The recent sudden death of a 65 year old woman I know made me wonder if she wasn't one of those women who struggled with an undetected eating disorder in the final two decades of her life. She had become "painfully thin" and looked so frail I couldn't imagine how she stood up on her own. When I saw her at social gatherings, she never had a plate of food. And although she had some medical problems, her death came as a shock to everyone who knew her.
There's plenty of evidence to show women do not stop caring about their weight as they age. How they deal with it separates the perpetual dieters from those with anorexia, bulimia or other disordered eating. Unfortunately, the societal pressures on women to be thin have become so persistent that women over 40 are just as likely to have eating disorders as those under 40.
The appearance of an eating disorder in an older woman is often the resurfacing of a problem that started in her youth. Anyone who learned at a young age to cope with stress by controlling her appetite is susceptible to resuming those coping mechanisms when life gets difficult. For women over 40, the trigger may be a trauma, such as the end of a marriage, loss of a loved one, or onset of menopause.
But even a woman who never dieted in her 20s can resort to unhealthy food restriction in her 50s when she realizes her tummy is not flat as it used to be. A study published in the International Journal of Eating Disorders in June 2012 found 62% of women age 50 and older said their weight negatively impacted their lives.
The danger for older women is that they are not as readily diagnosed as young girls. Changes in the eating habits of a teenager are noticed by her parents, as is a sudden drop in weight or the absence of menstruation. Since weight loss and a diminished appetite are common side effects of many illnesses and medications, they are not as surprising when seen in an older woman.
Yet the health risks of eating disorders are just as great for older women as young. The heart muscle is weakened, cognitive function declines and bone loss accelerates. If left untreated it can lead to organ failure and death. The goal is to get treated before these problems begin.
Signs of Possible Eating Disorder
- Excessive concern with dieting and losing weight
- Dissatisfaction with body weight, shape, size
- Weighing oneself more than once a day
- Denial of hunger
- Excessive or compulsive exercise
- Self-induced vomiting after eating
- Binge-eating followed by guilt, shame, regret
- Use of laxatives, diuretics or diet pills without medical supervision
Even though eating disorders look like food issues on the outside, they are rooted in unresolved psychological issues. The American Journal of Psychiatry reports almost 50% of people with eating disorders meet the criteria for depression. Focusing on how much you weigh can be much easier than dealing with low self-esteem or feelings of worthlessness.
With that in mind, it is important to remember that the behavior of someone with an eating disorder is an expression of their pain. They do not need to be told to eat more or exercise less. What they need is recognition of their pain, and an offer of help to get some relief.
Do you recognize the signs of an eating disorder in anyone you know?