Reports of eating disorders in older women continue to increase. The emergence of these cases leads to a number of questions. Are these new eating disorders, or recurrences of old ones? For those who never had eating disorders before, what caused them? And most importantly, what can be done about this "new" problem?
Treatment Centers Handle More Older Women With Eating Disorders
Park Nicollet Health Services' Eating Disorders Institute, near Minneapolis, Minnesota, reported that 35% of their patients in the first half of 2007 were 38 or older. Meanwhile, the Renfrew Center's Philadelphia location saw the proportion of women age 30 and above peak at 20% in 2005, though there was a decline in 2006. Other facilities report upward trends without hard statistics.
Eating Disorders Not New to Many Older Women
Though more and more women ages, 30, 40, 50, and beyond are entering treatment for eating disorders for the first time, they are often veterans of eating disorder symptoms. Some have either had continuous problems since they first developed symptoms (perhaps in their teens). Others are simply experiencing relapse after a significant time of remission.
A 2008 study at the Eating Disorder Center of Denver found that of their eating disorder patients between ages 30 to 65, 94% had eating disorders earlier in life. The Renfrew Center's statistics indicate that 80% of their patients over 30 had experienced symptoms before age 30.
Unique Stressors For Women in Midlife
Still, some do develop symptoms in midlife for the first time. These women, and those who relapse in midlife after a period of remission, are subject to unique risk factors for eating disorders.
While adolescents experience massive changes to their bodies within a short period of time, adult women also deal with physical change. Having children is obviously a big one, as the body is often slower to recover from childbirth than desired. As time passes, aging begins to be visible. Of course, plenty of marketing money is spent on targeting this population for collagen treatments and various kinds of cosmetic surgery. As more people choose these huge (and often drastic) changes, others can feel more pressure to keep up.
New stress also arises when kids leave the home. Women may find that they can ignore their own well-being when their children are around and in need of care, but without the kids, they may begin to examine themselves and not like what they see. Women of any age are at greater risk for eating disorders at times when self-examination increases.
Barriers to Treatment
Women 30 and over can get away with their disordered eating more easily, because many assume that eating disorders only occur in teens. Some women use this knowledge to their advantage: As long as they function well in most areas, few people will question their eating patterns.
Even those who enter treatment can be at a disadvantage. It's been shown that family-based treatment can be effective in treating eating disorders. The family can learn how to avoid being manipulated by their daughter (or son) and help to foster better eating patterns. But for women 30 and over, their parents and siblings are not present day-to-day and don't have the same influence.
The good news for women who enter treatment in their thirties and later is that they are usually more focused and motivated to recover.
What's Next?
Some facilities are working toward offering treatment tracks that are geared to an older population, eliminating the shock of entering group therapy and being at least 15 years older than every other group member. Interestingly, the over-30 group does not seem to differ much with teens in terms of psychological issues. So there is merit in letting older patients in treatment centers interact with younger patients: Each can learn from the other group. However, though the two groups may deal with life in similar ways, there is no denying that their respective life circumstances are different.
In my opinion, dual tracks should provide new avenues to address a teen's eating disorder when investigation reveals that her mother (or father) has disordered eating as well. Mom could enter the track for her peers while the daughter stays with other teenagers. In a well-structured treatment plan, they would then have the chance to come together to address family dynamics, making the home (and the relationships in it) safer for healthy eating.
As with any eating disorder treatment, treatment for those in midlife that begins soon after symptoms start is more likely to be successful. Continuing to build awareness of eating disorders in women (and men) beyond their teens and twenties is key to creating the best chance for the greatest recovery.
Sources:
Profiling midlife eating disorders. Eating Disorders Review 17 (2006): 4-5.
Pryor T. The desperate housewives syndrome: Research on mid-life patients with eating disorders. In press. Obtained through correspondence with author, 16 June 2008.
