Today we’re going to hear from a dad who is worried because his son has gained weight, and he wonders if it’s binge eating disorder. I’ll talk through some of the things to consider and help him make some decisions about moving forward.
My son was chubby as a kid, but a few years ago he got really healthy, lean and muscular. He exercised several hours every day, including when we were on vacation. He also had a really rigid keto diet and drank protein shakes to stay in shape. It was a little annoying frankly, but I was proud of his fitness and appearance so I supported him.
During quarantine, he lost all his motivation to work out. He stopped going to the gym and running, and basically all his workouts. He started eating carbs again and now he just basically sits around on the couch and binge eats all the time.
His weight has gone way up, and he’s lost the amazing athletic build he worked so hard to achieve. I want to say something, but I’m not sure how. Can you help?
Hi Jake, I can completely understand why you’re concerned. Whenever we see a major behavior change in our kids we should look carefully at it. We want to determine whether something is wrong. And lots of people worry that when a child has gained weight it may be binge eating disorder.
Before I address your question about your son’s weight, let’s back up. I want to take a look at the previous massive change in his behavior: over-exercising and food restriction. You described these behaviors as healthy, but they sound like eating disorder behaviors to me.
What eating disorders look like
Eating disorders can be harder to spot in males, mainly because they present themselves quite differently than what we typically think of. The most obvious eating disorder that we think of is medically underweight anorexia. But that is actually the least common eating disorder.
Fewer than 5% of people who are diagnosed with an eating disorder are medically underweight. The majority of people maintain what is medically considered not underweight.
But they may still be underweight based on what their body is programmed for. And they may still have a serious eating disorder. Body diversity is a real thing, and a body that has always been on the larger side is likely naturally meant to be on the larger side.
So what I’m hearing is that your son was limiting food, closely monitoring food, having unusual food requirements, and engaging in rigid, excessive exercise. These behaviors had a physical impact, but since it wasn’t weight gain or emaciation, it looked healthy to you.
Eating disorder behaviors have been prescribed as healthy in our culture, especially for kids who are naturally larger. We are constantly told to increase exercise and reduce food intake, and doctors regularly tell parents to watch kids’ weight.
So I understand why you saw your son working out and restricting his food as a positive, healthy thing.
And of course looking at your son and seeing a thin body, someone who appeared fit and healthy, felt good. We have been taught that weight and appearance is how we judge health, and parents want their kids to be healthy. So I totally get this.
But what your son was doing sounds excessive. It’s possible he was engaged in an eating disorder. And this restrictive eating disorder may have set up the binge eating and the weight he’s gained since.
The human response to excessive restriction is going to the opposite extreme and completely relaxing and compensating for the effort of restricting and over-exercising. What I’m hearing from you is that your son became obsessed with refinding his shape and size by using eating disorder behaviors.
What we don’t know is whether his behavior now is a sign that he has recovered from his eating disorder or has shifted into another eating disorder like binge eating disorder or bulimia. I’m definitely concerned about this major shift in his behavior.
What I recommend
What I recommend is that you schedule a mental health check up for him.
Please leave weight out of the conversation. I know that your greatest concern is his weight gain, and I understand where that comes from. But research definitively shows that focusing on kids’ weight has no positive impact and significant negative impacts.
So I would focus instead on how he is feeling rather than what he’s doing. What we do is a symptom of how we feel.
So when he started obsessively exercising, he may have been feeling like his body needed to be controlled and dominated to be acceptable. And when he was rigidly planning his food and restricting an entire nutritional category, he may have been worried that his weight was an indication that he was bad, and the only solution was to lose weight.
Is this an eating disorder?
Now that you’re seeing him relaxing and lounging, it could be that he has accepted his body. That would be a bit unusual after what you’ve described to me, but it is possible.
Alternatively, he may be overwhelmed by the effort it takes for him to achieve what society deems as healthy and fit. He may be depressed because even after all that effort, his body wasn’t permanently fixed, and required a tremendous amount of work to look that way.
He may be binge eating and resting because his body lost out on the calories and nutrients it needed for a long time and it needs to regain the weight it lost to achieve health.
There are so many things that behavior can tell us. And I’m not here to give the answers today, but instead to ask the questions. What I’m interested in more than the weight gained is whether he had a restrictive eating disorder and whether that’s morphed into binge eating or something else now.
Weight is not a behavior
Also remember that weight is not a behavior. Eating and exercise are, but weight is not. When we have a child who has always been at the higher end of the weight scale, that is likely going to be their natural weight range for life. Trying to move down the weight scale on purpose almost always results in binge eating and weight cycling.
This, along with eating disorders, is the dangerous outcome of our cultural obsession with weight.
We prescribe intentional weight loss through food restriction and over-exercise. And the natural, physiological response in more than 95% of cases is weight regain, often plus more, and a bunch of side effects.
So I think that your son would benefit from a mental health check-up, which should probably involve at least a few meetings with a therapist who has experience with eating disorders. Weight is a really touchy issue, so again, don’t make this about weight. Make it about health.
And I also recommend a meeting with a non-diet dietitian who can help your son learn about eating to fuel his unique body.
The non-diet approach
I believe it is crucial to work with non-diet providers who practice Health at Every Size. I have a list of providers to help you get started.
Meanwhile, it would be great if you and the rest of your family could learn about the non-diet approach to health. Essentially, a non-diet approach still pursues healthy behaviors like eating well, moving the body, emotional hygiene, and getting enough sleep. But it does all of this without a weight or shape goal.
And we do this based on the belief that we don’t need to dominate and control our bodies, but rather that we need to respect and listen to our bodies. This has been shown to be both protective against eating disorders and healthier for the body and mind.
I know this can be a big shift for people to take on. I’ve got an article showing the science behind the non-diet approach to help.
What is health?
And this is something I work with a lot of parents to do. Most of us have been taught that weight equals health, so we need to redefine what it means to raise a healthy kid.
What does health mean, and how are we helping, not hurting our child’s chances of being healthy and happy for life? These are questions that are addressed with the non-diet approach to health.
Jake, I know it’s hard to see your son change so quickly. And I am really concerned about it. Please get your son assessed and get him some dietary counseling to help him pursue true health free from weight stigma.
I hope this has been helpful and given you some ideas about next steps.
I wish you and your son all the best as you move forward.
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