of fresh, fresh-stored, and frozen fruits and vegetables","volume":"59","author":"Li","year":"2017","journal-title":"J Food Compos Anal"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2458-9-88","article-title":"The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis","volume":"9","author":"Guh","year":"2009","journal-title":"BMC Public Health"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1113060","DOI":"10.3389\/fnut.2022.1113060","article-title":"Good nutrition across the lifespan is foundational for healthy aging and sustainable development","volume":"9","author":"Rodr\u00edguez-Ma\u00f1as","year":"2023","journal-title":"Front Nutr"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1093\/advances\/nmy033","article-title":"Perspective: food-based dietary guidelines in Europe\u2014scientific concepts, current status, and perspectives","volume":"9","author":"Bechthold","year":"2018","journal-title":"Adv Nutr"},{"key":"ref14","year":"2016"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e037554","DOI":"10.1136\/bmjopen-2020-037554","article-title":"Health impacts and environmental footprints of diets that meet the Eatwell guide recommendations: analyses of multiple UK studies","volume":"10","author":"Scheelbeek","year":"2020","journal-title":"BMJ Open"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1038\/s43016-021-00225-9","article-title":"Food systems are responsible for a third of global anthropogenic GHG emissions","volume":"2","author":"Crippa","year":"2021","journal-title":"Nature food"},{"key":"ref17","year":"2021"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.physbeh.2016.04.025","article-title":"The food-insecurity obesity paradox: a resource scarcity hypothesis","volume":"162","author":"Dhurandhar","year":"2016","journal-title":"Physiol Behav"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"S36","DOI":"10.1111\/j.1753-4887.2009.00157.x","article-title":"Obesity, diets, and social inequalities","volume":"67","author":"Drewnowski","year":"2009","journal-title":"Nutr Rev"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"107290","DOI":"10.1016\/j.appet.2024.107290","article-title":"Changes in UK price disparities between healthy and less healthy foods over 10 years: an updated analysis with insights in the context of inflationary increases in the cost-of-living from 2021","volume":"197","author":"Hoenink","year":"2024","journal-title":"Appetite"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"107794","DOI":"10.1016\/j.appet.2024.107794","article-title":"\u201cWe go hunting\u2026\u201d: understanding experiences of people living with obesity and food insecurity when shopping for food in the supermarket to meet their weight related goals","volume":"205","author":"Hunter","year":"2025","journal-title":"Appetite"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"104547","DOI":"10.1016\/j.appet.2019.104547","article-title":"\u2018Eating to survive\u2019: a qualitative analysis of factors influencing food choice and eating behaviour in a food-insecure population","volume":"147","author":"Puddephatt","year":"2020","journal-title":"Appetite"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"3689","DOI":"10.1002\/fsn3.2969","article-title":"A mixed-method systematic review and meta-analysis of the influences of food environments and food insecurity on obesity in high-income countries","volume":"10","author":"Eskandari","year":"2022","journal-title":"Food Sci Nutr"},{"key":"ref24","author":"Stiebahl","year":"2025"},{"key":"ref25","year":""},{"key":"ref26","year":"2024"},{"key":"ref27","year":"2022"},{"key":"ref28","year":"2023"},{"key":"ref29","year":"2011"},{"key":"ref30","year":"2025"},{"key":"ref31","year":"2025"},{"key":"ref32","year":"2024"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1093\/pubmed\/fdab408","article-title":"Risk of food insecurity in undocumented migrant households in Birmingham","volume":"45","author":"Jolly","year":"2023","journal-title":"UK Journal of Public Health"},{"key":"ref34","author":"Kirk-Wade","year":"2024"},{"key":"ref35","year":"2025"},{"key":"ref36","author":"Howes","year":"2023"},{"key":"ref37","author":"Haux","year":"2024"},{"key":"ref38","year":"2023"},{"key":"ref39","volume-title":"Social Murder? Austerity and Life Expectancy in the UK","author":"Walsh","year":"2024"},{"key":"ref40","author":"Bashir","year":"2024"},{"key":"ref41","year":"2020"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"107255","DOI":"10.1016\/j.appet.2024.107255","article-title":"The impact of the cost of living crisis and food insecurity on food purchasing behaviours and food preparation practices in people living with obesity","volume":"196","author":"Stone","year":"2024","journal-title":"Appetite"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1111\/nbu.12626","article-title":"Food insecurity in people living with obesity: improving sustainable and healthier food choices in the retail food environment\u2014the FIO food project","volume":"48","author":"Lonnie","year":"2023","journal-title":"Nutr Bull"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"102798","DOI":"10.1016\/j.foodpol.2025.102798","article-title":"Understanding the barriers to purchasing healthier, more environmentally sustainable food for people living with obesity and varying experiences of food insecurity in the UK","volume":"131","author":"Stone","year":"2025","journal-title":"Food Policy"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"e26","DOI":"10.1542\/peds.2009-3146","article-title":"Development and validity of a 2-item screen to identify families at risk for food insecurity","volume":"126","author":"Hager","year":"2010","journal-title":"Pediatrics"},{"key":"ref46","first-page":"1","volume-title":"The coding manual for qualitative researchers","author":"Salda\u00f1a","year":"2021"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1007\/s40271-014-0065-0","article-title":"A systematic review of the impact of patient and public involvement on service users, researchers and communities","volume":"7","author":"Brett","year":"2014","journal-title":"Patient Patient Centered Outcomes Res"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"110549","DOI":"10.1016\/j.nut.2019.07.001","article-title":"Scientific evidence of diets for weight loss: different macronutrient composition, intermittent fasting, and popular diets","volume":"69","author":"Freire","year":"2020","journal-title":"Nutrition"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1987","DOI":"10.1038\/oby.2011.230","article-title":"Four-year weight losses in the look AHEAD study: factors associated with long-term success","volume":"19","author":"Wadden","year":"2011","journal-title":"Obesity"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.socscimed.2015.11.025","article-title":"Economic constraints on taste formation and the true cost of healthy eating","volume":"148","author":"Daniel","year":"2016","journal-title":"Soc Sci Med"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.appet.2018.12.009","article-title":"What factors influence ultra-processed food purchases and consumption in households with children? A comparison between participants and non-participants in the supplemental nutrition assistance program (SNAP)","volume":"134","author":"Moran","year":"2019","journal-title":"Appetite"},{"key":"ref53","year":"2024"},{"key":"ref54","volume-title":"Views and experiences of people living with obesity and food insecurity on supermarket messaging: A reflexive thematic analysis","author":"Greatwood","year":"2025"},{"key":"ref55","year":"2024"},{"key":"ref56","year":"2024"},{"key":"ref57","author":"Scott","year":"2023"},{"key":"ref58","year":"2024"},{"key":"ref59","year":"2021"},{"key":"ref60","year":"2016"},{"key":"ref61","year":"2023"},{"key":"ref62","volume-title":"Stuffed and starved: From farm to fork: The hidden battle for the world food system","author":"Patel","year":"2013"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"S145","DOI":"10.1016\/j.amepre.2016.08.017","article-title":"Behavioral economics and the supplemental nutrition assistance program:: making the healthy choice the easy choice","volume":"52","author":"Ammerman","year":"2017","journal-title":"Am J Prev Med"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"1070","DOI":"10.1186\/s12889-021-11112-0","article-title":"Women\u2019s perceptions of factors influencing their food shopping choices and how supermarkets can support them to make healthier choices","volume":"21","author":"Dhuria","year":"2021","journal-title":"BMC Public Health"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1016\/j.neubiorev.2021.05.019","article-title":"Explaining socioeconomic disparities in health behaviours: a review of biopsychological pathways involving stress and inflammation","volume":"127","author":"Kraft","year":"2021","journal-title":"Neurosci Biobehav Rev"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1126\/science.1238041","article-title":"Poverty impedes cognitive function","volume":"341","author":"Mani","year":"2013","journal-title":"Science"},{"key":"ref67","first-page":"213","volume-title":"Inequality from the bottom up: Toward a \u201cpsychological shift\u201d model of decision-making under socioeconomic threat. The social psychology of inequality","author":"Sheehy-Skeffington","year":"2019"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"35","DOI":"10.15179\/pkiep.27.2.2","article-title":"Benefits and pitfalls of online grocery shopping as perceived by the consumers: evidence from the Czech Republic","volume":"27","author":"\u0160arkovsk\u00e1","year":"2019","journal-title":"Privredna Kretanja Ekonom Polit"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1509\/jmr.14.0490","article-title":"Clicks as a healthy alternative to bricks: how online grocery shopping reduces vice purchases","volume":"54","author":"Huyghe","year":"2017","journal-title":"J Mark Res"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"1050","DOI":"10.1111\/ajae.12262","article-title":"Online shopping and the healthfulness of grocery purchases","volume":"104","author":"Harris-Lagoudakis","year":"2022","journal-title":"Am J Agric Econ"},{"key":"ref71","year":"2021"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s12916-023-02726-9","article-title":"UK government\u2019s new placement legislation is a \u2018good first step\u2019: a rapid qualitative analysis of consumer, business, enforcement and health stakeholder perspectives","volume":"21","author":"Muir","year":"2023","journal-title":"BMC Med"},{"key":"ref73","volume-title":"Sustainability: Only seen as a priority for the rich?","author":"Kemp","year":"2023"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"12429","DOI":"10.1073\/pnas.1804698115","article-title":"Diverse segments of the US public underestimate the environmental concerns of minority and low-income Americans","volume":"115","author":"Pearson","year":"2018","journal-title":"Proc Natl Acad Sci"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1111\/1468-2346.12708","article-title":"The Paris agreement and the new logic of international climate politics","volume":"92","author":"Falkner","year":"2016","journal-title":"Int Aff"},{"key":"ref76","volume-title":"State of climate action","author":"Boehm","year":"2023"},{"key":"ref77","year":"2024"},{"key":"ref78","year":"2010"},{"key":"ref79","doi-asserted-by":"publisher","first-page":"664","DOI":"10.3399\/bjgp12X659466","article-title":"Making health habitual: the psychology of \u2018habit-formation\u2019 and general practice","volume":"62","author":"Gardner","year":"2012","journal-title":"Br J Gen Pract"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1646056\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T04:18:12Z","timestamp":1759897092000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1646056\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,8]]},"references-count":79,"alternative-id":["10.3389\/fnut.2025.1646056"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2025.1646056","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,8]]},"article-number":"1646056"}}