Empty Plates for “Empty Nesters”
Eating Disorders Among Older Women
Eating disorders have typically been seen as a group of conditions affecting adolescent girls. After all, reportedly 90% of the estimated 8 million people in America with eating disorders are female between the ages of 12-25, according to a report by the National Alliance for the Mentally Ill. However, eating disorders are being detected among older women.
Throughout the community—in doctors’ offices, gyms, etc—it is becoming more noticeable that some older women are going to extremes to control their eating behaviors and weight. The New York Times and similar sources have reported anecdotal evidence from psychiatrists in private practice who have identified this trend among their patients.
Characteristics of Eating Disorders
- Anorexia nervosa, the least common eating disorder affecting 0.5% to 3.7% of women with eating disorders, is an illness that leads persons to deprive themselves of food so that they experience a state of starvation and dramatic weight loss.
- People with bulimia nervosa, which affects 1.1% to 4.2% of women with eating disorders, often have urges to eat extreme amounts of food and then immediately engage in behaviors (eg, vomiting, using laxatives, excessive exercise) to rid themselves of the excess food they have consumed. People with bulimia nervosa may appear overweight or have a normal weight.
- Binge-eating disorder, which affects 2% to 5% of Americans, is usually characterized by bingeing, or excessive intakes of food without purging, which usually leads to excessive weight gain.
Although more research is needed to fully explore this area, all of these eating disorders, or a combination of the three, appear to be increasingly common among older woman—especially those in midlife years. In general, women of all ages typically describe a feeling of being “out of control” when relaying their thoughts and feelings on issues of food and weight.
Potential Reasons for the Trend
This trend in eating disorders among older women is likely the result of a variety of factors. However, it is difficult to accurately obtain statistics relating to eating disorders, in part because many women have been secretive about these disorders. It is difficult to determine whether there are actually more women experiencing eating disorders in recent years, or if there is less secrecy and more women are now seeking help for the disorders. The following scenarios are possible explanations for the increase in prevalence:
- About half of adolescents with anorexia or bulimia have a full recovery over time, but 30% have only a partial recovery, and 20% have no substantial improvement in their condition. Therefore, eating disorders may continue in some people, as they get older.
- In the British Journal of Psychiatry, researchers S.G. Gowers and A.H. Crisp describe a case of anorexia in an 80 year-old female patient, who struggled with the condition as a teenager. After 50 years of being symptom-free, the patient had a relapse of anorexia.
- In addition, some middle-aged women may have the proverbial “mid-life crisis,” during which they exhibit signs of eating disorders as a result of life’s pressures, such as peer and societal pressure to be thin and young, fear of sexuality (especially relating to aging issues and spouse’s interest), and family conflicts. In this scenario, these women may have previously engaged in healthful behaviors, but now are exhibiting signs of disordered eating and behaviors relating to weight.
- Finally, some women may be engaging in more healthful behaviors, such as exercise, than they had previously. But life pressures may build, pushing them to extremes as they fit in several hours of exercise per day—at which point this becomes an unhealthful behavior. Subsequently, it develops into a disordered behavior relating to weight. Some have referred to this behavior as “gym bulimia.”
Long-lasting Generational Effects
Eating disorders at any age can have devastating health and psychosocial consequences. But perhaps what’s most alarming is the fact that older women with eating disorders may be passing on their disordered behaviors to their children. Eating disorders seem to run in families, as do most psychiatric disorders. In fact, as many a 10% of mothers and sisters of anorectic women may have anorexia. Some researchers think there may be a genetic link, but at minimum the attitudes and behaviors of mothers with eating disorders are likely to be passed on to children, particularly daughters.
While eating disorders are typically detected in adolescents, they are not only a problem for younger women. Women of all ages may be affected by one eating disorder or a combination of disordered behaviors relating to weight. While eating disorders are potentially life threatening to the women who have them, if left untreated, they also have the potential to adversely affect the children of women with eating disorders. Therefore, seeking help from a qualified counselor has the potential to benefit both individuals and families affected by eating disorders.
National Eating Disorders Association
National Institute of Mental Health
National Eating Disorder Information Centre
Women's Health Matters
Eating disorder statistics. South Carolina Department of Mental Health website. Available at: http://www.state.sc.us/dmh/anorexia/statistics.htm. Accessed June 9, 2009.
Gowers SG, Crisp AH. Anorexia nervosa in an 80-year-old woman. The British Journal of Psychiatry. 1990;157:754-757.
Inagaki T, Horiguchi J, Tsubouchi K, et al. Late onset anorexia nervosa: two case reports. Int J Psychiatry Med. 2002;32:91-95.
Komaroff, AL. Harvard Medical School Family Health Guide. New York, NY: Simon & Schuster; 1999:413-414.
Scholten A. Eating disorders. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Updated May 2009. Accessed June 9, 2009.
Wiseman CV, Sunday SR, Klapper F, et al. Changing patterns of hospitalization in eating disorder patients. Int J of Eating Disorders. 2001;30:69-74.
Last reviewed May 2009 by ]]> Theodor B. Rais, MD ]]>
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