Why you should be concerned about the biggest eating disorder in the U.S.
Parents who are worried that their teen has an eating disorder may look
for warning signs such as extreme weight loss or throwing up, hallmarks
of anorexia and bulimia. But they would also be wise to check their pantry
or refrigerator for missing food. That’s because in America, binge
eating disorder is three times more common than anorexia and bulimia combined,
according to the National Eating Disorders Association.
“Binge eating disorder is becoming a better-recognized disorder,”
says Laura L. Adams, RDN, a registered dietitian nutritionist in private
practice and a consultant for the
Mission Hospital, Laguna Beach Outpatient Behavioral Health,
Partial Hospitalization and
Intensive Outpatient programs. “When the Diagnostic and Statistical Manual of Mental
Disorders included it as a diagnosis in 2013, we began seeing more cases
of it. Binge eating disorder was acknowledged as not just the idea of
'chips are yummy and we eat too many of them'.”
What Is Binge Eating Disorder?
Adams says that binge eating disorder is defined as eating a large amount
of food in a small amount of time comparable to what is considered normal—and
it’s not like overindulging in an amazing meal. “The person
will also feel out of control while eating,” Adams says. “It
doesn’t matter if he or she feels full or is burned out on the taste
of it—for instance, after a certain amount of ice cream, the tongue
feels frozen, but the person would continue eating. It’s like a
The binge eating patterns also have to occur with regularity—at least
once a week for three months, Adams says. She adds that people with the
disorder do not take measures to counteract the extra amount of food being
eaten, such as extreme exercise or vomiting. (Throwing up combined with
binge eating is considered bulimia.)
Finally, there is no normal enjoyment to be found in binge eating disorder—food
isn’t usually savored and enjoyed. “Someone who is binge eating
may feel numbed out while eating, and they are likely to feel shame or
embarrassment after the binge is over,” Adams says.
The Signs to Look For
Binge eating disorder can start fairly early on in life—Adams says
the median age of onset is 12 to 13 years old. Parents who are concerned
their child may have the disorder can look for the following signs:
Unusual weight gain. Adams says when she assesses patients one of the things she looks at is
the weight percentile on the child’s medical charts—if a child
has always measured in the 60th percentile but suddenly moves up to the 80th percentile, for instance, that could indicate a problem.
- Complaints of stomach pain, gastric esophageal reflux disorder or a distended stomach.
Missing food. Is a bag of pretzels bought yesterday just a handful of crumbs today? With
binge eating disorder, food that disappears quickly without an easy explanation
can be a red flag. “The teen may say somebody else ate it or mix
in other foods to hide what's been eaten,” Adams says. “It
can also be easier to hide binges in households where food is bought in
Costco-sized packs of 24 instead of a regular six-pack.” She adds
that popular binge foods can include bread, tortillas and cereal and milk,
which can change state in the mouth, such as from crunchy to mushy. Chips
and crackers are also ripe for binging because of the repetitive hand-to-mouth
motions needed to eat them.
Adams adds that a teen can be at higher risk for binge eating disorder
if another family member has had any kind of eating disorder. Also, while
a teen may seem depressed or anxious while binging, others may not show
any mood changes. “One other consideration is if a child is restrained
in their eating by a parent—such as eating only vegetarian food,
or restriction of sweets or packaged food--but that doesn’t align
with the child’s values or palate, they may want to get their hands
on more palatable food and that can be a possible trigger.”
It’s also important to keep in mind that the binges have to happen
consistently over time to qualify as the disorder. “A teen can be
going through a growth phase and may be eating more out of genuine hunger,
or a child may go to a friend’s birthday party and eat two cupcakes—they
could just be amazing cupcakes,” Adams says. “Parents should
keep in mind the official definition of binge eating disorder when determining
if a child is just overeating on occasion or if it’s something more.”
How to Get Help
If parents suspect their child has a binge eating disorder, Adams recommends
prompt professional intervention. She conducts full evaluations of teen
and adult patients at her private practice in Orange County and of adults
at Mission Laguna Beach to make a diagnosis, and treatment can involve
a team of professionals, such as a dietitian, physician and a therapist.
Adams also includes families in the treatment process as a
support network for the teen. She urges parents to promote the viewpoint that food is fuel
for the body to grow, it is meant to be enjoyed, and struggling with binge
eating is not to be shamed nor judged.
“It’s really important to not villainize food or moralize it;
it’s not good or bad,” Adams says. “Some food offers
more nutrition than others and you can acknowledge that certain foods
taste good and we like them. But tell children to notice, ‘I don’t
feel good if I eat two cupcakes at a party but when I eat a balanced dinner
at home I feel better.’ It can take more time for parents to address
it this way and not just say something is ‘junk,’ but try
to have the overall attitude for the family that all foods fit.”
To learn more about the treatment of eating disorders, visit the
National Eating Disorder Association or contact Laura L. Adams, RDN at (949) 683-3674.
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