Childhood Obesity and Binge Eating

"Energy Imbalance" vs.
"Disordered" Eating
Some children who weigh-in over a healthy weight have an "Energy Imbalance". That means they eat more calories than they expend in physical activity. Therefore, they gain weight or maintain a weight that's higher than healthy. These children may not have any emotional issues that contribute to overeating. Their weight may reduce to a healthier range if they are taught more about healthy eating and they become more physically active. Still, other overweight children may be suffering from "Emotional" or "Disordered" eating patterns. Some may have some degree of depression and an actual binge eating disorder. If that's the case, the child may be using food and maladaptive eating behaviors to take care of emotional needs. For example, food may be what the child is using to self-soothe, to regulate his or her mood, to "stuff" down feelings in an effort to feel better.



Signs And Symptoms Of
"Disordered" Eating In Children

• The child often appears preoccupied with food: his or her next meal or snack

• The child may be eating more than usual and still says he or she is hungry

• The child may eat very rapidly

• Parents may find evidence of constant eating, sneaking or hoarding food, even immediately after meals. Feeling ashamed or fearful, some children deny this when confronted

• Some children exhibit excessive concern with body shape and weight and a desire to restrict food intake...Even so, he or she may still be overeating and gaining weight

• Some children make negative comments about themselves

• Some children say other children don't like them and don't want to play with them

• The child may seem lonely or may describe him or herself as lonely

• Some seem depressed, worried and/or preoccupied

• Some isolate. Not wanting to be with friends, the child may spend a great deal of time alone in his or her room or in front of the television or computer

• Some children's school performance slips, while other children will cover-up their negative feelings about themselves and their moods by appearing compliant, pleasant and over achieving...all the while using food as their coping strategy of choice. (A child with an eating disorder may be a very good student. But still, the center of their world seems to be food or dieting)

• The child's focus on food and the amount of food consumed may have increased in reaction to a vulnerable time for the child, such as their parent's divorce or a family member's illness or death

Why is the Child Overweight?
There are many factors that impact a child's weight range. Regardless, we do not believe a child should ever be put on a diet!!! Today's prevailing wisdom says the following…

1. Find out as much as you can about why the child is currently above a healthy weight

• Is the child genetically predisposed ? (e.g. Dad's a big guy!)

• Could Mom and/or Dad improve their eating habits?

• Is the child bored and eating because he has nothing to do in the afternoons, or…

• Is the child focused on food because Mom and Dad are getting a divorce and she doesn't know any other ways to deal with her feelings?

• Is the child depressed?

• Has the child's Pediatrician been consulted yet to rule out possible physical reasons?

2. Explore interventions that fit your findings

• If the child and parents are genetically predisposed or have poor eating habits, the whole family can make it a project to learn more about healthy eating. Then, together they can make some changes in food choices, eating habits and activity levels. (Don't make the child the focus of this new project. Talk about improved health for the whole family.)

• If the child is bored, work with the child on finding some satisfying activities.

• If you suspect that your child is having trouble expressing feelings, find resources in the community where you can get help as a family. (Today, there are some great board games out designed to help the whole family learn how to better identify and communicate feelings).

• If you suspect depression, get professional help.
  

3. Most importantly, try your very best to ensure that none of the interventions you choose harm the child's sense of self-worth and self-esteem. How?

• Don't focus on food or weight! (This is hard because you want your child to be healthy and slim. But focusing on food and weight just makes the child more unhappy and makes the child want to eat more. You've probably seen that already.)

• Teach your children (and all others you know) that children and adults come in a wide variety of shapes and sizes...and that that's what makes life interesting!

• Arm your child with some actual things to say to other children when those children make fun of their size. (Unfortunately, some abuse is likely for any chubby child in our culture). Example…"I'm a big kid and that's O.K. I like myself just the way I am! Want to play?"
  

Again, find activities the child can excel in…Activities where he or she can feel some success. (Don't force a slow overweight child to play soccer if that experience makes him feel badly about himself… even if it is good exercise and you think it will result in weight loss. Instead, enroll him in something like a martial arts class or any program where children are taught to respect themselves and others.)



If you Suspect a Binge Eating Disorder,
Seek Professional Guidance
Ideally, a treatment approach for a child involves a parent or parents, the child and a Licensed Psychotherapist who has experience with disordered eating and kids. When indicated, also add the Pediatrician, a Dietitian and maybe an Exercise Specialist who has had experience with children. When there are obsessive-compulsive behaviors, impulse control problems or depression suspected, a Child Psychiatrist may also be an important part of the treatment team.

At our Treatment Center in Cincinnati we have learned the importance of coordinating care on behalf of the child. With help, change can occur. The child can feel better and be healthier in many, many ways!

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