Below is my response to a parent who worries about her neurodivergent daughter who is binge eating.
Dear Ginny,
Do you have any advice for me regarding binge eating in a neurodivergent child?
I have an 8-year-old daughter who is neurodivergent and is frequently binge eating to the point where she complains that she ate too much and feels nauseous. I’m trying not to shame her about food, but it’s as if she has no “off” switch and then I’m stuck dealing with the aftereffects, which sometimes take hours to resolve.
It seems like I should intervene and stop the binge to avoid the consequences, but I worry about adding shame to the pain.
Also, it doesn’t work! Pointing out the natural consequences of this behavior don’t seem to make a difference. She feels so bad, but she keeps doing it anyway. Why is she going after food like this despite the repeated natural consequences of doing so? How can I help her avoid binge eating so she doesn’t feel so bad after doing it?
Signed,
Loving Mom
My Response
You are a loving and attuned mom, and I’m so glad you asked this question! This is a tricky situation, and you bring up many important issues about feeding a neurodivergent child. The more we see the complexity of eating issues, especially relating to neurodivergence, the better equipped we are to prevent eating disorders.
When a neurodivergent child is binge eating we want to consider the sensory drivers of binge eating. Eating has two purposes. It’s a response to hunger signals but is also a powerful, hard-wired way to regulate our nervous systems. Most infants are physically and emotionally soothed when eating, and it’s common and natural for us to continue to find eating soothing when we feel dysregulated.
Trying to stop a binge eating episode in progress is like trying to stop a runaway train. And you’re correct that without coaching on how to do it, you can accidentally add stress and shame, increasing dysregulation and the likelihood of future binge eating.
Instead of interrupting binges, we want to address the causes of binge eating. Luckily, there’s a lot you can do on the prevention end of the binge eating equation!
Does your child need more food?
The most common trigger for dysregulation followed by binge eating is not eating enough food regularly throughout the day. Skipping meals and under-eating leaves kids unmanageably hungry and deeply dysregulated. This is more common with neurodivergent kids who are more likely to avoid eating, have different interoceptive appetite signals, or forget to eat during the day. Their overwhelming urge to binge eat is a biological drive to get the calories they need to regulate their physiology.
Being over-hungry is extremely dysregulating physiologically and emotionally. When you address the cause of the dysregulation, which is inadequate and irregular eating patterns, you’re likely to see a reduction in binge eating.
The first treatment for a child who is binge eating is to feed and support them in eating adequate meals every 2-5 hours. They should never go more than five waking hours without a substantial meal. Your child may need tremendous support to build this habit, but it is the foundation of emotional regulation and essential to preventing binge eating episodes.
To be clear: binge eating cannot be meaningfully addressed until regular feeding is firmly established and has been in place for a significant amount of time. Trying to solve binge eating without feeding enough food regularly will create more challenges than it solves.
Does your child need to soothe dysregulation?
If your child has been eating regularly and adequately throughout the day for at least six months but they are still binge eating, then it might be a way to seek sensory input to soothe emotional dysregulation coming from other sources. For example, they may be overstimulated from school, the dinner table is a place of stress, or they’re not getting the connection and stimulation they need throughout the day.
Try to see binge eating as a symptom of dysregulation and address the causes rather than the symptoms.
Binge eating has been pathologized in our society and brings up a lot of difficult emotions in parents. However, binge eating is like any self-regulating activity. It’s not uniquely dangerous or bad.
Let’s say your daughter was using a fidget toy to regulate herself. It started small, just something fun and light to fiddle with. But lately, she can’t put it down, becomes extremely distressed without it, and is actually getting pain in her fingers from overuse.
The problem is not the fidgeting itself, it’s that she’s feeling extremely dysregulated and is over-using the stimulation she gets from the toy as her only path to regulation. You would want to investigate the sources of dysregulation and support her in learning other methods of self regulation as well as offering more opportunities to co-regulate and connect with you in meaningful ways.
Ask yourself what your child needs throughout the day to support her need for regulation and stimulation. Is she getting enough sleep, play, and positive social engagement? What can you do to reduce the sources of dysregulation in your household? How can you support her in managing dysregulation when it shows up?
What to do instead of trying to control food or stop binge eating
Rather than controlling food or trying to stop binge eating, address the deeper issues of dysregulation. When you do this, food and eating issues become far less of an issue and even disappear.
First, make sure your child is getting enough food regularly throughout the day, every day. She may need a lot of support in eating regular, adequate meals. Next, look for physical, emotional, and relational methods to soothe her need for co-regulation and stimulation throughout the day while managing your own experiences of anxiety, obsession, distress, or disgust when your child binge eats.
Keep in mind that your feelings about food and eating might be part of the dysregulation she feels. It’s important to evaluate and address family dynamics anytime we see disordered eating behaviors since parents can unintentionally contribute, accommodate, and maintain them.
What to do when your neurodivergent child binge eats
While you’re working on this treatment, your neurodivergent child will likely have binge eating episodes. These cause physical and emotional pain to which you can respond by getting her a heating pad or an ice pack. Give her the level of attention you would if she stubbed her toe or fell down while learning to walk, neither over- nor under-responding to a very normal, natural occurrence.
Don’t tell her she should avoid eating so much next time if she wants to avoid feeling so bad. While it seems like a good thing to say, it’s not helpful and can backfire, especially if you’ve repeatedly said it in the past and it hasn’t helped.
Binge eating is deeply pathologized in our society, so we need to be very thoughtful about how we talk about it with our kids to avoid triggering shame.
Repeated experiences of feeling over-full without judgment or recrimination will help her build her intuitive interoceptive sense of hunger and fullness over time. With your compassion and support, she will make those learning leaps herself.
Parent Coaching for Binge Eating
Getting parent coaching can help you be more effective in supporting your child or teen with binge eating. Binge eating recovery is possible, but it’s difficult, and parents who get support, training, and skills are more effective and less burned out. If you’re interested in learning more, drop me a note:
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