Today I’m blogging for World Mental Health Day. This year’s theme is mental health and older adults, so I’m focusing on eating disorders in this population.
One of the biggest myths about eating disorders is that they only affect adolescent girls, that somehow older adults are immune to them.
However, eating disorders affect people of all ages, young and old. (They also affect all races, religions and both men and women.)
As clinical psychologist and professor Cynthia Bulik, Ph.D, writes in her book Midlife Eating Disorders: Your Journey to Recovery:
…[C]ountless women and men in midlife and beyond from all racial, ethnic, and socioeconomic backgrounds wake up each morning to an ongoing battle with eating and body image, with many suffering from anorexia nervosa, bulimia nervosa, purging disorder, BED [binge eating disorder], and night eating syndrome. Millions more lurk below the diagnostic radar with enough disordered eating to disrupt their lives, but not to receive an official diagnosis.
Eating disorders are caused by a complex combination of factors, including genetic, biological and environmental factors. For most older individuals, who are already genetically vulnerable to an eating disorder, a midlife stressor can trigger symptoms.
“Many of the middle-aged women I have treated have had symptoms of eating disorders their whole lives but the full-fledged eating disorder did not start until later in life, when a life changing event may have happened that became a gateway for the development of the eating disorder,” said Bonnie Brennan, MA, LPC, a certified eating disorder specialist at Denver’s Eating Recovery Center.
The life changing event may be anything from marriage problems to divorce to post-pregnancy to illness to kids leaving home, she said.
“Oftentimes, this group is also caught in between being parents themselves and having to be parents of their own parents, who are getting older.”
The physiological and psychological changes that happen during menopause seem to echo changes at puberty, Bulik says, which may make this time a high-risk period for the development of new eating disorders or the reemergence of old ones. These changes occur against the backdrop of America’s youth-oriented culture, which embraces the idea that aging — and the extra pounds that can accompany it — must be fought at any cost.
“Women don’t have a way of talking about the physical changes that go along with menopause,” says Margo Maine, Ph.D., a clinical psychologist in West Hartford, Connecticut, and author of The Body Myth: Adult Women and the Pressure to be Perfect. “Instead they seek to manage their bodies with the next exercise craze or taking the latest diet pill.”
For a small percentage of older adults eating disorders start for the first time in midlife.
Eating disorders are dangerous and life-threatening. Anorexia has the highest mortality rate of any psychiatric disorder (at 20 percent).
Eating disorders have serious health consequences, which lead to cardiovascular problems, severe fatigue, ulcers, pancreatitis, electrolyte imbalance, osteoporosis, tooth decay and kidney failure. These may be especially severe in older adults, because the body becomes less resilient with age, according to Bulik.
If you are struggling with an eating disorder, please get help. Seek professional support. Find a therapist who specializes in eating disorders, and get a proper evaluation.
As Joy Tapper, a woman in her 70s, who recovered after a 55-year battle with bulimia, said in this article: “I thought I would never be healed, but I finally am. The most important thing I learned in the process is that it’s never too late.”
Cynthia Bulik’s website has a helpful list of resources. You’ll also find several valuable pieces from Bulik on midlife triggers. In the next few weeks, I’ll also be sharing more information on eating disorders in midlife.