Binge eating disorder can be a tricky subject, so when a dad reached out to get my opinion on whether his son has binge eating disorder, I dove into several questions. Binge eating is sometimes an adaptive response to not eating enough food. Other times though, it’s a serious eating disorder.
So I asked a lot of questions to try and find out more so we can point the dad in the right direction for getting help.
My 16-year-old son has started binge eating. He eats a lot of food. For example, yesterday he made himself an entire package of hot dogs and ate them all, with buns, and then ate an entire bag of cookies.
He’s gained quite a lot of weight lately, and food is going missing lot. He’s also been hiding out in his room and generally seems more secretive.
I don’t know what I’m supposed to do. Does my son have binge eating disorder? Should I call a therapist? Doctor? Nutritionist? Can you help?
Well, Marcus. First of all I want you to know that I fully understand how alarming this is.
We all want our kids to be healthy, and the way they eat food is an important part of that.
Of course, I can’t diagnose your son’s behavior. I can’t definitively say whether your son has binge eating disorder. But I do have some questions that should help you, and at the end I’ve provided my recommendation for what to do once you’ve answered them:
1. Is he eating regular meals?
My first question is whether he is eating regular meals on a fairly regular schedule?
I ask because most teenagers are erratic eaters unless their families implement structured mealtimes. So what I’m curious about is whether you know if he’s getting at least breakfast, lunch, dinner, and about two nutritionally balanced snacks per day.
We want to start there because sometimes binge eating is a fairly simple response to getting too hungry. When the body gets too hungry, it screams out for food. This is often where we see binge eating happen.
For example, if he ate nothing all day and then came home really hungry from school, a bunch of hot dogs and cookies might have been what his body needed to get the calories he should have been eating throughout the day.
While it may seem like a lot to eat in one sitting, if you look at how many calories a kid of this age needs to function through the day, it might make a lot of sense. So you want to consider whether he’s eating regularly throughout the day to manage his hunger levels and avoid getting too hungry.
2. Is he restricting food at other times?
Next, I want to know whether he is restricting food at other times.
What I was talking about earlier is unintentionally skipping meals because of a lack of structure. But on the other side of that, when we intentionally skip meals or feed ourselves too little because we are trying to lose weight or avoid weight gain, we also tend to binge eat.
We live in a culture that perceives dieting and intentional weight loss as a good thing. This means that a lot of kids think that it’s healthy to skip meals, cut out carbs or sugar, or otherwise limit their food.
But what we know is that when people do this, the natural human response is that our bodies demand the nutrients we’re denying them. This is often where binge eating begins.
For example, if he is waking up really hungry but limits his breakfast to a piece of bacon and diet soda, then eats a turkey lettuce wrap for lunch and a diet soda, his body is going to be craving carbs. This is how our bodies keep us healthy – they tell us what they need with cravings.
So in this case, the hot dogs and cookies might seem extreme, but it’s actually just his body’s way of demanding the carbohydrates it needs. So you want to consider whether he is intentionally restricting his food intake because it can be the reason for binge eating.
3. Is the secrecy normal teenage behavior?
Next, I want to try and address the secrecy you described.
So, secrecy can be a symptom of binge eating disorder, but it can also be normal teenage behavior. What we want to try and tease apart is why is he being secretive.
For example, he gets over-hungry and eats a bunch of hot dogs and cookies, you may respond with a shocked look or say something like “are you really going to eat all that?”
Now I understand how natural that feels, and I get it. But that response may result in him feeling ashamed of his need for food.
If that’s the case, his secrecy is his way of hiding from feeling ashamed of his hunger. And that is a big concern to me. On the other hand, we have to recognize that teenagers naturally become more secretive as they grow up.
Most of them figuratively and literally close their doors to us more often as they grow up. So we always have to ask ourselves if a teen’s secretive behavior is normal, or if it’s in response to shame.
4. Is the weight gain a symptom of health or illness?
Finally, let’s address the issue of weight.
In our culture we generally assume that weight gain is bad and weight loss is good. However, that’s a pretty dangerous way of thinking about things.
When it comes to teenagers, parents are rarely told that puberty, which can last as long as four years, often requires significant weight gain. It can be alarming to see your child gain the weight that’s required for puberty, but many times it’s just part of their biological process of maturing.
Also, it’s important to know that body diversity is a real thing. Not every body is supposed to be thin.
So you want to look at his overall growth and determine whether he’s jumped to a new weight category or if he’s still following approximately the same path his whole life.
The weight gain may be a symptom of an eating disorder, but we want to be careful about pathologizing something that might be perfectly healthy.
5. What to do?
OK, so what should you do?
Binge eating disorder is a serious eating disorder that can lead to a lifetime of suffering. If your son is binge eating, you do want to take that seriously.
So I think the best place to start is to consider the questions I’ve asked. If you think that he’s eating regularly and is not restricting food, and if you think his secrecy and weight gain may actually be a part of his natural development, then there’s less reason for concern.
Look carefully at whether you are judging how much he is eating and his weight, and work to reduce your reactions. Encourage him to eat regular meals and eat enough. Schedule family meals and encourage him to eat enough food to sustain his growth.
However, if you think that he is restricting his food and that there is something really off with the secrecy and weight, that might be more of a concern.
Get some help
Either way, I would recommend reaching out to a qualified Registered Dietitian.
I have found that this can be one of the best ways forward with binge eating disorder, simply because RDs are usually able to evaluate whether we’re looking at an issue of food structure or an eating disorder. Doctors just aren’t trained in looking at weight and eating through this lens.
I suggest finding an RD who practices Health at Every Size and specializes in eating disorders. A general RD can, unfortunately, cause more harm than good in binge eating situations. I’ve put together a directory of RDs who I consider to be “eating disorder safe,” which you can find here.
Most of them work remotely, so you don’t have to find someone in your city to get started. A single consultation should give you a lot of ideas about what you need to do next.
I know how stressful food issues are, and I just want you to know that I know you’re doing the very best you can. I hope that if your son has binge eating disorder, you are able to get him the help he needs. And I hope this has been helpful.
You can listen to this article as a podcast. Check it out and subscribe using your favorite podcast player.