Eating disorders are much more common in older women than you might think

Sara Lindberg
Photo: Getty Images
Photo: Getty Images

There are roughly 30 million Americans today struggling with eating disorders. And while eating disorders are commonly thought of as a disease that afflicts the young, the reality is that many older people and people in midlife struggle with eating disorders too.

Highlighting that fact is one of the many reasons why this week, National Eating Disorders Awareness Week (Feb. 26-March 4), is so important. This year’s theme, Let’s Get Real, aims to expand the conversation around eating disorders and highlight stories we don’t often hear, like the stories of women in midlife and older who are living with eating disorders. To that end, Yahoo Lifestyle is homing in on older women with eating disorders — hoping to help de-stigmatize this underdiscussed and painful issue.

How common are eating disorders in midlife?

The prevalence of eating disorders in older women has historically been an underreported topic. This is partly because of the stereotype that eating disorders are a younger person’s disease and partly because older women have often become masters at hiding their struggles.

Fortunately, there are organizations like the National Eating Disorder Association and eating disorder specialists who are fighting to get the word out and provide help for so many women.

In fact, one of those eating-disorder experts, Margo Maine, has been studying and treating eating disorders for decades. She is the author of several books, including her most recent: Pursuing Perfection: Eating Disorders, Body Myths, and Women at Midlife and Beyond, which gives us a glimpse into the world of eating disorders in older women.

Maine says that in 2005, when she wrote her first book about adult women and eating disorders, there was almost no data on the issue. The information that was available made it seem as if once women got past the age of 25, their body concerns and eating issues went away. But that was not what Maine was seeing in her practice.

In fact, Maine offered Yahoo Lifestyle some information that fundamentally disproves the idea that eating disorders are only evident in the young.

  • About 75 percent of American women ages 25 to 45 report disordered eating and body-image dissatisfaction.

  • A recent U.S. survey of women over 50 found that 79 percent report that weight/shape perceptions affect their self-image, and 13.3 percent reported behaviors that would be considered symptomatic of an eating disorder.

  • A large study in the U.K. reported a prevalence of eating disorders in 15.3 percent of midlife women.

Licensed clinical social worker Carolyn Karoll says women ages 35 to 65 are in fact the largest new group of sufferers seeking eating-disorder treatment.

Another expert, Dena Cabrera, says there has been a significant increase in women over 40 admitted to treatment centers in the past decade. “These are women who struggle with body-image issues that arose during their youth and never really abated and women who may have suffered from an eating disorder in their teens but have been recovered for decades, only to relapse when they are older,” she explains. They’re also women who may have been preoccupied with food and weight for years but have never been compromised until now.

Why are older women susceptible to eating disorders?

“Midlife is full of developmental transitions, and it is these transitions that can trigger bodily concerns and a need for control that weight loss, body preoccupation, excessive exercise, and other body rituals can bring,” explains Maine.

The stressors in midlife are many, say all three experts, including physical changes resulting from the normal aging process, child-rearing, loss and trauma, divorce, infidelity, caring for aging parents, menopause and associated hormonal changes, financial stressors, empty-nest situations, and competing with younger women in the workplace.

Why do eating disorders remain hidden in midlife?

Maine points out that older women experience significant shame and embarrassment for having a “teenager’s problem,” which makes it really difficult for adult women to admit they have an eating disorder.

Unfortunately, they see these as adolescent concerns and feel they “should know better.” And since many of them are quite accomplished, high-functioning, and perfectionistic, the idea that they may need help just doesn’t fit.

Cabrera says that in her experience it is more difficult for older women to seek help due to the pressures of career, family, financial resources, and home life. They may struggle with self-care and self-compassion, plus carving out time for treatment and making it a priority can be seen as a challenge.

On top of that, women in midlife may not self-identify with an eating disorder diagnosis. Karoll often encounters women in her private practice who — despite reporting behaviors such as preoccupation with food and weight, restrictive eating habits, compulsive exercise routines, habitual laxative use, bingeing, and even self-induced vomiting — don’t self-identify as having an eating disorder.

“These behaviors are often couched as diets, wellness plans, ‘cheat days,’ and lifestyle choices in the pursuit of health,” she explains. The rigidity is referred to as discipline, and the compensatory behaviors are simply seen as a response to “falling off the wagon.”

What can you do if you’re struggling with an eating disorder?

Maine says most women need individual therapy, some dietary counseling, and possibly couples work. She also recommends group therapy, since it can help people feel less alone.

All of the experts agree that going to a therapist who specializes in eating disorders is important. And Karoll suggests getting support from your therapist to educate family and friends about the recovery process.

In addition to individualized help, you can also access information and support from the National Eating Disorder Association and other organizations.

Finally, Karoll reminds us that if you are suffering or even think you may be suffering from an eating disorder — and are outside the demographic often associated with this illness (i.e., adolescents, teens, 20s, or early 30s) — it’s important to know that you are not alone.

“Not only are there other women just like you struggling with eating-disorder symptoms in all stages of recovery, there are also providers who are passionate about helping midlife women make peace with food and their bodies,” Karoll says.

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