Eating disorders like anorexia and bulimia are often seen as afflictions concerning only young women and teens, and are often overlooked in older women. Eating disorder treatment centers have seen an increase in older adult women seeking help. The National Eating Disorders Association reports that in 2003, one-third of all women admitted to inpatient eating disorders programs were individuals over 30 years old. Eating disorders in mid-life are caused by many factors, and it is important to examine the factors in order to address these often hidden disorders.
An intense fear of becoming fat and a dissatisfaction with one’s body drives eating disorders. Our culture and the media have embraced strict, unattainable ideals regarding weight and appearance for women. An eating disorder in middle life may be disguised by the cultural acceptance of unhealthy dieting and standards which often equate thinness with health. Moreover, a woman who is dieting in an attempt to “slim down” is often praised for her efforts and reinforced by others because she is attempting to attain the culturally established standard of beauty. However, this control of one aspect of life can easily become a slippery slope of obsession that gradually overtakes all other priorities in life. Even a normal weight gain of five to 10 pounds per decade of life triggers the fear and body dissatisfaction which can fuel the disorder.
The three categories of eating disorders are Anorexia Nervosa, Bulimia Nervosa and a general category—Eating Disorder Not Otherwise Specified (EDNOS). The criteria for Anorexia Nervosa includes a weight loss below 85 percent of what is normal and healthy, distortions in body image (feeling fat even when too thin) and an intense fear of becoming fat. Bulimia Nervosa is characterized by bingeing and then purging of food by self-induced vomiting, use of laxatives, diuretics or diet pills. Another behavior often seen in eating disorders is excessive exercise to burn calories. Others who do not meet the exact criteria for Anorexia or Bulimia may fall into the EDNOS category and may exhibit some of the above behaviors such as overeating, over-exercising or only eating certain foods.
The course of eating disorders in adult women varies. While some women in middle life are experiencing an eating disorder for the first time, often triggered by a diet, others have struggled since youth and continue to have eating issues. Still others may have had a history of eating disorder behavior that resolved or improved as a teen. A crisis in a woman’s life—such as loss or divorce—can trigger another episode of eating problems. Some women seeking treatment have had the eating disorder throughout their lives and as a result of the disorder are experiencing significant medical complications such as heart disease, brittle bones and increased psychiatric complications. Others may have obsessed about food and weight for years and developed more problems later in life. Sometimes adults seek help because they see their own teen struggling with eating problems and want help to prevent eating disorders in the next generation.
But adult women face additional barriers in seeking treatment. Older women may feel ashamed or embarrassed about having this common disorder and are therefore hesitant to seek treatment. Sufferers may fail to accept the reality of the aging process and that their bodies are moving further away from the cultural ideal. They may feel a stigma in having a disease that is thought to only affect the young. Women are caretakers of others and many feel they cannot take the time to care for themselves. A sufferer may be unwilling to give up control of the one thing in life that is controllable—thinness. She may be unwilling to give up the illusion that she is in charge. Paradoxically, as an eating disorder takes control, a person is taken more and more distanced from what is important to her.
Recovery includes challenging the “ideal” body standard and automatic negative thoughts that drive the dangerous behavior of anorexia and bulimia. Women must learn to identify their authentic inner selves and their authentic needs. They need to grieve the loss of the ideal body, which is intimately tied to greater self-acceptance. Then, they can examine the absence of the valued activities in their lives which they have sacrificed due to their eating disorder. With treatment, a woman learns to nurture the self through relaxation, creative energy and wholeness of mind, body and spirit. Middle age provides the potential for growth in both health and wholeness. Increased body acceptance frees the self to achieve greater satisfaction in relationships, acceptance of the self and the truly richer and valued experiences of life.
If you or someone you care about is concerned about eating disorders, please contact OSF Saint Francis Eating Disorders Program at 655-2738. tpw
