As a mom of a 4- and 6-year old and a psychologist whose research focuses on eating and weight disorders, I frequently worry about my kids’ eating and activity habits (among many, many other things!) Am I feeding them too much and setting them on the road to obesity? Am I too restrictive and inadvertently increasing their vulnerability to developing an eating disorder? Are they getting too much screen time when they should be outside running around? I know that many moms and dads have similar concerns, so I thought I would take this opportunity to share what I know about loss of control eating in children, a behavior that lies at the intersection of eating disorders and obesity.
“Loss of control while eating” refers to a feeling that one cannot control what or how much one is eating. It can, but does not always, involve consuming an unusually large amount of food: for example, a child can report feeling out of control while eating an entire bag of chips, or just one handful. Loss of control eating is one of the most commonly reported eating disorder behaviors
in children and adolescents, yet parents are often completely unaware that their kids are struggling with this problem. It is particularly common in children with obesity and can be linked with other physical and psychological health problems, such as high blood pressure, lower LDL (“good”) cholesterol, and symptoms of depression and anxiety. Often, parents will seek treatment for what they see as their child’s weight problem but are confused about why their child is gaining weight since he or she seems to be eating normal amounts or types of food. This is not surprising, as children often engage in loss of control eating in secret—after school when no one is home, or late at night after everyone has gone to sleep. In addition, many children who have loss of control eating episodes attempt to compensate for their behavior by reducing their intake at other meals so it may seem to their loved ones that they eat much less than other kids their age.
Because kids are often distressed and embarrassed by their loss of control eating, they may feel too ashamed to ask their parents for help. However, there are some warning signs parents might notice, like large amounts of food missing from the fridge, or finding hidden food or food wrappers in places where the family doesn’t usually have meals (such as a child’s bedroom). Parents
might also notice that their child is gaining weight more rapidly than usual, or engaging in other worrisome behaviors, like strict dieting. Although these behaviors may not always indicate that a child feels a loss of control while eating (many kids overeat on occasion without feeling a loss of control), it’s a good idea for parents to start a conversation about what they are noticing in case something more serious is going on and to provide positive messages around healthy eating and moderation. It’s important for parents to talk to their kids about the behaviors they are noticing in a way that doesn’t make their child feel even more ashamed or embarrassed.
Getting angry about missing food can make children feel even more guilty and distressed, which could worsen existing eating problems and cause the child to be even more secretive about their eating. It’s often best for parents to bring up their concerns outside of meal times, so the child doesn’t feel self-conscious and may be more open to talking. Trying to emphasize that your child is not in trouble may be helpful, as can emphasizing that you want to know what’s going on so you can figure out the best way to help.
If you are worried about your child’s eating, a pediatrician or mental health professional may be able to provide some referrals for clinicians who specialize in helping kids who are struggling with their eating. There are several psychological treatments that seem to be effective in helping kids manage their eating behaviors, like cognitive behavioral therapy and interpersonal therapy,
and structured weight management programs may help kids eat more regularly throughout the day (including treats!) so they aren’t at risk for loss of control eating episodes due to being overly hungry or restrictive with their eating. The Adolescent Weight Management Program and Eating Disorders Program at Hasbro Children’s Hospital may
be able to provide treatment and/or referrals.
We are currently doing research to understand why children develop these problems in the first place so we can help figure out ways to prevent eating problems and obesity. In fact, we are currently looking for kids aged 10-17 to participate in studies examining their brains, thinking patterns, and emotions, so if you have a child who has overweight or obesity, or seems to have
trouble controlling their eating, give us a shout! (Erin Jackson, 401-793-8962; [email protected]).
Most importantly, don’t blame yourself—if your child has an eating or weight problem, it is highly unlikely that you did anything to intentionally cause it, and you are your child’s best ally and advocate for getting better. So, if you are worried, make sure to bring up your concerns with a trusted healthcare professional to figure out the best action plan. We are all doing our best and want the best for our children—even those of us who give their kids dessert every night! (hint, hint—that’s me).
Andrea Goldschmidt is a mom to two boys, aged 4 and 7. She is a native East Coaster who relocated to Providence from the Midwest in 2016. Andrea is currently an Assistant Professor (Research) of Psychiatry and Human Behavior at the Miriam Hospital and the Warren Alpert Medical School of Brown University. She received her Ph.D. in Clinical Psychology from Washington University in St. Louis in 2010, and was a postdoctoral fellow and faculty member at the University of Chicago prior to her current affiliation as a faculty member at Brown. Her primary research interests focus on eating behaviors that are related to adverse weight outcomes in children and adolescents, particularly loss of control eating. In her spare time, Andrea enjoys reading, baking, and doing crafts with her kids.