About 30 million Americans have an eating disorder.
When you think about anorexia, bulimia, and binge eating, you probably picture adolescent girls or young adults. That’s because eating disorders tend to appear early in life and are more frequent in females than males. But it’s estimated that about 13 percent of women over age 50 are living with an eating disorder.
And because older women may not recognize the symptoms or are reluctant to admit it, the problem may be bigger than we realize.
Life transitions can trigger eating disorders
Dena Cabrera, PsyD, CEDS, executive clinical director of Rosewood Centers for Eating Disorders in Arizona, told Healthline that the reasons older women develop eating disorders vary.
Some may have had eating disorders in their teens and had decades of recovery, only to relapse when they’re older.
Others may have been preoccupied with food and weight for a long time, but have never been compromised until now.
The loss of status in a youth-oriented world can also contribute to development of eating disorders or distorted body image, explained Cabrera.
She added that other triggers include the death of a loved one, divorce, traumatic illness, and suddenly finding yourself with an empty nest.
Julie began struggling with food and weight as a teenager.
“I lost a lot of weight before I went to high school. Then I learned from friends about bulimia. It seemed like a good way to keep the weight off,” she told Healthline.
Now 47 years old, Julie (who asked that her last name not be used) acknowledges the secrecy surrounding eating disorders.
“It seems easier in your 40s because no one is looking over your shoulder,” she explained.
Through therapy, Julie discovered that her eating disorder is at least partly triggered by her husband’s frequent absences due to work. She realized she’d been planning for his overnight shifts and out-of-town trips by stocking up on binge foods.
New York City-based therapist Kimberly Hershenson, LMSW, specializes in eating disorders and body image.
“Life is full of transitory periods, especially as you get older, and this has an impact on eating behavior and body image,” she told Healthline.
“Usually, when somebody has struggled with an eating disorder as an adolescent, they’re predisposed to relapse later in life. It’s not as common to have a healthy relationship with food your entire life to then develop an eating disorder at midlife — although that does happen,” Hershenson said.
When you feel things are out of control, you might try to gain control through food and body issues, she explained.
“It’s really an unhealthy coping mechanism that develops when a person has trouble dealing with life on life’s terms,” Hershenson said.
Treatment may differ for older women
Cabrera said there are unique treatment issues for those who are in midlife to late life.
Older women may need help in coming to terms with normal life cycle changes.
And older women may have a hard time committing to treatment.
“My experience is that due to the pressures of career, family, financial resources, and home life, older women may have a more difficult time carving out time for treatment and making it a priority. Also, they may have more difficulty with self-care and self-compassion. Also, later in life, the behaviors become more habitual and may be more difficult to break,” explained Cabrera.
The health consequences are serious at any age.
“When you’re younger, your body can withstand more,” said Hershenson. “Restricting and purging have a greater effect when you’re older, and you’re not able to bounce back as quickly.”
Julie didn’t receive treatment when she was younger.
“I was more ‘scared straight’ by my older brother, who would tell my parents every time I went to the bathroom after a meal and purged. It just got more complicated because he was always watching me,” she said.
Things were different this time around.
“As an adult, I struggled a little bit with bulimia, but I could hide it by saying I was throwing up due to migraines. But the purging actually created a migraine, so throwing up resulted in me being in bed for days. So, I gradually stopped throwing up,” she explained.
Julie has since been through a 10-week binge eating program and a year of follow-up at an eating disorder clinic.
Recognizing the signs
Cabrera said that changes in eating patterns, yo-yo dieting, and weight changes may indicate that someone has an eating disorder.
So can obsessive exercising, anxiety, and increasing isolation.
Asked if one should intervene, Hershenson said it depends on the person.
Some may not recognize that they have an eating disorder and will be surprised to realize it. Others may retreat even more.
“The best thing is to let the person know you love them and care about them and you’re always there for them to talk to. Offer to help them find the support they need. But be prepared when you confront someone. They might be very defensive and say they have no problem,” she cautioned.
Hershenson said older women might feel embarrassed by the stigma of having a “teenage disease.”
“My older clients — I have two in their 50s — will not go into a treatment center,” she said.
There is a way out
Eating disorders are complicated.
“It is not about willpower or lack of commitment that they are unable to get better on their own. Eating disorders are an illness. Help, support, and healing are available,” advises Cabrera.
“Don’t blame yourself if you have an eating disorder. This is just your way of coping. You can find healthier ways to cope. Know you are not alone. There are support groups around the country, in the community, and online. You don’t have to live like this forever. There is a way out, but it will take work and time,” she said.
“This is probably the best piece of advice I can give. You need to think of you and your eating disorder as two separate entities,” she added. “The ‘true you’ probably wants to have friends and be sociable and eat well and take care of yourself. But your eating disorder brain takes over. Really try to recognize that you are not your eating disorder. Verbalize that your eating disorder is telling you that you don’t deserve to eat, or that you need to run, but you don’t need to do that.”
Julie still has her ups and downs. She doesn’t believe she’ll ever be truly healed from her eating disorder.
“I would tell women that an eating disorders clinic is a great resource for getting help. I went through a 60-day outpatient program four hours a week, and then a year of group therapy and one-on-one therapy. The women I met in group therapy were amazing. I learned so much from them,” she said.
“Also, it can take a while to find the right therapist. I’ve had a few that I didn’t really connect with. Don’t give up. The right therapist for you is out there,” Julie added.