The Thing No One Tells Parents About Binge Eating Disorder in Teens

Teenager looking upset and withdrawn

If your teenager has been struggling with binge eating, there’s a good chance you already feel confused and a bit perplexed. You may have noticed food going missing. You may have found wrappers hidden in their room, or realized they’re eating in secret late at night. You may have tried talking to them about it and hit a wall. Or maybe they’ve shut down entirely, and you’re not sure why.

Here’s what I want you to know first: you are not the only parent in this situation. And your teen is not the only teenager going through it.

But there’s something about binge eating disorder that makes it much harder to talk about than other eating disorders, and that silence is part of what keeps families stuck. So let’s talk about it.

What Binge Eating Disorder Actually Is

Binge eating disorder, often called BED, is the most common eating disorder in the United States. More common than anorexia. More common than bulimia. And yet many people have never heard of it as a real diagnosis.

BED involves recurring episodes of eating large amounts of food in a short period of time, often past the point of fullness, and often feeling out of control while it’s happening. What makes it an eating disorder and not just overeating is the distress that comes with it. The shame afterward. The secrecy. The sense that something happened that your teen didn’t quite choose and couldn’t quite stop.

Unlike anorexia, BED doesn’t come with visible signs that most people are trained to look for. Your teen may not be losing weight. They may not look sick. And so the eating disorder can go unnoticed sometimes for a very long time.

The Thing Most Parents Don’t Know: Shame Is Running the Show

Here’s what I don’t see talked about enough: the central experience of binge eating disorder, for most teens, isn’t the eating itself. It’s the shame.

By the time a teenager is in the middle of a binge eating disorder, they are usually already caught in a cycle that’s very hard to see from the outside and very hard to break from the inside. Something happens. Stress, boredom, emotional pain, a fight with a friend, a hard day at school. The urge to eat feels overwhelming and then suddenly unstoppable. And then, after, comes the shame. Why did I do that? What is wrong with me? I have to hide this.

That shame does something important, and not in a good way: it drives the behavior underground. It makes it harder for your teen to tell you what’s happening. It makes them less likely to ask for help. And it often feeds the next episode, because shame is one of the most powerful emotional triggers for binge eating there is.

This is the cycle. It isn’t about willpower. It isn’t about discipline. It isn’t about how you raised them or what you put in the pantry. It’s a shame cycle, and it has a life of its own.

Your teen is probably hiding it from you not because they don’t trust you, but because they’re deeply ashamed of something they can’t explain. They may not have words for what’s happening, or they may worry you’ll be angry, disappointed, or put them on a diet, which often makes things worse. The hiding isn’t defiance. It’s self-protection, and it’s part of how well this disorder hides, even from a parent who’s paying close attention.

If You’ve Already Been Trying to Help

Most parents who end up here have tried to help their teen, often for a long time, in ways that made complete sense given what they knew.

Maybe you’ve had heart-to-heart conversations with your teen, the kind where you stayed up late, chose your words carefully, told them you loved them and just wanted them to be okay. Maybe you framed it around health, not weight, because you knew that was the right thing to do. Maybe you’ve started cooking differently, suggested a family walk after dinner, or quietly cleared the house of certain foods.

None of that is wrong. All of it came from love. But most of those approaches, even the thoughtful ones, work on the surface of the problem. A heart-to-heart about wanting your teen to be healthy, even when you’re genuinely not making it about weight, can still land on a teenager in a shame cycle as one more reminder that their eating is a problem, that they are a problem.

This isn’t a reflection of what you’ve done wrong. It’s a reflection of how well BED hides, and how much of it lives underneath the behaviors you can see.

What Helps (And What Doesn’t)

If you’ve been trying to address this by monitoring your teen’s food, commenting on what or how much they’re eating, or encouraging them to eat less, I want to gently tell you: that approach usually backfires. Not because you’re doing something wrong, but because it increases shame, and shame is what’s keeping this going.

What actually helps is the opposite of what most parents instinctively want to do. It starts with lowering the temperature around food in your home. Not making meals a place where your teen feels watched or judged. Finding small ways to signal that you are safe to talk to, not about eating, but about whatever is hard.

It also helps to get a professional involved. Binge eating disorder responds well to treatment. Cognitive behavioral therapy approaches have strong evidence behind them. A therapist and registered dietitian specializing in eating disorders can help your teen build a more regular relationship with food that reduces the conditions under which binges are most likely to happen. These aren’t quick fixes, but they work.

What your teen needs most from you, right now, probably isn’t a conversation about food. It’s to feel like you see them, that you’re not disgusted or disappointed, and that the relationship between you isn’t contingent on what or how much they eat.

What to Say (and What Not to Say)

This part is hard, because your instincts as a parent are to problem solve. To fix it. To say something useful.

But the most useful thing you can often say is something much simpler. Something like: I’ve noticed you seem like you’ve been having a hard time lately. I’m not here to make things harder. I just want you to know I’m in your corner.

And then leave space. Don’t push for details. Don’t bring up food or eating. Just let them know the door is open.

What tends to make things worse: comments about their body, about portions, about eating habits, about weight. Even gentle, well intentioned comments. Even comments framed as health concerns. For a teenager already deep in a shame cycle, these land as confirmation that they are the problem, and that confirmation makes the eating disorder louder, not quieter.

Getting the Support You and Your Teen Need

If you’re reading this and recognizing your family in it, the most important thing you can do right now is get support. Not a diet plan, not a meal tracking app, actual clinical support from someone who understands eating disorders.

That means finding a therapist who specializes in BED, and ideally also working with a registered dietitian who has eating disorder training. These two pieces, together, the psychological piece and the food relationship piece, are what give treatment the best chance of working.

You deserve support too. Parenting a teenager through an eating disorder is exhausting and frightening and often isolating. Finding a therapist or a parent support group can make a real difference, not just for you, but for your teen, because a calmer, more grounded parent is one of the most stabilizing things a teenager in recovery can have.

Your teen is not broken. You are not at fault.

If you have questions about what treatment for binge eating disorder might look like for your teenager, feel free to reach out. I’m happy to talk through what support could look like for your family. Schedule your free 20-minute consultation today.

Frequently Asked Questions

Q: My child seems “addicted to sugar.” I’ll buy a pack of cookies, and they eat the whole thing in one sitting. When I ask about it, they tend to fib. Should I stop buying sugary foods?

It’s a completely understandable instinct. If the food disappears, maybe the problem does too. But this isn’t really about the cookies. If you remove sugar from the house, your child will likely find a way to get it elsewhere, because the food itself doesn’t drive the behavior. It’s driven by what the eating is helping them cope with. The more useful path is getting your child support to build other ways of handling difficult feelings. The food is the symptom, not the cause.

Q: Our pediatrician referred us to a dietitian, and we’ve been going, but it doesn’t seem to be helping. What should we do?

Working with a dietitian who has experience treating eating disorders is a great foundation. What I’d suggest adding is a therapist who also specializes in eating disorders. Binge eating has a psychological component that needs its own dedicated attention alongside the nutrition piece; the two work best in tandem, not in place of each other.

Q: We eat very “clean” at home, but when our teen is out of the house, they go after sugary food like crazy. We don’t understand what’s happening.

This happens more often than parents realize, and once you understand what’s driving it, it starts to make sense. We’re surrounded by confusing, often fear-based messaging about food, the idea that we’re one bite away from disaster. But research tells a different story: dietary restriction and rigid food rules are a known contributor to binge eating developing in the first place. The “clean” eating at home and the “going crazy” outside it are often two sides of the same cycle, not two separate problems.

Please feel free to reach out for a free 20-minute consultation if you would like to discuss your child’s relationship with food further.

If you are a clinician who wants to learn more about eating disorders, check out my services for clinicians here.

Overtraining and Undereating: Could It Be an Eating Disorder?

by Alison Pelz, LD, RD, CDE, LCSW

The short answer: possibly, and you’re not alone in wondering.

If you’re an athlete questioning your relationship with food and exercise, or a parent worried about a teen who trains hard and eats less, this is worth understanding. The line between athletic discipline and disordered eating can be genuinely hard to see, especially from the inside.

This post breaks down the signs of an eating disorder in athletes, why athletes are at higher risk, and what to do if you’re concerned.

What Is Disordered Eating in Athletes?

Disordered eating in athletes exists on a spectrum. It doesn’t always look like the stereotypes.

You might be:

Following strict food rules that feel necessary for performance
Eating in ways that feel out of control after high-output training days
Restricting intake to make weight or achieve a certain body composition
Exercising through illness or injury because skipping feels unbearable

These patterns can overlap with recognized eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, and ARFID, as well as clinical syndromes specific to athletes, including Relative Energy Deficiency in Sport (RED-S) and the Female Athlete Triad (low energy availability, menstrual dysfunction, and low bone density).

Signs of an Eating Disorder in Athletes

Behavioral signs:

Rigid rules around food: what, when, and how much to eat
Binge eating: large amounts of food consumed with a feeling of loss of control
Purging behaviors
Continuing to train when sick or injured
Excessive preoccupation with food, weight, or body shape
Low insight that eating has become a problem
Excessive worry about food, weight, and body shape
Continuing to train when sick or injured

Physical signs:

Significant weight changes (loss or gain)
Low resting heart rate
Loss of menstrual cycle
Changes in appetite, mood, or energy
Dizziness or lightheadedness
Low blood sugar
Stress fractures or osteopenia

If any of this sounds familiar for yourself or a teen you care about, an evaluation by a doctor or mental health provider is a worthwhile next step.

Why Athletes Are at Higher Risk for Eating Disorders

Eating disorders don’t develop randomly. For athletes, several factors converge:

Performance culture. Athletic environments reward discipline, control, and pushing through discomfort — qualities that can easily slide into disordered patterns.
Perfectionism. Strongly correlated with anorexia nervosa, perfectionism is common among high-achieving athletes.
Body and weight pressure. Many sports emphasize a specific build to be competitive. That pressure is distressing on its own and even more so because genetics, not willpower, largely determines body shape and weight.
Diet culture overlap. The pressure athletes feel to eat the “right way” is amplified by a broader culture already obsessed with food rules.
Sport type. Endurance sports (distance running, triathlon, ultra-endurance) and weight or appearance-focused sports (wrestling, gymnastics, figure skating) are associated with a higher risk of eating disorders.

Eating Disorders Affect All Athletes

Disordered eating in athletes does not have a single look. Eating disorders affect:

Elite and recreational athletes
All genders
All ages: children, teens, young adults, and adults at midlife and beyond
All body sizes: most people who meet diagnostic criteria have what others would consider a “normal” body
All races, ethnicities, and socioeconomic backgrounds

Presentations vary widely, too. You might restrict and binge, purge without restricting, eat the same foods on rotation, or go all day without eating and then have a seemingly ordinary dinner. You may have gone to the doctor and gotten a “clean bill of health”, but the psychological distress of the eating disorder feels like it’s taking on a life of its own. None of these patterns is less real or less deserving of care.

What to Do If You Think You (Or Your Athlete) Has an Eating Disorder

Get support sooner rather than later. Eating disorders are chronically undertreated. Most people don’t seek help until things have been serious for a long time. You don’t have to wait.

If you have had an eating disorder for years and have “been O.K.” so far you still deserve treatment. If you have had a chronic eating disorder and received treatment before, don’t give up.

Eating disorders rarely announce themselves as disorders. They often start as wanting to “eat healthier” or “get in better shape” and then take on a life of their own. Like all behaviors, they serve a function: managing distress, feeling in control, and coping with difficult emotions. Recovery involves both nutritional stabilization and building new ways to navigate life.

Frequently Asked Questions: Eating Disorders and Athletes

What is the difference between athletic training and disordered eating? The key distinction is psychological distress and functional impairment. Athletes who train hard but eat flexibly, rest when injured, and don’t experience significant anxiety around food are generally not in disordered territory. When food rules feel rigid and non-negotiable, when missing a workout causes panic, or when eating feels out of control — those are signs worth paying attention to.

I don’t look like I have an eating disorder. Does that mean I don’t need help? No. Body size is not a reliable indicator of eating disorder severity. You can have a larger body and be dealing with a serious, life-affecting eating disorder that deserves treatment.

My eating disorder doesn’t feel that bad. Do I still need treatment? Yes. Eating disorders are underdiagnosed and often minimized by the people experiencing them and by providers. They can become chronic, affect relationships, work, school, and family life, and they can be fatal. They also carry a significant association with suicide.

If I start treatment, do I have to stop my sport? Maybe, but likely only temporarily. Whether exercise needs to pause depends on your physical and mental health at the time. The goal of eating disorder treatment is always to restore a healthy relationship with both food and movement and ultimately return to sport.

ADHD and Eating: Why It Might Feel So Hard (& Why That Makes Sense)

by Alison Pelz, LD, RD, CDE, LCSW

Have you ever had moments where you wondered, Why is eating so much harder for me than it seems to be for other people? Or maybe, I can manage work or school, so why does something as basic as feeding myself feel so overwhelming?

If that sounds familiar, there may be a reason that actually makes sense.

We know from research that people with ADHD are more likely to experience eating disorders such as anorexia, bulimia, binge eating, or ARFID. But beyond the statistics, what matters most is this:

For many people, their struggles with food are not random. They are connected to how their brain works and how they are trying to cope in a world that often expects consistency, structure, and follow-through.

That mismatch can be exhausting.

When ADHD Doesn’t Look Like ADHD

A lot of people don’t immediately recognize themselves in ADHD.

You might have been told that you are doing fine. Maybe you did well in school or you are managing your job. From the outside, things may look steady enough. And part of you might think, If I really had ADHD, wouldn’t it be obvious?

But many forms of ADHD, especially inattentive ADHD, are easy to miss. This is particularly true for girls and women. Instead of being loud or disruptive, it often shows up internally. It can feel like constantly pushing yourself to stay organized, to keep up, to not forget things that seem like they should be easy. It can mean feeling overwhelmed by everyday tasks while also being very hard on yourself for struggling.

On the outside, you may appear capable. On the inside, it can feel like you are working much harder than everyone else just to stay afloat.

Over time, that gap between how things look and how they feel can turn into shame or self-doubt. You may not have the language for it, but you can feel that something is off.

Why Challenges Often Show Up Around Food

When eating feels difficult, it is easy to assume it is a personal failing. You might think you lack discipline or that you should have figured this out by now.

But eating regularly asks a lot from your brain. It requires planning, starting tasks, remembering, organizing, and following through. These are all part of executive functioning, which is exactly where ADHD creates challenges.

So when you find yourself putting off meals, skipping them, or feeling overwhelmed by the idea of cooking and cleaning, it is not because you do not care. It is because your brain has a harder time getting started and moving through all the steps.

You may even notice a pattern where you do not eat for a while and then suddenly you are extremely hungry and trying to catch up. Then afterward, there can be confusion or frustration about how it got to that point again.

When Food Feels Complicated or Overwhelming

For some people, eating is not just about getting started. It is also about how food feels.

You might notice that certain textures or smells are hard to tolerate, or that food has to be just right for you to eat it. At the same time, it may be difficult to recognize hunger until it becomes intense.

This can create a strange push and pull. Sometimes eating feels like too much. Other times it barely registers until your body demands attention all at once.

From the outside, this might look inconsistent or restrictive. From the inside, it often feels confusing and hard to predict.

When Eating Becomes a Way to Cope

If you have experienced binge eating, you might feel stuck in a cycle that does not make sense to you. You may wonder why it keeps happening, especially when you genuinely want it to stop.

But in those moments, eating often serves a purpose. It can soothe overwhelming emotions, create stimulation when things feel dull or restless, or provide a sense of relief. Even if that relief is temporary, it matters.

Understanding this does not mean the behavior feels good or sustainable. It simply means there is a reason your brain keeps returning to it.

When Control Starts to Feel Important

For others, the struggle can look very different. Eating less or creating strict rules around food can feel grounding, especially when everything else feels unpredictable or overwhelming.

You might notice a sense of calm or clarity when things are controlled, and anxiety when that control is disrupted.

This can become more intense during times of change, like adolescence or moving into adulthood, when external structure disappears and you are expected to manage everything on your own. Without enough support, food can become one of the few areas that feels manageable.

A More Compassionate Way to Understand Your Eating Patterns

It is easy to fall into the belief that something is wrong with you.

But what if your eating patterns are not random or broken, but actually attempts to cope with stress, overwhelm, or disconnection?

That does not mean they are working in the long term. But it does mean they deserve understanding, not judgment.

How Healing Can Look Different for People with ADHD

Instead of focusing on fixing yourself, the work becomes about understanding yourself.

Together, we look at how your brain works, what makes things harder, and what kinds of support actually help. We explore what your eating patterns have been doing for you and where there may be unmet needs.

From there, we begin to build systems and strategies that feel more sustainable. Not perfect, not rigid, but supportive and realistic for your life.

If You See Yourself in This

You might feel tired of fighting with yourself. You might feel confused about why something that seems simple feels so difficult. Or you might just want to feel more steady, more nourished, and less overwhelmed.

That is where this work begins.

Ready to Take the Next Step?

If this resonates with you, you do not have to sort it out alone. I offer a free 20-minute consultation where we can talk about what has been going on and what kind of support might actually feel helpful.

Are you struggling with eating, food, or your relationship with your body, or just not sure if something feels off? You don’t need all the answers to reach out. If you’re in Texas and interested in working with me, click here to fill out a contact form.

If you’re a parent supporting a child with an eating disorder or ARFID/”picky eating”, therapy can give you the space to heal and show up for your child. You don’t have to carry this alone.

The Binge–Purge Cycle in Bulimia and Why It Feels So Hard to Stop

by Alison Pelz, LD, RD, CDE, LCSW

You may not think of it as bulimia.

More often, it sounds like a quiet, ongoing negotiation with yourself: I just need to get my eating under control. Or, I won’t do this again.

And yet, it keeps happening.

If you’re reading this, you may be struggling with your relationship with food, or you may be worried about someone you love. Either way, you’re not alone, and help is available.

In my work with clients, I help you understand the factors that contributed to the development and what keeps you feeling stuck in the cycle of binge-purge, while compassionately guiding you toward a path forward grounded in hope and recovery.

The binge-purge cycle you may feel trapped in

For many, bulimia isn’t just about behavior but it’s about a painful cycle that can feel impossible to escape.

It might look something like this:

“I’m not going to do this again. Tomorrow will be different.”
“I’ll be more disciplined. I’ll eat perfectly.”

And for a while, maybe things feel under control. But then something happens: an increase in stress, loneliness, boredom, overwhelm, or even just hunger and the urge builds.

“I’ve already messed up. I might as well keep going.”
“I’ll just start over tomorrow.”

The binge happens. Then comes the guilt, the discomfort, the shame.

“I can’t believe I did that again.”
“I need to fix this.”

Purging follows, bringing a brief sense of relief both physically and emotionally.

And then the cycle resets:
“I swear this is the last time.”

What is bulimia nervosa?

Bulimia nervosa is a serious eating disorder characterized by a cycle of:

Binge eating, or consuming large amounts of food in a short period, often with a sense of loss of control, followed by
Compensatory behaviors such as vomiting, excessive exercise, fasting, or misuse of laxatives to “undo” the binge

One of the hallmarks of binge eating is that feeling of “I can’t stop.” It’s often followed by intense shame, guilt, and distress.

This isn’t a failure of willpower. It’s a learned cycle in which your brain and body try to cope with distress and emotions.

Why does bulimia nervosa develop?

There isn’t a single cause of bulimia. It’s a complex condition influenced by emotional, psychological, and biological factors.

Some known risk factors include:

Chronic dieting or food restriction
Body image distress
ADHD, anxiety, depression, or chronic stress
Low self-worth
Family history of eating disorders

Bulimia often begins in late adolescence (around age 18), and while it is more commonly diagnosed in women, it affects people of all genders, body sizes, and backgrounds, including those in marginalized communities.

Without support, it can become chronic. Unfortunately, only about 50–60% of people ever seek treatment.

Why bingeing and purging “work” (in the short term)

Binge eating often serves a purpose. It can temporarily soothe intense emotions like anxiety, loneliness, exhaustion, or overwhelm. In those moments, food can feel like relief. But that relief is short-lived, and over time, it often increases distress.

Purging behaviors tend to follow intense emotional or physical discomfort including shame, panic, or sensory overload. Purging can create a rapid shift in the body, leading to a temporary sense of release.

Your brain learns: this reduces distress.
And so the cycle repeats.

Even if it feels “manageable,” the toll adds up physically, mentally, and emotionally.

The impact on physical and mental health

Physically, bulimia can lead to:

Electrolyte imbalances (which can be life-threatening)
Gastrointestinal distress
Dental problems
Hormonal disruptions

Emotionally, the cycle often deepens distress over time.

Thoughts like:
“Why do I keep doing this?”
“What is wrong with me?”
“I’ll stop tomorrow.”

…can reinforce shame, guilt, and self-criticism.

Many people begin to isolate themselves to hide the behavior. Relationships can suffer. You may find yourself avoiding socializing. You may not find joy in activities that you normally would. Going to school or work may feel harder.

Thoughts of what to eat and not eat and worries about your body may take over much of your thoughts.

You may feel more easily annoyed and frustrated.

The eating disorder takes up more and more space in your life.

What recovery looks like

Recovery from bulimia is both behavioral and insight-oriented.

That means we work on:

Gradually reducing eating disorder behaviors
Building more consistent, nourishing eating patterns
Developing healthier ways to cope with emotions
Understanding and addressing underlying factors like anxiety, depression, or low self-worth
Challenging unhelpful thoughts about food and body image
Building self-compassion and resilience

In my work, I use a combination of cognitive behavioral therapy, mindfulness, parts work, and radical acceptance to help guide recovery.

Recovery is not linear. It often feels like a few steps forward and a few steps back. It can feel messy at times and that’s okay. That’s part of the process.

You don’t have to do this alone

Many people with bulimia feel stuck in secrecy and shame. Reaching out can feel scary but it can also be the beginning of something different or perhaps feel a bit of relief.

If you are struggling with your eating, it doesn’t mean something is wrong with you. It means you’ve been trying to cope in the best way you knew how.

Recovery is possible. Healing is possible. Whether this has been going on for a short time or for years, it is not too early or too late to get help.

If you’re ready to take the next step, I invite you to reach out. Even a single conversation can begin to shift things. Sign up for a free consultation to learn more about how I can help you.

Understanding Eating Disorders: Looking Beyond the Behavior

by Alison Pelz, LD, RD, CDE, LCSW

When you or your child is struggling with food, whether that looks like purging, restricting, binge eating, and/or rigid exercise, it can be terrifying and confusing for parents. It can also feel deeply isolating for the person living inside the experience.

What we see on the outside is food behavior: increased rigidity around food, eating in isolation, eating large amounts of food, or purging. The behaviors can look or feel so baffling that it may be hard to get curious about what is happening on the inside. But having this understanding is key to long-standing eating disorder recovery.

Most eating disorders serve some function, which means that they are “helpful” or serve a purpose for the person living with them. This may sound counterintuitive, because the behaviors can feel distressing and can be physically harmful. While the outcome is harmful, there is often a root need that it feels like the disorder is addressing.

Eating disorders are rarely about stubbornness or vanity

Eating disorder behaviors are the tip of the iceberg. These behaviors can look willful, defiant, obsessive, or confusing. But they are rarely about stubbornness or vanity. They are usually nervous system strategies.

When a child (or adult) cannot eat, eats beyond fullness, purges, or restricts, their body is often trying to regulate something overwhelming inside.

The nervous system is the hidden driver. Our nervous system is constantly scanning for safety or danger. This process happens automatically and below our conscious awareness.

Eating disorders are a survival response

When our nervous system is well regulated and feels safe, we can eat with flexibility, have awareness of hunger and fullness, digest food well, tolerate a wide range of emotions, and have the capacity for problem-solving.

In contrast, when our nervous system is in fight, flight, or freeze in reaction to distress, our brains and bodies do quite the opposite. Eating disorder behaviors often map directly onto these survival responses.

Not eating enough calories can subdue emotions

Dietary restriction, or not being able to eat enough, functions to dampen the nervous system over time, which reduces the intensity of our feelings. When the world feels chaotic, overwhelming or unpredictable, malnutrition can create a sense of safety and stability.

This is one of the reasons we think that anorexia nervosa often begins in early adolescence. During this time, lots of change is happening, including the onset of puberty. Additionally, the transition between high school and college represents another vulnerable period during which anorexia may emerge.

Binge eating and purging can function to help reduce distress

Binge eating is thought to be soothing when intense emotions crop up. In other words, food is used as an attempt to self-soothe or regulate distress. For someone who feels anxious, overwhelmed, depleted or lonely, eating can temporarily bring short-term relief. However, longer-term it makes one’s distress grow.

Purging behaviors often follow intense nervous system activation, including overwhelm, shame, panic, or sensory overload. Purging can create a rapid physiological shift. It may temporarily reduce anxiety or provide a feeling of release. The body learns: This brings relief. And so the cycle repeats.

Similar to purging, rigid, compulsive or overexercising can create quick physiological changes. These changes include a release of endorphins and changes in dopamine and serotonin, which can improve mood. Exercise can create short-term relief from emotions such as anxiety, guilt, shame, stress or sadness. Because of this relief, the brain learns to repeat it, which leads to increased amounts of exercise.

Understanding eating disorders is a key step in recovery

You or your child may be experiencing one or any combination of these eating disorder behaviors. The thing to remember is that eating disorder behaviors are serving some function. So, it makes sense that attempts to “have more willpower” or trying to abstain from the behaviors are often short-lived and ineffective. In fact, approaching eating disorders this way often causes an increase in shame, isolation and feelings of failure.

Treating eating disorders usually utilizes a combination of insight-oriented & behavioral therapies. The goal of insight-oriented therapy is to develop a deeper awareness of unconscious patterns, past experiences, and internal conflicts that influence current problems. The goal of behavioral therapies is to identify, modify, and replace maladaptive behaviors with healthier ones by changing the learning and reinforcement patterns that maintain them. Both are needed to recover.

Eating disorders are not just about food. They are about regulation, safety, and survival. If you or your teen are living inside this experience, your behaviors make sense in the context of your nervous system. They are not proof that you are broken or weak or that you failed as a parent.

Remember: recovery is possible.

Do you want to learn more about your treatment options? Sign up for a free consultation to learn more about how I can help you.

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Understanding ARFID in Adults

by Alison Pelz, LD, RD, CDE, LCSW

When Avoidant/Restrictive Food Intake Disorder (ARFID) is discussed, the focus is often on children. Pediatric feeding clinics, early intervention models, and parent-led treatment approaches dominate the literature and training spaces. While this work is essential, it can unintentionally leave an important group of overlooked: adults with ARRID.

People do not “grow out of” ARFID simply because they age. Many adults meet full diagnostic criteria, experience significant impairment, and struggle to access appropriate care, often because ARFID is still viewed primarily as a childhood condition.

ARFID started in childhood

If you are an adult with ARFID, your eating challenges may have started in childhood. In fact, you may not remember ever not struggling with food. Perhaps differences in your eating may have waxed and waned over the years–for some people with ARFID, when stress increases, their ability to eat decreases.

As a child, you may not have gotten any help with your eating. Your parents may have asked your well-meaning pediatrician about your food selectivity, and the pediatrician may have offered advice along the lines of: “they will grow out of it.” Children often reject new foods at first, this is a normal part of learning to eat. In the case of ARFID, more often than not, children don’t naturally “grow out of it.”

“When they get hungry enough, they will eat” is another piece of advice your parents may have received. Again, if you have ARFID, this advice doesn’t appear to be effective. Often, people who experience ARFID struggle to eat due to sensory differences, fear, and/or low hunger. Even when they may feel hungry, eating feels too overwhelming.

ARFID started after a medical condition or traumatic experience with food

Your ARFID may have developed due to medical or chronic conditions that started in childhood or adulthood. For instance, gastrointestinal disorders (IBS, gastroparesis, heartburn, etc.), chronic nausea or vomiting, pain with eating or swallowing, and sensory differences, are a few common examples.

ARFID can also develop if you had a traumatic event around food, such as a choking episode, allergic reaction, vomiting, or other medical emergency involving food.

Over time, food avoidance may become reinforced as a protective strategy, thereby reducing discomfort, symptoms, or fear of symptom flare-ups. While initially adaptive, this avoidance can evolve into a rigid restriction that persists even when medical symptoms improve.

The medical community, family, friends, and our culture at large may have indicated that your eating challenges are “all in your head.” These messages are not true but often stigmatize eating and lead to an increase in shame and embarrassment, which can then function as a barrier to accessing treatment. Treatments such as CBT-AR and client-centered treatments that pay particular attention to sensory differences are being studied.

Socializing like dating, getting together with friends, and going to work or school events is often what brings adults into treatment. Reduction in socializing can lead to feelings of isolation, depression, anxiety, and low self-confidence.

Wanting to increase body weight is another reason adults seek treatment. You may also be experiencing physical symptoms such as fatigue, low energy, and nutritional deficiencies.

ARFID treatment

You are not “just a picky eater” or “difficult,” but rather you do deserve to receive care that addresses ARFID as a legitimate eating disorder. It is not too late to change your relationship with food and, most importantly, reduce feelings of shame about your eating.

Do you want to learn more about your treatment options? Sign up for a free consultation to learn more about how I can help you.

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