Binge eating disorder (BED for short) is a relatively new diagnosis, although binge eating has been around for a very long time. While many teens binge eat from time to time, the behavior becomes problematic and serious when it’s occurring on a regular basis. Since the excessive eating often occurs in secret, it’s not always apparent to many parents. Others may see the binge eating episodes, but mistakenly attribute them to an “adolescent growth spurt” rather than consider the possibility of a serious mental health issue.
When it comes to your teen’s eating habits and psychological well-being it can be difficult to determine what’s normal and what’s not. This brief guide is designed to help you know the signs to look for and the steps to take if you suspect your teen may have binge eating disorder.
Binge Eating Disorder Statistics and Facts
Following are several statistics and facts pertaining to binge eating disorder:
- Although most people associate eating disorders with females, an estimated 40% of individuals suffering from binge eating disorder are male
- In the U.S., binge eating disorder is the most common eating disorder
- The onset of binge eating disorder typically occurs during the late teens or early twenties, although it can potentially start much earlier or later in life
- Anyone can develop binge eating disorder, regardless of education, income, or race
- Like other disorders, individuals with binge eating disorder are more vulnerable to having or developing depression, anxiety, and suicidal thoughts and behaviors than those who don’t have an eating disorder
- Studies have shown than approximately 1 in every 3 women with binge eating disorder have struggled with suicidal thoughts, and an estimated 15% of women with the disorder have attempted to kill themselves at some point
Co-Occurring Disorders
It’s not uncommon for teens with an eating disorder to also have another psychiatric disorder. The most common co-occurring disorders include:
- Mood disorders, such as depression or bipolar disorder
- Anxiety disorders
- Substance use disorders
- OCD (obsessive-compulsive disorder)
Individuals with BED often have a history of trauma. The may intentionally harm themselves at times as a way to cope, often by burning or cutting themselves.
Risk Factors
No one knows the exact cause (or causes) or binge eating disorder. However, things that may cause your teen to be at greater risk for developing it include:
- Family history
- Negative self-image
- Difficulties expressing and / or tolerating painful emotions
- An addiction to alcohol or drugs
- A history of trauma (e.g. physical or sexual abuse) or neglect
- Conflicted relationships with those closest to them
- Being teased or discriminated against due to their weight
- Major weight fluctuations over time
- Frequently dieting
Potential Complications of Binge Eating Disorder
Binge eating disorder may cause a variety of issues, both short-term and long-term. These include:
- Low self-esteem
- Difficulties functioning in various areas of life
- Feeling socially isolated
- Significant weight grain or obesity
- Health issues including type 2 diabetes, point pain, sleep apnea, heart disease, osteoarthritis, gall bladder disease, high cholesterol, high blood pressure, digestive problems, gallbladder disease
Looking for and Recognizing the Signs of Binge Eating Disorder
Knowing what to look for and how to recognize the symptoms of binge eating disorder in your teen will enable you to intervene sooner than later. This is especially important with eating disorders as they become increasingly difficult to treat with time. One of the most important things to remember:
- Look for and pay close attention to any changes from your teen’s normal personality or behavior
Signs to watch for include:
Signs that your teen may have binge eating disorder include the following:
- Frequently finding food wrappers or containers, often in the trash or in your teen’s bedroom
- Noticing large quantities of food frequently disappearing, and not knowing who ate it (e.g. you just bought a large bag of chips or box of cookies and they’re gone, but no one is owning up to eating them)
- Eating really fast (literally “scarfing” down his or her food)
- Significant weight gain, or noticeable weight fluctuations. Individuals with binge eating disorder are often overweight, but their weight may also go up and down frequently
- Frequent late-night eating; it’s not uncommon for individuals with binge eating disorder to binge late at night when others aren’t likely to notice
- Finding food hidden in unusual places in your teen’s bedroom, car, or throughout the house
- Frequently skipping meals or eating very little at mealtime, but continuing to maintain or gain weight – the secret bingeing is what keeps weight relatively level or causes weight gain
- Continuing to eat even though they’re uncomfortably full
- Eating in secret – binge eaters often feel ashamed of their behavior and will go to great lengths to hide their excessive eating
- Difficulties coping – binge eaters often use food as a coping mechanism, attempting to “stuff” unpleasant feelings
- Frequently going on diets, at least for a short while (it should be noted that they often don’t lose any noticeable weight from dieting)
- Consuming excessive amounts of food in a short period of time
- Feelings of shame or guilt, especially after a binge eating episode
- Signs of depression or anxiety
- Suicidal thoughts or behaviors*
*Suicidal thoughts or behaviors should never be ignored. Don’t assume your teen is just being “dramatic” or manipulative. The risk of suicide is particularly high for individuals suffering from an eating disorder, including binge eating disorder.
Knowing the First Steps to Take
If you’ve been noticing signs that suggest your teen is struggling with binge eating disorder, take the following steps manage the situation and helping your teen:
1 – Have a conversation with your teen. Let your teen know that you are genuinely concerned regarding the behaviors you’ve been observing. Assure him or her that you want to help in any way you can, and that you’re there if he or she wants to talk – about anything.
Expect the wall to go up. Individuals with eating disorders are often either in denial or highly reluctant to admit they have a problem. Your teen may become defensive. Instead of reacting, strive to avoid criticizing, shaming, or judging our teen in any way, as those tend to make things worse. If your teen does disclose symptoms that strongly suggest an eating disorder, strive to remain calm.
2 – Set up an appointment for an evaluation. Your teen’s pediatrician or your family doctor can do an initial evaluation, including a physical examination to rule out any underlying medical issues that may be causing or contributing to your teen’s disordered eating.
With eating disorders, however, it’s essential that you have your teen undergo a thorough evaluation by a psychologist or psychiatrist early on. Look for one who not only specializes in treating children and adolescents, but who also has substantial experience in treating eating disorders. These professionals have the specialized training to identify and understand the complex challenges, potential complications, and emotional aspects of binge eating disorder in this age group. Your family doctor may be able to give you a referral or recommendation.
3 – Get your teen into treatment. Early intervention is crucial with eating disorders, as they become increasingly difficult to successfully treat if treatment is delayed.
Eating disorders are often addressed with a multi-faceted approach that often includes a combination of:
- Individual psychotherapy or “talk therapy” – Psychotherapy can help your teen understand binge eating disorder, including the underlying issues (e.g. a distorted body image). Evidence-based therapies for BED include: 1200
- Cognitive Behavioral Therapy
- Interpersonal Therapy
- Dialectical Behavior Therapy
- Mindfulness-Based Therapies
- Family Therapy – This is often a necessary component of successful treatment for eating disorders. It addresses unhealthy family dynamics that may be contributing to and reinforcing your teen’s binge eating disorder. Family therapy can also be helpful by teaching parents and other family members how to be supportive without enabling.
- Nutrition counseling – Nutrition counseling can help your teen reach a healthy weight. A registered dietician (RD) usually provides this component of treatment.
- Dual diagnosis treatment – Substance abuse problems often co-occur with eating disorders. Dual diagnosis treatment is designed to simultaneously address the eating disorder and the substance use disorder. It’s often offered in conjunction with an outpatient or residential treatment program.
- Medication – Medication may be prescribed to help treat your teen’s binge eating disorder. Vyvanse (lisdexamfetamine dimesylate), a drug used to treat ADHD in children age 6 or older, was approved by the FDA in 2015 to help treat binge eating disorder in adults. It is not currently approved for treating BED in adolescents. Other medications that are sometimes prescribed for BED include SSRI antidepressants and Topamax, an anti-seizure drug.
- Residential treatment – Teens with eating disorders often benefit from residential treatment. This allows them to focus on healing round the clock in a supportive and therapeutic environment. There are many residential treatment centers throughout the country that specialize in eating disorders.
- Hospitalization – Teens with binge eating disorder may need to be hospitalized in a medical or psychiatric unit, usually in more severe cases and / or when serious medical complications or psychiatric issues need addressed
Supporting and Encouraging Your Teen
Binge eating disorder can have a serious negative impact on your teen’s life. As a parent, two of the most crucial things you can do to help is to provide ample support and encouragement. Two important things to remember are 1) binge eating disorder isn’t an indicator of weakness or lack of discipline and 2) it isn’t something your teen can simply “overcome” by sheer willpower and determination. Think of it as you would any other serious health condition.
Ways you can be supportive include:
- Learn everything you can about binge eating disorder. This will enable you to have more empathy and compassion for your teen
- Make yourself available (and willing) to listen and let your teen know you’re there for him or her, but refrain from pressuring your teen to open up to you
- Don’t minimize, ridicule, or shame what your teen is experiencing
- Strive to avoid commenting on or discussing your own, your teen’s, or other people’s weight or appearance
- Model healthy behaviors for your teen, including healthy ways to manage stress, healthy self-acceptance, and having a healthy relationship with food (if you struggle with any of these yourself, consider working with a therapist to address them)
- Avoid nagging or lecturing; it can make things even worse by adding further stress to your teen’s life; instead, talk to your teen in a respectful, honest, and open manner
- Respect your teen’s privacy. Your neighbors, relatives, and friends don’t need to know about your teen’s battle with binge eating disorder
- Respect your teen’s experience, even though you may not be able to understand it; the behaviors associated with eating disorders often seem irrational and extreme if you’re on the outside looking in
- Take an active role in y our teen’s treatment
- Refrain from offering overly simplistic solutions; remember, eating disorders are complex
- Be patient and understanding, but avoid enabling your teen
- Strive to create a peaceful and calm home environment
What to Do When Things Escalate
Dealing with binge eating disorder may feel like an emotional roller coaster ride for your teen. If there’s a co-occurring mental health issue, such as moderate to severe depression, the risk of suicidal thoughts and behaviors is quite high. Additionally, health complications may lead to a medical emergency if not monitored closely and addressed in a timely manner.
If your teen is becoming increasingly depressed or manic, actively suicidal, engaging in self-harm, physically weak, or exhibiting any type of medical distress, you must take immediate steps to ensure his or her safety and wellbeing. A visit to the nearest ER or a brief hospital stay may be necessary to stabilize any medical issues, keep your teen safe from self-harm, and / or get serious depressive symptoms under control.
Don’t hesitate to reach out for help. You can:
- Contact your child’s treatment provider asap
- Enlist the help of a close family member or friend for support or assistance
- Call an emergency hotline
- Take your child to the nearest hospital emergency room (if you can do so safely)
- Call 911
When Individual Therapy isn’t Enough
Eating disorders can be very difficult to treat, which is why individual therapy alone often isn’t sufficient. Your teen may need additional treatment and support beyond what individual therapy can provide. A more intensive level of treatment may be necessary to help your teen learn to effectively manage and, ultimately, recover from binge eating disorder. Consider further treatment for your teen if he or she is:
- Frequently relapsing or sabotaging any progress made in therapy
- Refusing to follow the treatment recommendations made by his or her therapist
- Experiencing severe depression, anxiety, or other psychiatric symptoms that require a higher level of care
- Threatening or planning suicide, and / or engaging in suicide gestures or attempts
- Developing or experiencing serious or potentially life-threatening medical problems related to his or her binge eating disorder
This may involve one or more of the following:
- Intensive outpatient treatment (IOP) / Psychiatric day treatment
- Residential treatment
- Inpatient psychiatric treatment
- Hospitalization on a medical unit (to monitor and stabilize medical issues)
Intensive outpatient treatment or psychiatric day treatment can vary in terms of the amount of time spent in treatment and how many times a week your teen is required to go. These programs are often the next step up from regular outpatient treatment.
Residential treatment requires having your teen stay at a non-hospital treatment facility that specializes in treating adolescents with eating disorders and other mental health disorders. Residential treatment typically lasts between 30 to 180 days, depending on the severity of symptoms and your child’s rate of progress.
Inpatient psychiatric or medical hospitalization is the highest and most intensive level of treatment for adolescents with eating disorders. It involves admitting your teen to an adolescent psychiatric or medical hospital unit where medical staff is on hand to monitor patients 24/7. This level of treatment may last for a few days to several weeks, and is particularly beneficial for teens who are a danger to themselves due to severely disordered eating, strong suicidal thoughts and behavior, or severe depression.
Each of these intensive levels of treatment typically provides daily or bi-weekly visits with psychiatrist and various types of daily therapy.
Taking Care of Yourself
As mentioned earlier, eating disorders can take a toll on the entire family. As a parent, you will likely struggle at times with your own anxiety, frustration, and stress. It’s important to take care of yourself, especially while your teen is recovering. Things you can do include:
- Surrounding yourself with ample support, through a support group, therapy, and friends and family
- Getting sufficient rest so you have the energy to help your teen
- Making time for yourself
- Finding effective ways to manage your stress, such as yoga, meditation, and regular exercise
Countless individuals recover from binge eating disorder and learn to have a healthy relationship with food and with their bodies. Hold on to the hope that, with proper treatment and support, your teen can recover and heal from binge eating disorder