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 compulsion.”
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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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.