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Binge Eating Disorder in Teens

Characterized by recurrent episodes of rapid, excessive food consumption followed by extreme guilt, binge eating disorder impacts thousands of American teens each year. If your child’s addiction is occurring alongside this eating disorder, it is time to seek help.

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8 min read

What is Binge Eating Disorder?

Binge eating disorder (or BED) is a psychological condition wherein an individual habitually and uncontrollably consumes large amounts of food within a two-hour time period. After each binge, teens with BED experience deep shame and utter self-loathing. Because this medical condition is rooted in emotional rather than physical problems, your teen may not even be physically hungry during binges. Unlike bulimics, BED sufferers do not engage in post-binge compensatory actions such as purging or over-exercising. People who suffer from BED are usually quite embarrassed of their behavior, but do not know how to stop binge eating.

Binge eating disorder is a comparatively new diagnosis. In 1990, psychiatrist Robert Spitzer noted that some of his patients suffered from distressing binge eating episodes, but did not exhibit the purging behavior of bulimia. Spitzer spent the next several years leading research efforts dedicated to understanding and classifying this set of symptoms. As a result, BED was listed in the American Psychological Association’s Diagnostic Statistical Manual of Mental Disorders (DSM-IV) as a subcategory of Eating Disorders Not Otherwise Specified (EDNOS). In 2013, the fifth and most recent DSM finally listed BED as a distinct eating disorder all its own. This is an important breakthrough, as many insurance companies will cover treatment costs only if there is a legitimate eating disorder diagnosis.

Males vs. Females

Young woman on scale in casual clothes

It is a common misconception that eating disorders do not impact men and boys. Though anorexia and bulimia disproportionately impact females, BED is split almost evenly between the sexes. Millions of teen boys suffer from eating disorders, including BED. Out of the approximately 1.6% of adolescents that are impacted by BED, about 60% of BED patients are female, and 40% are male.

Sadly, since eating disorders are often regarded as a “female’s disease,” mental health stigma prevents many male teens from seeking help. Additionally, it can be more difficult to pinpoint BED in teen boys than in girls, because it is more socially acceptable for boys to eat large amounts of food.

What Causes Binge Eating Disorder?

The exact causes of BED differ from person to person and are often multifaceted. However, clinicians do have some insight into common threads that run through the lives of those with BED.

Traumatic Events

Sometimes BED is preceded by an unnerving event that has caused severe anxiety. Post-traumatic stress disorder (or PTSD) can result from a distressing event such as witnessing a murder, being assaulted or severely bullied or experiencing a car accident. Although PTSD has been linked to multiple eating disorders, it is associated with binge eating in particular. About 25% of teens who suffer from BED also have PTSD.

“People with PTSD have such a hard time focusing on the present and future because they are preoccupied with traumatic memories or trying to avoid traumatic reminders. Sometimes that means they don’t plan well for future meals, and [so] they may get very hungry and overeat or overeat compulsively.”

Rachel YehudaDirector of the Traumatic Stress Studies Division at the Mount Sinai School of Medicine

Rachel Yehuda, Director of the Traumatic Stress Studies Division at the Mount Sinai School of Medicine, sheds some light on the reasoning behind this strong association.

Physical Issues and Genetics

Unhappy Teenage girl sitting on floor looking at scale

Although BED is most often caused by emotional issues, sometimes physical issues can promote the development of the disorder. For example, hormonal imbalances can be the culprit behind a voracious appetite. Ghrelin, nicknamed “the hunger hormone,” tells the body when to start eating. Leptin, “the satiety hormone,” indicates satiety. Ghrelin and leptin levels may be skewed in teens with BED — especially if your teen is obese.

There can also be a genetic element involved in BED. If your child has a family member who has suffered from BED, he or she is twice as likely to suffer from the disorder as well.

Bear in mind, however, that although hormonal discrepancies and genetics can play a role in the development of BED, they are rarely the lone cause of the disorder. There are almost always emotional problems involved as well.

Co-Occurring Disorders

Teens with BED languish beneath a crushing amount of self-hatred. Oftentimes, depression and anxiety precipitate the development of BED, but the eating disorder only exacerbates any existing mental issues. Approximately half of teens with BED are also clinically depressed.

Sadly, many teens suffer not only from BED but also comorbid disorders such as substance addiction. When a mental disorder co-occurs with a substance use disorder, it is called a dual diagnosis. Nearly 50% of teens with BED also abuse substances. Oftentimes BED precedes substance abuse, and a teen turns to drugs or alcohol to alleviate the anguish of BED. But once substance abuse is added to the mix, your teen must deal with the vicious cycle of bingeing and using, both of which are done to combat the negative emotional impact of the other. Though these co-occurring disorders can be more complex to treat than an eating disorder alone, getting proper treatment means there is great hope for your teen’s full recovery.

Symptoms of Binge Eating Disorder

People with BED binge at least weekly, for a period of three months or longer. Additionally, any or all of the following symptoms may be present:

  • Uncharacteristically rapid eating
  • Consuming considerably more food than necessary
  • Feeling out of control while eating
  • Refusing to eat with other people
  • Anxiety
  • Feeling guilt or disgust after eating
  • Hoarding food
  • Depression
  • Obesity or fluctuating weight

Risks of Binge Eating Disorder

Although not all teens with BED are obese, many are. With obesity comes a litany of physical risks, including:

  • Breathing issues
  • Certain cancers
  • Diabetes
  • Gallbladder disease
  • Gout
  • Heart disease
  • High blood pressure
  • High cholesterol
  • Insomnia
  • Joint pain
  • Osteoarthritis
  • Stroke

The emotional risks of BED are equally as devastating as the physical ones. If your teen is suffering from BED, he or she is shouldering extreme shame about his or her bingeing behavior. This guilt does not improve self-esteem, which is often already dismal. Because bingeing is used as a coping mechanism for dealing with problems such as anxiety, depression and low self-esteem, the behavior then becomes cyclical. As bingeing episodes begin to take a toll on a suffering teen, everyday functioning is significantly impaired, leading to worsened depression and a lowered quality of life.

Some teens with BED begin to self-harm, as a way to cope with their inner turmoil.

“It’s generally held that [eating disorders] are fueled by an underlying level of anxiety, and they branch out in many different ways. The eating soothes the anxiety, but creates a new set of problems. Then they worry about being fat. Then [they] have to resolve that. Then they cut, [which] produces endorphins that produce an anti-anxiety effect.”

Dr. Richard PesikoffClinical Professor of Psychiatry at Baylor College of Medicine

Binge Eating Help

Anorexic woman with tape measure

Fortunately, there is light at the end of the tunnel. The harmful eating behaviors themselves can be modified, but unless their underlying causes are addressed, they could return. It is rare that either an eating disorder or a substance addiction can be cured without professional help. Discuss your options with a rehab professional who can help go over dual diagnosis treatment options that may be available. If your teen is suffering from both a substance use disorder and BED, specialized therapy will be required. Reputable treatment centers will aim to alleviate not just the symptoms of BED, but also treat the issues behind those symptoms.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (or CBT) is usually the most effective method for tackling BED. This form of talk therapy involves strategically exposing a person to the source of his or her anxiety, in an effort to reduce said anxiety. A therapist using CBT will help your child to identify triggering events and set up concrete steps to prevent future BED episodes. The overarching goal of CBT is to change your teen’s thinking about food and his or her body.

Interpersonal Therapy

Interpersonal Therapy (IPT) is another method of treating BED, when the eating disorder is accompanied by depression. This form of short-term therapy operates under the belief that depression is rooted in interpersonal problems — IPT focuses on identifying and remedying one or two of your teen’s most unhealthy relational tendencies. Interpersonal Therapy has proven especially effective in treating adolescents.

Does My Teenager Need Help?

A teenage girl looking in a mirror

If your child is suffering from eating disordered behavior and you recognize the signs of a co-occurring drug or alcohol problem, it is time to intervene. You can discuss the situation with one of our understanding and experienced treatment advisors at TeenRehabCenter.org, who can assess the facts and recommend next steps for you. Any conversation you have with us is both free and private.

We at TeenRehabCenter.org have spoken with many parents who have felt confused, angry, and scared due to their child’s addiction. Please know that you are not alone in this battle — we are here for you. Though it can be difficult to admit that your teen needs help, it is worth the effort a thousand times over. Together, we can get your child on the road to recovery. Call us today. There is no cost or obligation, just help.

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