By Patrick J. McGrath, OC, PhD, FRSC
Question:
My 14-year-old daughter really likes ice cream. She is small and weighs about 100 lbs, which is right for her size, but she will eat a big bowl of ice cream late at night and then will skip breakfast the next day. This happens about once every three weeks. She calls it "pigging out" and is not very happy about it. She says she starts and then can't stop. She might eat about 1/4 to 1/3 of a litre of ice cream at a time. She now avoids eating ice cream at other times. If we don't have ice cream in the freezer, she will go out and buy some late at night. I am pretty sure she is not "pigging out" more than what she has told me. She is doing well in school and has friends. She is worried that she may have an eating disorder. What can we do?
Dr. Pat responds:
There are two related eating disorders that involve bouts of excessive eating: bulimia and binge eating disorder.
Bulimia involves overeating (bingeing) and then purging, fasting, or doing excessive exercise to get rid of the weight. Purging can be accomplished by vomiting, taking laxatives, or using diuretics (drugs that make you pee a lot). Fasting means not eating for a full day after a binge. Excessive exercise would involve hours of exercise each day.
People with binge eating disorder are often overweight and:
- eat fast during binges
- eat until they are really uncomfortable or in pain
- eat much more food during a binge than during a normal meal or snack
- diet often without losing weight
- feel that their eating is out of control
- are depressed or anxious
- often eat alone
- have hidden food stashes
- hide empty food containers
- feel disgusted or upset about the binges
If what you know is accurate, your daughter is not suffering from either disorder. She has some features of binge eating disorder. But her binges, although worrying to her, are not huge and do not occur very often. She has not been hiding her eating. She is not overweight. You have not noticed any purging, fasting, or excessive exercise. If she is getting rid of the ice cream by vomiting or purging, then it is a more serious problem.
It is very good that she is talking to you about it. Make sure you keep up the conversation. Let her know that you think she is OK and that many people "pig out" a bit, once in a while. You can probably come up with some examples from family and friends overindulging on holiday meals.
I would encourage teaching her healthy eating attitudes and behaviours:
- When she wants to pig out, ask her to get you to join her in having a modest bowl of ice cream.
- Encourage eating leisurely and enjoying it.
- Have meals together as a family.
- Have regular unhurried meals.
- Everything is OK in moderation.
Your daughter may "pig out" when she is stressed. Can you chat with her about what is causing her stress these days? If you mention it to her doctor she can discuss it with your daughter.
For more information about healthy eating, see our "Nutrition" section in our Health A-Z.
Patrick J. McGrath OC, PhD, FRSC is a clinical psychologist and a researcher. He is Professor of Psychology, Pediatrics, and Psychiatry at Dalhousie University and Vice President - Research at IWK Health Centre in Halifax. He is also the CEO of the Strongest Families Institute, which provides mental health care to families across Canada.
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