By: Leslie Schilling
FOR EATING DISORDER specialists and nutrition therapists like myself, the scenario isn’t uncommon: A parent calls concerned their adolescent is eating foods which have been restricted in the home – they’ve found wrappers in the child’s bedroom. Unbeknownst to the parent, however, the problem isn’t primarily a child “sneaking” food.
Rather eating disorder dietitians suspect that a societal “war on obesity” and a parent’s own history of chronic dieting or untreated disordered eating combined with an over-control of food may be putting kids at risk for developing binge eating disorder.
According to the National Eating Disorders Association, “binge eating disorder (BED) is a severe, life-threatening, and treatable eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards; and not regularly using unhealthy compensatory measures (e.g. purging) to counter the binge eating. It is the most common eating disorder in the United States.” It’s not just adults who are being diagnosed, either. Clinicians across the country are seeing more and more children and teens with this disorder.
“Often, a parent who has dealt with eating and body issues as a child (or) teen, hoping to protect their child from the same discomfort, will over-control and monitor the child’s eating and movement,” says Elyse Resch, a registered dietitian, eating disorder expert and author of “The Intuitive Eating Workbook for Teens.” “I have seen this frequently result in the child feeling deprived and rebellious, acting out these feelings by sneaking forbidden foods and over-consuming ‘legalized’ foods. These are the beginning signs of binge eating disorder.”
Certified eating disorder dietitian Lauren Anton also sees this situation in her Los Angeles-based private practice. During an evaluation with a family, she may find that the parent of the teen with binge eating disorder also suffered with BED. Resch, who is the coauthor of “Intuitive Eating: A Revolutionary Program That Works,” says that defensiveness or rebellion around food happens when “the child is simply trying to assert autonomy, which is a healthy developmental task. Unfortunately, the manner in which the child rebels can end up in a serious eating disorder.”
In her Bay Area nutrition practice, Stephanie Brooks, who is also a certified eating disorder dietitian, reports she tends to find that the teens impacted by BED are often hoarding or sneaking food and engaging in secretive eating behaviors.
Brooks adds that youth may show signs of being depressed, socially isolate themselves and report they’re not hungry for regular meals. When engaging in secretive eating behaviors, it makes sense that normal eating patterns can be disrupted. “I’ve had kids use Uber Eats with their allowance or quinceanera money for binge foods when parents are not home,” says Beth Harrell, a registered dietitian and director of certification for the International Association of Eating Disorders Professionals.
Sometimes BED is noticed at a routine well-check when there is an unexplained spike in the growth curve that’s not related to puberty or an endocrine issue, Harrell notes. When this happens in her practice, she quickly advises parents to respond to this growth chart discovery first with a nonjudgmental observation of the child’s behaviors to gather more information.
American Academy of Pediatrics’ guidelines warn against prescribing diets or putting the focus on weight changes. These guidelines, which were developed after research suggested that weight-focused care causes harm, recommend that pediatricians avoid talking about weight with patients and instead promote family-centered behaviors like eating meals and moving together.
Binge eating disorder is treatable. Experts agree that all foods have to be “legalized,” and parents need to remove any focus on weight or body size for treatment to be effective. When foods are taboo or off-limits, we teach restrictive behaviors that don’t allow children to learn how to listen to and trust their unique bodies.
“If we can put focus on what the behaviors are communicating and listen to this communication, then we can get to the root of the problem,” says Tina Laboy, a certified eating disorder dietitian based in Texas. Laboy says she finds the most success with treatment when parents allow the treatment team to get to the root of the problem quickly, see what the child is communicating, and give full permission to eat all foods. “In that situation,” she says, “the child can then get their emotional and physical needs met without playing the game of the deprivation cycle.”
If you’re worried that a child may be suffering from binge eating disorder or another eating disorder don’t wait to seek professional help. I’d suggest seeing a certified eating disorder professional, or ask the health professional you do see if they’re familiar with an intuitive eating approach.
“Prevention of disordered eating will be accomplished when all foods are presented as emotionally equivalent, and a child can listen to their own hunger and fullness signals to navigate their eating,” Resch says. Regaining the innate skills of self-regulation is a key component of treatment that can empower a teen to move into adulthood without food and body concerns.
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