Eating disorders affecting more adult women

At any given time, about 70 per cent of women and 35 per cent of men are on a diet. We bet you aren’t surprised by this number. Thin always seems to be “in” — and, if you’re over 40, there’s an additional pressure to look years younger than your age. It isn’t enough for women to juggle career and family and cope with changes in their hormones and bodies: they have to look good doing it too. Judging eyes aren’t kind to people who “let themselves go.”

Now, a new U.S. survey confirms what some experts have long suspected: eating disorders are affecting more women over the age of 50, not just teenage girls.

The online survey, conducted through the University of North Carolina Eating Disorders Program, polled 1,849 women over age 50. The questions tackled topics ranging from their attitudes towards aging, body image and weight loss to their weight loss behaviours.

The results published in the International Journal of Eating Disorders reveal some troubling numbers. Nearly 80 per cent of respondents said their weight affects how they feel about themselves and about 70 per cent reported they were currently trying to lose weight. Just over one third reported being on a diet for at least half of their time over the past five years. Weight is top of mind on a daily basis for about two thirds of the women, and 40 per cent said they stepped on the scales at least a couple of times a week.

Even more worrisome is the extreme lengths some women are going to in order to lose weight. Eight per cent of women report purging behaviours, and nearly as many women resort to diet pills. In addition, 7 per cent of participants admit excessive exercise, 2.5 per cent use diuretics, 2 per cent use laxatives and 1 per cent resort to vomiting. About 13 per cent of participants suffer from an eating disorder.

While you might expect that some participants have been struggling with eating disorders since they were younger or have relapsed, that wasn’t the case with all women. Many of the participants grappling with eating disorders developed this health issue after age 50, report the researchers.

Are the numbers surprising? If you’ve followed the media coverage, like this report on Time.com, the researchers say the numbers aren’t all that shocking. The survey provides proof to what many experts have seen in their practices.

However, no one knows the exact number of older women and men who are affected. Overall, about three per cent of women and 0.3 per cent of men will be affected by an eating disorder during their lifetime, according to the Public Health Agency of Canada — but the data doesn’t look at age groups.

Worse yet, experts warn that as many as 10 to 20 per cent of people with eating disorders will eventually die due to a related complication like a heart condition or kidney failure. Statistics may not tell the whole story because some eating disorders are never diagnosed, and among older adults it’s the complication (not the eating disorder) that’s listed as the cause of death. Experts warn that older bodies can’t “bounce back” from the ravages of disordered eatign the way young women can.

Why now?

Contrary to popular belief, there’s more to eating disorders than a desire to be thin. People who develop them often fixate on weight and food as a way to gain a sense of control in their lives. Disordered eating can become a coping mechanism for problems like anxiety, depression, loneliness, dysfunctional relationships, a lack of self-esteem and even abuse. People who develop anorexia and bulimia often believe they would be happier and their problems would lessen if they lost weight.

So why is age a catalyst for relapsing or developing an eating disorder? Experts have a few theories, including: 

An increasing awareness of our bodies as we age. Being self-conscious about our bodies doesn’t go away with age — in face, we’re invited to fight back against every wrinkle, grey hair and pound we gain. More adults are returning to school, the workforce or the dating scene, and they might be increasingly worried about how others judge their appearance.

Grief. As we get older, we’re more likely dealing with the loss of loved ones. Not only can grief affect the appetite, food can become a way to cope with these emotions and find control in a situation where there is none.  

Divorce. It’s a different kind of loss than grief, but experts warn the failure of a marriage can affect how a women views herself and her body — especially if a spouse has left her for a younger women.

Weight changes due to illness. Many chronic illnesses and their treatments cause changes in weight — and consequently changes in how we see ourselves. For instance, people who have gained weight might struggle to get back their figure. People who have lost weight may fight to maintain their new weight when they recover.

Midlife can also be a time when people seek treatment after years of dealing with an eating disorder. Sometimes, the cumulative effects — like morbid obesity, type 2 diabetes, malnutrition, dental problems or osteoporosis — force people to face the underlying issues. An acute crisis like a stomach rupture from forced vomiting can also reveal the problem.

And sometimes it’s simply a matter of “enough is enough”. Years of hiding a secret takes its toll on people, and an event like a loved one’s death or a health scare can prompt them to seek help. (For more information, see the Harvard Health Newsletter‘s Disordered eating in midlife and beyond.)

The aging of the population also plays a role. The sheer size of the baby boomer demographic affects statistics as they age.

We’re also better educated about eating disorders than in the past. Awareness campaigns like National Eating Disorders Awareness Week have helped people identify risky behaviours.

The warning signs

It isn’t always easy to tell if you or someone you know is headed for trouble. Here are some warning signs to keep in mind:*

Changes in weight. Someone suffering from anorexia nervosa may lose an extreme amount of weight while someone with binge-eating disorder may end up obese.

A preoccupation with weight and body shape. Many people worry about how they look, but people suffering from an eating disorder become obsessed with weight and often think they are fat even if they are underweight. Their feelings of self worth are closely related to how they look, and they’re fearful of gaining weight.

Preoccupation with food. People might restrict certain foods associated with weight gain, or go through periods of fasting. Someone with anorexia nervosa might refuse to eat and deny they are hungry. Someone prone to binging might be obsessed with what to eat and when.

Negative feelings associated with food. Some people may feel guilt or shame about food, or be secretive about their eating habits.

Excessive exercise. Some people may exercise many hours each day to help lose weight or make up for a binge — and feel guilty when they miss a workout.

Eating more food than is normal for a meal or a snack. Eating unusual amounts — and filling up on desserts or junk food to the point of discomfort — could be a sign of bulimia or binge-eating disorder.

Laxative use or prescription medication abuse to lose weight.

Disappearing to the bathroom during or after meals.

Psychological symptoms like becoming socially withdrawn and lack of emotion.

Many of the signs are physical like abdominal pain, bowel problems, irregular heartbeat, weakness, fainting, dehydration, sores in the mouth and throat, dental problems, body hair (known as lanugo) and changes to the skin.

(*For a full list of symptoms broken down by type of disorder, see the Mayo Clinic’s section on eating disorders.)

You may have noticed that some of these symptoms overlap with other conditions affecting older adults.  Experts warn that can make eating disorders harder to spot — and the symptoms easier to dismiss.

What you can do

Do these signs sound familiar? If you think someone you know is affected, there are ways you can help.

Learn about the condition. As with any illness, educate yourself so you can better offer support and help. There is a lot of stigma surrounding eating disorders — especially for adults.

Not sure where to start? The National Eating Disorder Information Centre (NEDIC) and Canadian Mental Health Association have more information online and can direct you to resources and treatment centres in your area. The U.S. National Institute of Mental Health also has a downloadable guide on eating disorders.

Express your concerns and let the person know you are there to support them. Let the person know you care and that you’re there to help. Be aware that he or she may reject your initial efforts to help and may deny there is a problem. (NEDIC has a conversation guide with useful tips.)

– Encourage the person to get professional help. As much as you want to be there for your loved one, experts warn to let the professionals handle the role of therapist and doctor. Treatment often involves a multidisciplinary approach targeting both the behaviours and the health issues.

Be patient. It takes time to for people to accept help, and recovery has to happen at their own pace. It’s important not to judge and to be respectful of the other person’s feelings.

Avoid power struggles over food or eating. Remember, being in control is a factor behind eating disorders. Trying to force someone to eat or demanding that they change can make matters worse. You can’t control someone’s health: they have to want to change.

Instead, experts recommend to take the focus off food and weight. Emphasize other positive aspects of their lives and help them to see beyond the eating disorder.

Take care of yourself too. Eating disorders can leave loved ones feeling fearful, frustrated and helpless. Experts warn it’s important for family and friends to make sure their own physical, emotional and spiritual needs are being met too. Many communities have support groups for people whose lives are touched by eating disorders.

(For more advice, see NEDIC’s Help for Friends and Family.)

Eating disorders can affect people of all ages, but people of all ages are overcoming them too. The takeaway message from experts is to be aware of the problem — and it’s never too late to seek help.

Additional sources: Academy for Eating Disorders, the Associated Press, Public Health Agency of Canada, News Canada, Statistics Canada

Photo ©iStockphoto.com/ Erik Reis

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