Binge eating disorder (BED), like all eating disorders, can affect people of all ages and backgrounds. However, the treatment of BED in children and teens requires special considerations. Let’s explore the unique factors influencing BED in this population and how treatment can be tailored to their developmental needs.
Disordered eating trends in children and teens
A recent meta-analysis from 2023 found that over 1 in 5 children and teens across 16 countries exhibit signs of disordered eating, with girls being more affected than boys. This risk is even higher in children with a higher body weight (1). The presence of disordered eating increases the likelihood of developing an eating disorder later in life, making early intervention critical. Alarmingly, these behaviors are on the rise worldwide (1).
Binge eating disorder in children and teens
BED is defined by episodes of eating a large amount of food in a short period while feeling a loss of control. Other symptoms include eating rapidly, eating despite hunger/fullness cues, and feeling guilt or distress after binges.
However, diagnosing BED in children and teens can be complex:
- Growth and Development: Changes in appetite and eating patterns during growth spurts can resemble binge episodes.
- Hidden Behaviors: Shame or guilt may lead children to hide their eating, making it harder for parents to recognize the problem (1).
- Understanding “Loss of Control”: Younger children may struggle to articulate or identify feelings of losing control (2).
When and Why Does Binge Eating Develop?
BED often emerges in adolescence, though the median age for developing eating disorders, including BED, is around 12 years (1,3). Research estimates BED prevalence to be 1–5% among individuals aged 10–24, with girls more commonly diagnosed than boys (3).
Several factors may contribute to BED, including:
- Emotional Regulation Challenges: Binges may act as a coping mechanism for emotions like sadness, anger, or boredom (4).
- Co-occurring Conditions: Depression, anxiety, ADHD, and low self-esteem are associated with BED (4).
- Adverse Childhood Experiences: Factors such as household mental illness or violence, and food neglect may increase the risk of BED (5).
The Role of Weight Stigma
Weight stigma is a pervasive issue that can fuel disordered eating behaviors. Children and teens in larger bodies are more likely to face teasing, bullying, and biased attitudes from peers, educators, and even healthcare providers. This stigma can lead to:
- Higher rates of depression, anxiety, and low self-esteem (6).
- Avoidance of healthcare, delaying treatment and perpetuating disordered eating patterns (6).
- Harmful attempts to lose weight, which can trigger binge eating as a response to restriction or distress (6).
It’s crucial to recognize that weight gain is a normal part of development, particularly during adolescence, when significant growth occurs.
Weight stigma is incredibly problematic given that it ignores the genetic factors that contribute to our weight, and the fact that children and teens are supposed to gain a significant amount of weight in order to meet their developmental needs. In fact, it can be expected for some children to more than double their weight from ages 10 and 19, especially boys. The image below shows the expected weight gain for girls and boys if they were to follow their percentile curve on their respective growth charts (keeping in mind it can be normal to jump a curve!):
Treatment of BED in Children and Teens
Treatment for BED in children and teens must account for their developmental stage, emotional needs, and family dynamics. Key components include:
- Creating a Supportive Environment: Promote food- and weight-neutral attitudes at home.
- HAES-Aligned Care: Seek providers who use a Health at Every Size® approach to minimize weight stigma.
- Nutritional Support: Focus on meeting nutritional needs through regular, balanced meals and snacks.
- Family Involvement: When possible, include families in treatment to foster a positive home environment.
- Therapeutic Approaches:
- Cognitive Behavioral Therapy (CBT): Addresses eating-related thoughts and behaviors.
- Dialectical Behavioral Therapy (DBT): Helps manage emotional triggers for binges (2).
- Interpersonal Psychotherapy (IPT): Resolves social challenges contributing to BED (2).
Conclusion
Although less studied in children and teens than adults, BED affects a significant number of young people globally. Factors like underfueling, adverse childhood experiences, and weight stigma can increase the risk of developing BED. Addressing these challenges requires a compassionate, individualized approach.
At Sööma, our HAES-aligned professionals provide body-neutral care tailored to the needs of children and families. If your child is struggling with BED or disordered eating, contact our team at (202) 738-4726 or by email at info@fuelingforrecovery.com.
References
- López-Gil JF, García-Hermoso A, Smith L, et al. Global Proportion of Disordered Eating in Children and Adolescents: A Systematic Review and Meta-analysis . JAMA Pediatr. 2023;177(4):363–372. https://doi.org/10.1001/jamapediatrics.2022.5848
- Bohon C. (2019). Binge Eating Disorder in Children and Adolescents. Child and adolescent psychiatric clinics of North America, 28(4), 549–555. https://doi.org/10.1016/j.chc.2019.05.003
- Kjeldbjerg, M.L., Clausen, L. Prevalence of binge-eating disorder among children and adolescents: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 32, 549–574 (2023). https://doi.org/10.1007/s00787-021-01850-2
- Via, E., & Contreras-Rodríguez, O. (2023). Binge-Eating Precursors in Children and Adolescents: Neurodevelopment, and the Potential Contribution of Ultra-Processed Foods. Nutrients, 15(13), 2994. https://doi.org/10.3390/nu15132994
- Chu, J., Raney, J. H., Ganson, K. T., Wu, K., Rupanagunta, A., Testa, A., Jackson, D. B., Murray, S. B., & Nagata, J. M. (2022). Adverse childhood experiences and binge-eating disorder in early adolescents. Journal of eating disorders, 10(1), 168. https://doi.org/10.1186/s40337-022-00682-y
- Haqq, A. M., Kebbe, M., Tan, Q., Manco, M., & Salas, X. R. (2021). Complexity and Stigma of Pediatric Obesity. Childhood obesity (Print), 17(4), 229–240. https://doi.org/10.1089/chi.2021.0003
