Eating Disorders in Older Women

Recently, there has been an increase in the number of older women that display symptoms of disordered eating.  Although this segment of the population appears to be having issues that are very similar to those seen in younger women (body dysmorphia, seemingly uncontrollable eating, yoyo dieting, etc.) they may not be showing up for treatment.  In my practice, I usually see them “indirectly” or in the role as parent rather than a patient.  It is becoming all too common to have a patient describe her mother’s issues with food as being a part of her problem.  From parents that engage in bingeing to moms that are obviously restricting, the problems run the gamut.  The problem is that they are not there to address their own disorder, but that of their child.

An eating disorder is always a very serious problem, but it may be even more serious in older women because eating disorders can be particularly harmful to older populations since their bodies are less resilient. Eating disorders can have devastating effects on cardiovascular health, musculoskeletal health, and gastrointestinal health; these effects are amplified in older populations. Oftentimes eating disorders in older populations are left undiagnosed since symptoms that would be telltale signs of an eating disorder in younger populations, such as amenorrhea, are chalked up to menopause.

This year, the International Journal of Eating Disorders published a study which examined body image and the prevalence of eating disorders in older women. 1,849 women participated in the study; the average age of participants was 59 years old. The body weight of participants varied; 56% were overweight or obese, 42% were normal weight, 2% were underweight. The study determined that:

• 71% of the women said their weight or body shape affected their self-perception
• 41% of the women reported checking their body daily
• 36% of the women reported spending at least half of the last five years dieting
• 13.3% of the women reported symptoms of an eating disorder
• 8% of the women reported purging without bingeing within the past five years
• There was a high incidence of the use of unhealthy methods aimed at weight loss; 7.5% reported using diet pills, 7% reported exercising in excess, 2.5% reported using diuretics, 2% reported using laxatives, 1% reported vomiting.

An Australian study was published that also examined eating behaviors, weight history, and body image in older women. 475 women participated in the study; their ages ranged from 60-70 years old. The majority of women in the study were slightly overweight with a BMI of 25. The study determined:

• 90% of the women reported feeling very fat or moderately fat
• 60% of the women reported feeling dissatisfied with their body; many reported wanting to obtain a BMI of 23
• More than 80% of them women reported making efforts to manage their weight
• 4% (18 participants) met diagnostic criteria for an eating disorder; one participant had anorexia nervosa, one participant had bulimia nervosa, fifteen participants had an eating disorder not otherwise specified (EDNOS)
• An additional 4% of participants reported a single symptom of an eating disorder such as abusing laxatives or diuretics, purging or binge eating.

Researchers attribute the majority of mid and late-life eating disorders to major life changes such as divorce, loss of a parent, having children leave home for university or jobs, having children return home upon graduating university, and adapting to the role of having to take care of both children/grandchildren and aging parents. During these stressful life changes, many women turn to food to help gain a sense of control and to regulate their mood. Additionally, aging women may feel even more pressure to lose weight because they feel they are losing their “youthful beauty” which today’s pop culture values so highly.

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