Eating Disorders More Common In Midlife

[February 28, 2007] You starve yourself, shedding pounds, and it feels too good to ever stop. Or you eat lots - as much as you want, more than you want - and then sneak away from your loved ones to purge it all.

But you are not 16, not 19, not 21. Not a young woman at all. You are in your 30s, 40s, or 50s. And you can not stop.

Anorexia and bulimia used to be considered health problems that afflicted teenage girls. But doctors are finding that a growing number of older women are now being diagnosed with some sort of eating disorder.

No Age Limits on Eating Disorders

National Eating Disorders Awareness Week takes place from Feb. 25 through March 3, and doctors hope the event will bring greater awareness that there is no age restriction when it comes to these disorders.

"It can happen to anybody at any stage of their life," says Dr. Alexander Sackeyfio, a psychiatrist and eating-disorder specialist at the Beaumont Hospital in Royal Oak, Mich. "I think we're becoming more aware of it and are better at diagnosing it."

Dr. Bunnell says anorexics tend to be preoccupied with their body shape or weight, and often suffer from anxiety, perfectionism and obsessive-compulsive disorder. By contrast, bulimics tend to be depressed and impulsive, often struggling with substance-abuse issues.

"The anorexic style is more overly controlled, tense and rigid, while the bulemic style is less controlled, impulsive or disregulated," Dr. Bunnell says.

Eating Disorders Can be Fatal

People tend to make another mistake in their perception of eating disorders - they assume they are relatively benign psychological problems that are easily treated and without lasting physical effects, says Dr. Doug Bunnell, clinical director of the Renfrew Center in Wilton, Conn.

"People are surprised when they learn these have the highest mortality rate of any psychiatric diagnosis, somewhere between 10 and 15 percent," says Dr. Bunnell, who is also a member of the National Eating Disorders Association board of directors.

Anorexia produces dramatic weight loss caused by excessive or compulsive dieting. An estimated 0.5 percent to 3.7 percent of women suffer from anorexia nervosa at some point in their lifetime, according to the National Institute of Mental Health.

Midlife Resurgence or First Appearance of Problem?

Dr. Bunnell says he is seeing more middle-age or even older women coming in for treatment of an eating disorder. But, he is not sure that all of these are new cases developing later in life.

"My experience is that virtually all the women we've seen with eating-disorder symptoms in their 30s or 40s had some prior activity in the more typical age range," Dr. Bunnell says. "It may not have been diagnosed, or just short of being serious, but there was a period when they were really struggling with it. We've not seen a lot of brand new, out-of-the-blue eating disorder cases in older women."

Other doctors believe that hormonal fluctuations that occur near menopause could set off an eating disorder, as could mid-life changes like divorce or the departure of grown children. As the family changes, some women find themselves grasping for some semblance of control - one of the needs that an eating disorder can fulfill.

Complicating matters for the older patient is the fact that women coming in for treatment later in life may find it harder to get the help they need. For decades, the focus has been young women, and only recently has the therapeutic field begun to expand into treatment for older women - and men, Dr. Sackeyfio says.

Ideally, someone with an eating disorder should be working with a team that includes a psychiatrist, a nutritionist, and a physician, Dr. Sackeyfio says.

"They aren't spoiled brats who are trying to make people's lives harder," he says. "They really have very little control over the physical changes that they cause in their own bodies."

Always consult your physician for more information.