When you picture someone with an eating disorder, you probably imagine a teenage girl.
Increasingly, however, conditions like anorexia, bulimia, or binge eating disorder (BED) are being diagnosed in adults — including those over 50.
Some reports have indicated that eating disorders (EDs) among older people, most often women, may be on the rise. The Renfrew Center, which specializes in treating eating disorders, recently noted a 42% increase within a decade in women over 35 pursuing treatment.
It’s not clear, though, whether more older people are developing eating disorders, or whether an increased awareness has led to the problem being more frequently identified. Often, experts say, it’s a decades-old issue that’s finally been recognized and given a name.
“You definitely are hearing a lot of stories about women in their 50s, 60s, 70s, and 80s who are being diagnosed with eating disorders that have been around for a lifetime,” says Chevese Turner, Chief Policy and Strategy Officer at the National Eating Disorders Association (NEDA).
But while EDs are serious for all age groups, Turner says the illnesses are especially dangerous for older people. They can lead to—or worsen—nutritional deficiencies, diabetes, osteoporosis, kidney problems, and gastrointestinal issues, not to mention heart disease.
They can even threaten your life; one report found that between 2008 and 2009, people age 45-plus accounted for a quarter of eating disorder hospitalizations.
Why older people are at risk
Potential triggers for EDs include low self-esteem and social pressure. While those certainly affect people of all ages, midlife often brings additional, unique challenges that raise the chances even more.
“Transitions such as a divorce or a traumatic event can make it more likely for this to happen,” says Maria Rago, a clinical psychologist and president of the National Association of Anorexia Nervosa and Associated Disorders (ANAD). Ongoing problems like chronic illness, financial strain, and caring for elderly parents or grown children can up the odds, too. Even worrying about retirement or an empty nest has an effect.
And then there’s aging itself. Women especially may struggle with physical changes like weight gain, wrinkles, and sagging. One study cited menopause as a frequent catalyst. “We know that often times, big metabolic changes in a woman’s life will be a time when an eating disorder will emerge, and menopause is one of those times,” says Turner.
How to recognize an eating disorder
Though more older women are seeking help for EDs, the condition still often goes unrecognized. That’s partly because fewer people and medical professionals think to look for it, and partly because one obvious symptom—weight loss—can be an indicator of many other health issues.
With that said, being thin isn’t necessarily a sign of an ED, says Turner—and they can also occur in people of all sizes. She suggests looking for these signs as well:
Dramatic weight fluctuations. This is called weight cycling, says Turner: “They’re losing a lot of weight and then they’re gaining it back, and those cycles are happening over and over again.”
Constant dieting, weight fixation, and problems eating in front of others. Some people may outright refuse to eat certain food groups. “Very often times we see people [with] orthorexia, meaning they only eat ‘health’ foods,” says Turner. “And anything that is deemed a junk food, they won’t touch.”
Other mental health issues, such as depression or anxiety. These can magnify each other and contribute to isolation—another exacerbating factor.
How to get treatment for an eating disorder
If you’re concerned that a parent or friend may be struggling, you may have the impulse to reach out for a heart-to-heart. But it’s important to tread carefully, says Turner: “It’s very, very difficult for anyone with an eating disorder to talk about it because there’s so much shame.”
Don’t be surprised if your loved one denies needing help, she adds, or simply think they’re too old for it.
You may have more success broaching the topic by introducing basic information about eating disorders, and seeing if your loved one seems open to a longer conversation.
If it’s an aging parent, see if you can talk to their doctor. That could also help rule out any medical issues that may be causing the problem.
If you think there’s any chance you might have an ED, it’s essential that you seek medical help. Work with a mental health professional who specifically specializes in these disorders, says Turner. Get your primary physician involved, too, since your treatment may involve nutritional and medical issues along with your emotional concerns. “Hormonal changes that come with aging may be a factor,” says Rago.
Finally, have some patience with yourself: For many patients, recovery can take years. Says Turner: “The disorder didn’t happen overnight, more than likely, and it’s going to take some time to recover.”