Binge Eating Disorder

July 09, 2024

Lucy Robinson

About the Author: Lucy is a low-intensity cognitive behavioural practitioner who treats and assesses adults who experience common mental health difficulties within the NHS.

What is Binge Eating Disorder (BED)?
Symptoms of BED in children and young people
Causes of BED in children and young adults?
Treatment options
What types of professionals are involved?
The recovery journey
How to support someone with BED
How can parents support their child with BED?
Useful resources

What is Binge Eating Disorder?

Binge Eating Disorder (BED), is a type of eating disorder characterised specifically by binge eating episodes. These binge eating episodes are where someone feels out of control of their eating behaviours.

This is not the same as eating more biscuits than you wanted or having a few more crisps. This is eating any type of food, healthy or unhealthy, past the point where you feel full.

People will report feeling physically nauseous because they have eaten so much, however, they still feel like they cannot stop. It is this lack of control over your response to food which plays a key role in BED.

It is estimated that 3% of children experience binge eating behaviours. However, due to the shameful nature of BED, people who experience this disorder can go to great lengths to hide their symptoms and may experience it for a while before reaching out for help.

Symptoms of BED in children and young people

As outlined above the main symptom of binge eating disorder is eating excessive amounts and continuing to eat, even when feeling full and physically uncomfortable due to the amount eaten.

The other symptoms that may come with this are outlined below:

Eating in private
Eating faster than usual
Feeling shameful and guilty after overeating
Experiencing self-depreciating thoughts after a binge eating episode.

Signs that may indicate that someone is hiding BED in your household:

Social withdrawal
Consistently changing weight
Food stashed in places around the house
Food wrappers in the bin you do not recognise
Food that goes missing

Causes of BED in children and young people

Binge eating disorders in children can be caused due to a variety of factors. While binge eating disorder can be caused by one triggering event, it can also be caused by a mixture of factors:

Genetics (family history)
Family eating habits
Deficits in impulse control
Emotional issues such as going through bullying and family troubles
Depression
Anxiety
Dieting behaviours

“Jenny’s mum has noticed that there are a number of food wrappers hidden under the sofa in the living room. She has started to realise that food is disappearing from the cupboards and has noticed that Jenny has been gaining weight and speaking negatively about herself. Jenny’s dad notices that Jenny is eating in secret and speaks to Jenny’s mum about it who mentions that she has seen Jenny hide food. They decide to speak to Jenny about it who tells them that she is struggling with eating and not being able to stop even when she is in pain because she is so full. Jenny’s parents say that it might be helpful for Jenny to speak to an expert”

Treatment

Guided self-help

This is a form of low-intensity cognitive behavioural therapy. It involves working through a structured treatment where most of the tools and techniques the child and/or young person learns will be implemented in their own time. They will then check in with a practitioner such as a specialised Psychological Wellbeing Practitioner (PWP) who will help to problem-solve any difficulties that come up, talk through new techniques, and monitor any changes.

Cognitive Behavioural Therapy

Cognitive behavioural therapy for eating disorders (CBT-E) is a specific form of cognitive behavioural therapy that targets eating disorders including BED. Research shows that it is effective in helping adolescents with binge eating disorders.

The idea behind CBT-E is to learn how to manage the behaviours and the thoughts that drive and maintain the binge eating disorder. The sessions will compromise many elements. There is firstly a formulation of how the binge eating disorder is maintained. There will then be a session targeting how to manage thoughts and emotions that come with binge eating and how to change the behaviours associated with it including the specific triggers. There can be home practice given as part of the therapy, this will help to consolidate what the patient has learnt and how to explore more about their disorder.

This will start out in a group setting and if that is unsuccessful individual cognitive behavioural therapy with be offered.

Medication

Currently, in the UK, it is not recommended that medication is prescribed for solely the management of BED in children and young adults.

What types of mental health professionals are involved?

There are different professionals that may or may not be involved throughout the treatment process of BED for children and young people. These might include, psychotherapists, cognitive behavioural therapists and doctors/psychiatrists, mental health nurses, support workers and social workers.

Psychotherapists

Psychotherapists have usually had about three years of training and use different modalities of therapy to best suit your needs. This means that it is not as structured as other types of therapy, but the psychotherapist will pull on what they feel is going to be most effective for you at that point in time.

Cognitive Behavioural Therapists

This is the therapist the child/young person is most likely to be treated by for BED. These are therapists who have been trained in Cognitive Behavioural Therapy using this model to form an idea of a patient’s mental health difficulties and to treat them. The cognitive behavioural therapist will support the child in managing their eating behaviours, changing their thought patterns and other symptoms throughout sessions.

Doctors

These are professionals who are trained in medicine. They may signpost you to different services that are most appropriate to treat you.

Psychiatrists

These are professionals who are also trained in medicine. However, they also specialised in the field of psychiatry. So they can provide consultation and medication for a wide range of mental disorders such as anxiety, depression, schizophrenia, psychosis, bipolar disorder and so on.

Mental Health Nurses

Nurses trained in mental health might also be involved with the child or young person. If the child or young person is in a hospital setting or is seen by a crisis team due to self-harm or suicide, a mental health nurse might help to give treatment by administering medication.

Support Workers

‍Workers trained in helping vulnerable people to live better lives might also be involved with the child or young person. This might be within a community setting or a crisis situation. Their role is to provide emotional and practical support (e.g. helping parents to cope, helping with paperwork, and making child-care arrangements).

Social Workers

Workers trained in protecting vulnerable individuals might also be involved with the child or young person. This might also be within a community or a crisis situation. Social workers will problem-solve and organise the right support for the child or the young person to ensure their protection.

The Recovery Journey

The journey of recovery from BED can look different for each child or young person depending on the approach that the therapist uses. But there are some things that are expected when going through therapy for BED.

Assessment

This is an important phase, where the therapist will get a feel of what is going on with the child or young person. The therapist might try to identify the severity of the BED, along with other important background information. The therapist will ask some questions, including certain questions about the possibility of self-harm or suicide. This will help to create a full picture of what is going on and to know what type of treatment will be most helpful.

Therapy sessions

These sessions will take place at a time and regularity that suits the child or young person and their parents. An important aspect of the therapy session is the relationship that the therapist will build with the child or young person. This will create a safe space that will encourage them to talk about their feelings. The child will be able to develop a better understanding of their feelings and learn helpful ways to tackle BED.

Homework

This can be an important part of treatment for BED, especially when having CBT. This is because BED affects everyday situations in the child or young person’s life. So, homework tasks will really help the child or young person to develop a sense of achievement and mastery over BED.

Progress and setbacks

When having treatment for BED, there will be progress and there may be setbacks. For example, because of the BED itself, a child or a young person might find it hard to believe that therapy will help. It is important not to feel discouraged when this happens, as these types of setbacks can be quite normal when dealing with BED. These situations provide opportunities to discover new ways to move forward together with the therapist.

Ending therapy

The therapist will eventually prepare the child, young person and parents for the end of therapy. This is a very important phase because it is vital for the child or young person to become confident in coping with difficult feelings without relying too much on the professional. The end of therapy will take place once the child or young person has made a lot of progress or has completely recovered from BED. The child or young person will leave therapy with many skills that they can use without the help of the therapist.

Follow up

There might be an agreement with the therapist to have a follow-up meeting. This is to check how the child or young person is coping. If they are doing well, there will be no need for more support. But if they continue to have challenges with BED or any other issues, this will be an opportunity to have extra support.

How to support someone with BED

When your loved one is experiencing BED it can feel like it is out of your control. There are, however, a few things you can do to help.

Understand binge eating disorder

Just like anything else, having a good understanding of what your loved one is struggling with is always a good idea. It means you will recognise their symptoms more and how they might manage those symptoms. Having BED can feel quite isolating, so to feel as if someone has knowledge about it can have a real impact.

Show acceptance

A real struggle for those with BED is the negative self-voice those who struggle with it have. They will already be struggling to accept themselves so showing acceptance is a great way to lead by example. This means that when they raise or explain symptoms with you, don’t try to give a different point of view just listen and accept.

Give validation

Validating the impact that BED will be having on their life is incredibly important. A good example of how to validate how someone is feeling is when they tell you how they are feeling saying things such as ‘I can imagine you are feeling that way, it must be hard’ or ‘That makes sense you are feeling that way with what occurred’.

E.g. I can imagine that you are feeling out of control, it must be quite scary.

Ask and listen to what they need

When people are angry or frustrated it is usually because they feel as if they are not being listened to. Asking your loved one how you can help or if they need anything from you and then implementing that (as best as you can) makes them feel listened to and less isolated.

Don’t contradict

It can be a really normal reaction to have to contradict a loved one when they say things about themselves that are not nice. Instead of saying ‘that is not true’ or ‘don’t be silly’ encourage them to share what makes them think that. Exploring the cause of the thought and trying to manage that cause encourages more conversation whereas contradicting their thoughts shuts it down.

Avoid comments

Comments surrounding food, weight and general appearance should not be made to a child in general but specifically to one who is struggling with an eating disorder. These comments, however small, can have a big impact on a child and can be very triggering.

Look after yourself too

There is a saying that you cannot pour from an empty cup. This means that we cannot give time and energy to looking after others unless we have looked after ourselves to make sure we have that time and energy in the first place. Make sure you lean on your own support network when supporting someone else as it can be very draining and challenging at times.

Help them find the right support

Encourage them to find support through a GP or therapist. If this involves your young child, you can contact these services. You might:

Help them to search for a therapist
Help them to book an appointment with a GP or therapist
Offer support when they attend appointments (e.g. waiting in the waiting room or attending some sessions if you need to)
Help them search for support groups or self-help resources
Encourage them to keep attending sessions and to not give up
Give them small reminders to do their homework assigned by the therapist

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How can parents support their child with BED?

When having a child and/or young person experiencing BED as well as the above there are other things you can do:

Support them to implement their home practice within their daily life.
Listen to your child if they do not want to tell anyone. It is their prerogative who knows and to maintain trust in your relationship it is important to listen to that.
Make sure you ask how your child is finding therapy. It can be difficult for a child to feel safe to voice their opinion of therapy to their therapist. Listening and then advocating for your child means that their treatment will be the best suited for them.
Keep any changes to the daily lives as normal and lowkey as possible e.g. if you decide not to buy particular triggered foods make this a really normal thing to everyone else in the household and if you do speak to them about it ask your child how they would like to approach that.
Make sure not to only focus on your child that is struggling. it can be a tricky balance but if there are other siblings, undivided attention can lead to fractures in relationships.
Make sure they feel cared and loved for. Sounds simple, but just telling your child that you love them and are here for them can have a big impact.

For urgent support

To get urgent help, you or your loved one should contact the NHS urgent helpline or the Samaritans.