Cheat meals linked to eating disorders in teens and young adults

What are cheat meals and why do people eat them?

“Cheat meals” are subjective eating episodes in which a person deviates from their typical eating behaviors, practices, or rules and then returns to their previously established eating practices. The individual’s dietary rules tend to be rigid and involve rules that restrict types of food, calorie intake, or otherwise to control body weight or reach weight loss goals.¹

Cheat meals may involve a variety of calorie-dense foods or food types.¹ They're essentially the opposite of "healthy foods" as perceived by some. For example, someone with a diet with a low-calorie intake may decide to eat unhealthy foods, such as french fries, on their cheat day.

Why people have cheat meals

There are a few reasons why someone may engage in cheat meals or have a cheat day. First, people in the fitness community who want to gain muscle and change their bodies may eat outside of their typical eating patterns in an attempt to speed up their metabolism without negatively affecting muscle development.¹

Another reason an individual may have a “cheat” meal is to control food cravings with planned permission to break their diet. They may view this as a means to avoid binge eating episodes, increase metabolism, or supplement exercise or fitness.¹ As such, cheat meals are closely associated with the pursuit of “ideal” body composition.

The connection between cheat meals and eating disorders

Despite the relative normalization of cheat meals, new research has revealed that labeling something a “cheat meal” is associated with eating disorder behaviors and symptoms in teenagers and young adults. This study consisted of nearly 3,000 Canadian young adults, with over half of the young men, women, and gender non-conforming people having engaged in considering some meals as “cheat meals” over the past year.¹

The study revealed that women who ate “cheat meals” in the previous year reported higher rates of all seven eating disorder symptoms and behaviors measured, including:¹

• Binge eating
• Self-induced vomiting
• Laxative misuse
• Loss of control while eating
• Overeating
• Compulsive exercise
• Fasting

Likewise, transgender and gender non-conforming participants who ate in the past year a “cheat meal” had much higher rates of eating disorder symptoms and other related metabolic disorders.¹

Meanwhile, men who ate “cheat meals” in the past year reported higher rates of the following specific disordered eating behaviors:¹

• Fasting 
• Compensatory exercise
• Binge eating episodes

Of everyone in the study, cheat meal rates were found to be highest among boys and young men. This may be because of the popularity of this practice among fitness and muscle-building communities.¹

Why cheat meals may increase the risk of an eating disorder

People who eat cheat meals inherently engage in a rigid pattern of eating consisting of rules and restrictions. Dieting, in and of itself, is a risk factor for eating disorders. This is because most popular dieting strategies involve maladaptive eating patterns or behaviors, such as:

• Restricting food
• Counting calories (limiting caloric intake)
• Cutting out a particular food group
• Cutting out a macronutrient, such as carbohydrates
• Forgoing food in favor of juice or other liquids 

Many of these dieting practices are also seen in people who have eating disorders, such as anorexia nervosa. In fact, about 25% of individuals who have an extreme diet plan wind up developing an eating disorder.²

One study found that teen girls who engaged in extreme dieting were about 18 times more likely to develop an eating disorder than adolescent girls who didn’t engage in these extreme dieting practices.³

Since those who diet may utilize “cheat” meals to ultimately change or control their bodies, which can increase the risk for disordered eating behaviors and full-blown eating disorders for the following reasons:

• They emphasize physical appearance
• They focus on body size, shape, and weight gain/weight loss
• They are associated with rigid diets and control
• They can lead to binge eating episodes

Implications for eating disorder detection and treatment

It’s important for providers to be aware of the connection between cheat meals and eating disorders, especially among teens and young adults and the fitness community. Knowing that cheat meal engagement is a risk factor for eating disorder development can help clinicians engage patients in early intervention to either prevent a full-blown eating disorder or to treat it early.

Additionally, it’s important for clinicians to understand the various reasons for consuming cheat meals, which can help individualize treatment plans as well as identify the motivations for engaging in various eating disorder behaviors.

Screening

Doctors and therapists should screen for cheat meals, dieting, and other disordered eating symptoms among adolescents and young adults given the high frequency of cheat meals, which is often proliferated by social media and fitness communities, both of which should be considered in the biopsychosocial evaluation.

Treatment planning

As far as treatment planning goes, a treatment team may utilize many different therapies, such as:

• Cognitive behavioral therapy
• Dialectical behavior therapy
• Experiential therapies
• Movement groups
• Group therapy
• Family therapy

Exposure therapy may help an individual with a pattern of rigid dieting and cheat meals to gradually begin to eat “forbidden” foods during non-cheat meal days.

Intuitive eating and mindful eating

Patients can be introduced to intuitive eating, which involves listening to your body’s hunger and satiety cues and eating accordingly. This means eating what you want and when you want, without rules or restrictions. This may be difficult at first, given how long the patient has been ignoring their internal hunger and fullness cues, but with practice, it can become easier and lead to more joyful, satisfying meals. 

Mindful eating is slightly different—it requires one to learn to appreciate the ability of certain foods to nourish the body and to accept and appreciate food for its benefits. To teach someone how to mindfully eat, it may be useful to put them on a meal plan created by a nutrition expert.

Teen-specific treatment programs

Teens may also benefit from a teen-specific eating disorder treatment program, which specializes in treating the unique needs and challenges of this age group, including:

• Peer relationships and peer pressure
• Bullying
• Social media issues
• Body image problems