The National Alliance for Eating Disorders says it’s time to dispel a harmful myth. Popular culture and faulty understanding have created the misconception that eating disorder patients almost always are thin, white, adolescent girls. In fact, eating disorders can affect anyone, regardless of age, gender, race, ethnicity or socioeconomic status.
“Women are far more likely than men to develop an eating disorder … but some 10 percent of people with anorexia and bulimia and a third or more of those with binge eating disorder are male,” according to AARP. And they aren’t all teenagers.
AARP reports that a review of research published in Current Psychiatry Reports suggests that some 30 percent of people seeking treatment for an eating disorder are over the age of 45.
Megan Benda, PA-C, works with patients of all ages at Psychiatry of the Palm Beaches’ location in Melbourne. She says that some of her older women patients dealt with eating disorders in their younger years and some are presenting for the first time.
“The triggers for eating disorders are different in middle-aged women than they are when you are younger,” she explains. “Divorce, menopause, losing your job – they can cause women to deal with disordered eating for the first time or bring about a resurgence of a long-simmering pattern from earlier years.
“Women dealing with empty nest syndrome are prime subjects,” says Benda. “There’s a feeling people don’t need you anymore, which causes some to feel they’ve lost their identity. Couple that with our obsession with youth and [the cultural] message of unattractiveness if you’re not thin, and you’ll find many possible causes for this midlife challenge.”
Doreen Marshall, Ph.D., CEO of the National Eating Disorders Association, added additional risk factors:
- Death of a loved one
- Retirement
- Divorce
- Illness or caregiving for someone with an illness
Even in cases where they are invisible to others, eating disorders can take a toll on the body. Harvard University Health Services outlined some of the health issues common to middle-aged women with eating disorders: - Bone loss. The risk of bone fracture is seven times higher in someone who’s had anorexia than in the general population.
- Heart problems. Lower electrolyte levels from disordered eating can lead to an irregular heartbeat. Women in midlife are also more likely to take medications for chronic conditions, which can increase this risk.
- Lung conditions. Chest muscles become weaker over time, especially in people who repeatedly force themselves to vomit. This raises pneumonia risk.
- Gastrointestinal issues. Reflux, bloating, nausea, vomiting, constipation or diarrhea may be dismissed as consequences of aging but instead may be related to an eating disorder.
- Diabetes. People with binge eating disorders have far higher rates of diabetes, likely fueled by frequent blood sugar spikes after gorging.
- Skin breakdown. Poor wound healing and profound facial wrinkling are common in people with longstanding anorexia.
Benda adds, “Medical consequences of disordered eating are going to affect you more in midlife – like your vehicle when the mileage adds up.
“People with OCD (obsessive-compulsive disorder) are at risk of developing eating disorders. Any medical professional should explore this connection when meeting a new patient.”
The National Alliance for Eating Disorders says that while some people may have obsessions that revolve around germs or contamination – with accompanying compulsions like excessive handwashing – others obsess over fear of losing control, which could be accompanied by a compulsion like calorie counting or intense food monitoring.
Benda agrees, explaining that people with both OCD and an eating disorder often don’t go to restaurants because no place is perfect enough. “Some can’t let other people see them eat. Their entire day is organized around food,” she says.
Managing an eating disorder tends to be a long-term challenge. Mayo Clinic says you’ll likely benefit from a referral to a team of professionals who specialize in eating disorder treatment. Members of your treatment team can include:
- A mental health professional, such as a psychologist or other therapist for talk therapy. It’s important to choose a mental health professional with specialized training in eating disorder care, which not all therapists have.
- A registered dietitian to educate about nutrition and meal planning.
- Medical specialists to treat health problems due to your eating disorder.
- Your parents or other family members. For young people still living at home, parents should be involved in treatment and may supervise meals.
In Benda’s opinion, the combination of treatment by a mental health counselor and nutritionist are a key part of treatment. “It’s not just about knowledge, but it’s learning to be disciplined. Just because people know how to eat doesn’t mean they do.”
Megan Benda, PA-C, has a BS in Biology from Morehead State University and a master’s degree in medical science from Lincoln Memorial University. She works at the Melbourne offices of Psychiatry of the Palm Beaches at 6300 North Wickham Road, Suite 110. For an appointment, call 561-407-7980.
