Children and Binge Eating Disorder

Binge eating disorders are often misunderstood as a problem related to willpower. There is a great deal of denial and misunderstanding about the multiple influences perpetuating binge eating disturbances among children.

Addressing the Misconceptions of Binge Eating

The misconception that binge eating disorder is nothing more than a lack of self-control around food can prevent many children and adolescents from seeking out the help and support needed for treatment and recovery. Early identification and awareness of binge eating disorder can allow for treatment that can support improved prognosis and outcomes for children and adolescents, particularly as they transition into their teenage years and early adulthood.

They may be undetected as serious eating disorders with severe medical, nutritional, and psychological consequences. There are many layers to understanding risk factors associated with BED that include the interplay of genetics and environment.

Regardless of gender, binge eating in children may be undetected due to the secretiveness of eating behaviors along with natural changes in appetite and eating behaviors that accompany the physical development of a child.

The consequences related to binge eating disorder may not be as obvious or apparent to well-meaning family members and loved ones, which can contribute to this eating disorder being undetected. Many children with binge eating disorder may be of normal weight, which can also make this eating disorder more difficult to identify based on physical symptoms alone.

What BED Is Not

There is a cultural tendency to label children and teens that may be on the higher end of the weight spectrum to have binge eating disorders. This is a misperception. Not all individuals who are within obese weight category struggle with BED. BED affects individuals who are within a normal weight range for height and developmental phase as well.

The opposite is also true in that normal weight does not indicate that there are not any eating disturbances on hand. Binge eating disorder can be present in a child who falls within the normal weight category.

The stigmas surrounding weight and body size with binge eating disorder can make it more difficult to understand if a child may be struggling with BED. It is important to understand that weight, while helpful for measuring some aspects, cannot be used alone to determine the presence of BED.

In fact, body mass index is a useful marker for growth expectations and healthful norms. But not for sweeping generalities assuming a disorder exists. Every child is different and individual factors such as genetics, physical frame; physiological, medical, activity levels and nutrition weigh into the picture.

Personal Stories About Binge Eating

Children struggling with eating disorders suffer tremendous pain. It is difficult to conceive of such suffering for children binge eating at such young ages. When undiagnosed, suffering may be repressed until they reach for help in their adult years after much damage has already occurred.
Years of yoyo dieting attempts may dangerously tax both mind and body. Whatever the storyline, one theme is common. Every once upon a time for someone with a Binge Eating Disorder often includes young memories of secret and uncontrollable binge eating. Many of those we work with recall compulsive eating prior to adolescents.

I felt my parents wanting me to be a normal sized kid

I remember the sweet smell of the apple pie my grandmother made. Respite at her farm during the summer months were the best memories of my life.

It was relaxed and fun, and I was always welcome with a smile and a warm fleshful hug from my grandmother. I loved the way her arms enveloped me and how comforted I felt in them.

Yet, at the same time, I was afraid of her size. I know where that came from now but struggled all my life not realizing the significance. And, every time I failed at yet another diet, the shame increased.  As I revisit my childhood, there wasn’t one memory I have of not feeling that I was going to lose control.  

Home was different than my summers with my grandparents. There was a lot of control and perfectionism expected at home. I felt my parents wanting me to be a normal sized kid. They were worried about me. It was weird really.

A desire to protect me maybe? But, I see that it may have been their own disappointments about their lives, now looking back. But it still hurts, more so then the kids picking on me.  That is part of the bulimia too, if I couldn’t get control one way, it was another.  

If I binged on something, the next day my parent would put out the empty jar on the kitchen counter. I was so ashamed we never talked about it, ever. Until now, I never realized it was their way of trying to control it. We were all out of control really.

If I was happy I ate, if I was sad I ate

It wasn’t like I ever made any connections about why I ate. If I was happy I ate, if I was sad I ate. I would go to the refrigerator and stare at the contents, seeming suspended in time. The cool air of the open door invited me in, and I felt safe somehow.

I would count the food I desired. One, two, three, things I want. I will pick one I would say. I always picked them all. At night I would be quietly seeking food. My secret and my own decision. I was pretty much quiet, alone and just blended in with people.

Food saved my life really. Yes, it was always not in my control, a compulsion, and I know I have missed a lot of life by hiding with it, but honestly, it was my friend. I had to learn to love myself, took 30 years, wish I could have gotten to that sooner, but I had to go on this journey, put the blame where it should be and release myself from that cage I was in all those years. I am grateful I have arrived at this place.

Actually, as I look back, my whole family did everything compulsively

I was only 11 years old when I remember getting into lifting weights and being introduced to steroids. It was a buddy of my brother. He was just three years older than me. It felt powerful and I was hooked. It is very similar to the feeling I get when I drink, that liquid courage they call it.

It was an illusion of control. But the binge eating, that is different. Never felt in control of it. I always hid that. I guess that did feel powerful, the hiding of it. I had my food, my power bars, and alcohol.  By the time I was a teenager I was already out of control.

The binging didn’t feel so good, never made me feel better, just worse. In the end, all those habits took from my life. I had to admit I do everything in compulsive ways. Actually, as I look back, my whole family did everything compulsively. I think this is strength in some ways really.

I just couldn’t get a handle on it. I kind of understand it all now. All the things that led to and ways I kept up the compulsion. My life, relationships, work, everything was on the fast track. My mind always worked on high speed.

A lot of what I have to do is make that decision to slow down, think, before responding.  It’s all very different than how I use to live. It feels unnatural at times but definitely better. I am not slowly killing myself anymore.

The Presence of Co-Occurring Disorders

The children binge eating in these three stories all additionally suffered from co-occurring disorders that added to the complications of assessment, treatment, and recovery.

It is not uncommon to see accompanying anxiety or depressive disorders, family factors such as a crisis or addictions, or trauma-related experiences connected to binge eating disorders.

However, this is not always the case. There are subsets of individuals who suffer from BED, but do not struggle with accompanying disorders. Whatever the case may be, the most common childhood storyline for most sufferers is secretive and out of control binging behaviors that became unmanageable and habitual ways of coping by using food to quell emotions or manage stress.

How do we help children binge eating and families struggling with binge eating disorders?

Work with pediatric and health care providers who understand the full spectrum of influences to children binge eating and the importance of working from a multidisciplinary team approach.  Medical, genetic, nutritional, familial and sociocultural factors must all be considered to inform the best fit for treatment.

Treatment for binge eating disorder should be comprehensive and individualized. It is important to understand that a child has unique needs that should be addressed as part of the treatment process for binge eating disorder.

Family education and skill development to tackle the eating disorder is imperative. Parents report being much more prepared to help their child when they understand the bio-psycho-social factors associated with the eating disorder.

Treatment must be delivered in kind and compassionate ways that work with the lifestyle and limitations of the family. While, simultaneously challenging existing habits, communications styles, and choices that inhibit their child’s treatment success.

Treatment providers guide the families to develop new skills that the whole family can practice.  For example, a helpful strategy may include recognizing the signs of stress overload for each family member on their overall and individual Emotions thermometer.

Family members should never be blamed or feel at fault for the development of an eating disorder in their child but understand their vital role in the recovery and healing process moving forward.

Discussing options for how to tackle stress before reaching the boiling point and conducting practice rounds will strengthen overall family resilience.  It is key as well that the child struggling with binge eating disorder see her parents modeling and taking part in practicing healthier coping skills.

Equally important is to fully understand the child’s specific developmental, learning and psychological needs to tangibly translate concepts of interventions.  The concept of the Emotional Thermometer, for instance; will be delivered differently to a child of seven years old versus an adolescent.

Often time’s emotions are so overwhelming, confusing and difficult to articulate.  Helping the child and their family create a Tool Box of communication props, such as a hand-held stop sign, or a teddy bear needing a hug can help a child deliver a need for help during a time when last she or he would secretly stow away and binge eat.

Treatment programs specifically designed for the whole family show promise. Parents additionally find it helpful to link up with other parents and support groups that speak to their specific real-life struggles.

Just as we encourage our young patients and their families to help us understand the factors that may increase their specific risks to BED (i.e.) genetic implications, lifestyle and eating patterns, and specific family dynamics.  So, also should we explore our overall social structure and norms related to food and body weight to assess the way a culture-wide change can assist in decreasing disordered eating incidences.

How to Speak with a Child About Binge Eating Disorder

Talking with our children about personal and sensitive topics may be one of the most difficult challenges facing parents. Whether it is discussing sex, money, personal hygiene or food and dieting, many parents fall into one of two categories; being too pushy or avoiding the topics all together. Others attempt to engage with their children on the topic but, find themselves feeling paralyzed and tongue-tied.

There are Challenges

There are many reasons that talking with our children can be so challenging. These include fear of saying the wrong thing, discomfort with the topic itself, and doubt or confusion about the issues at hand.

To skillfully discuss an issue like binge eating disorder with a child, parents need to honestly assess their motives, attitudes and fears before engaging in the conversation.

To be honest, as a parent of two teenagers, I’ve recently recognized that much of the energy in my parenting seems to go toward the goal of protecting my children from pain, shame and loss. I was recently discussing this with Michelle Watson, who is the author of Dad, Here’s What I Need from You; A guide for connecting with your daughter’s heart. Her comment to me stopped me in my tracks, “You can’t protect your kids from those things. They will be hurt. What you need to talk with them about is how they are handling the hurt.”

Factors to Keep in Mind

With this in mind, let’s consider a few other factors when talking with a child about binge eating disorder:

Don’t focus on weight. 

Weight isn’t really the issue and, at this point, will only complicate the discussion. The real issues are how the child is relating to and using food.

Share your observations and concerns, but not your judgement.

“Many parents want to pull out empty food wrappers and confront their children with evidence of bingeing. This unintentionally results in shaming the child” states Cherie Massmann, a professional counselor who treats binge eating disorder in St. Louis, Missouri. Instead, you need to “share your observations in a non-accusatory way with statements such as ‘I’ve noticed this’ and ‘I’m concerned about this.’”

Ask good questions driven by curiosity.

Use this as an opportunity to learn about your child and his or her behaviors. Here are some examples:

  • Do you ever feel you have lost control of how much you eat?
  • Do you have any concerns about how much you eat?
  • Have you tried to stop eating and you felt like you couldn’t ?

Staring with yes/no questions may allow you to ease into the conversation. If your son or daughter answers “yes” to any of these questions you can follow up with “tell me more about that.”

Give them Space and Time

Don’t try to have a life-changing conversation or a “come to Jesus” meeting all in one setting. It took some time for these issues to develop. No insight, perfectly-timed comment or parenting fairy dust is going to resolve things in one day. Talk with your child when you are alone together, express your thoughts, ask your questions and then back off. Periodically approach the subject, particularly if things seem to be getting worse. If you have significant concerns you might consider going to a professional counselor or registered dietitian and getting advice before bringing in your child for an appointment.

Article Contributors:

Staff of The Meadows Ranch

For over 25 years, The Meadows Ranch has offered an unparalleled depth of care through its unique, comprehensive, and individualized program for treating eating disorders and co-occurring conditions affecting adolescent girls and women. Set on scenic ranch property in the healing landscape of Wickenburg, Arizona, The Meadows Ranch allows for seamless transitions between its structured multi-phase treatment. A world-class clinical team of industry experts leads the treatment approach designed to uncover and understand the “whys” of the eating disorder through a host of proven modalities. Providing individuals with tools to re-engage in a healthy relationship with food – and with themselves – disempowers eating disorders and empowers individuals with a renewed enthusiasm for life. Contact us today at 888-496-5498 and find out why The Meadows Ranch is the best choice for eating disorder treatment and recovery. For more information call 1-888-496-5498. or visit www.themeadowsranch.com.

W. Travis Stewart, LPC, NCC writer for Eating Disorder Hope

Travis Stewart earned a Master of Arts in Counseling (2001) and a Master of Arts in Theological Studies (2003), both from Covenant Seminary in St. Louis, MO.  Travis is a Licensed Professional Counselor in the State of Missouri and a writer for Eating Disorder Hope and Addiction Hope.

Please Note:  The information contained in this article is intended to provide readers with helpful information and inspiration. The stories have been de-identified to honor and protect confidential details of all individuals. This article is not to be used to diagnose or treat. Consult licensed medical, and or mental health professionals for assistance.

Page Last Updated & Reviewed By: Crystal Karges, RD  on August 29, 2017
Recently Reviewed By Jacquelyn Ekern, MS, LPC on July 2, 2018
Published on EatingDisorderHope.com, Eating Disorders Information & Resources