Eating Disorders in Midlife: Not Just a Young Person’s Illness
What does the face of an eating disorder look like? Is it a young teenage girl struggling with body image? A college athlete trying to lose weight for a meet? The truth is, an eating disorder can strike anyone at any age. Midlife eating disorders are on the rise in both women and men, and the triggers are not just related to appearance and weight.
According to the National Eating Disorders Association , 43 million adult women in the United States are dieting to lose weight. Even among women aged 61 to 92, weight was identified as their most significant concern about their bodies. One-third of inpatient eating disorder admissions in 2003 were over 30 years old. These are alarming statistics that lay to rest any misconception that eating disorders are an adolescent illness.
The ratio of female to male eating disorders suggest that women and girls are more affected than men: according to the National Eating Disorders Association (NEDA), the female to male ratio for anorexia is 10:1; for bulimia, 10:1; and 2:1 for binge eating disorder. Although eating disorders in females and males are clinically similar, it is feared that the true statistics related to males are not fully known due to underreporting of symptoms and stigma.
What is Causing the Growing Epidemic of Disordered Eating
Clinical eating disorders have clear indications and criteria for diagnosis. Anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified (ED-NOS) are all represented in the Diagnostic and Statistical Manual-V (DSM-V) and have strict parameters for diagnosis. Not so easy to spot are those eating habits that, although they may not fit the definition of an eating disorder, have troubling consequences for a person’s physical and emotional health. These eating behaviors fall into a category termed disordered eating, and they are far more prevalent than we may have realized.
What Does Healthy Look Like?
I think it is fair to say that those who struggle with some type of eating disorder have a really hard time with knowing what a healthy lifestyle and diet is. I know this because I once lived a life with anorexia and bulimia for ten years and knew what I was doing to my body was wrong and hurting it, but at moments I didn’t really care. I didn’t know a life without restricting, binging, and purging, so healthy is a word that I never thought I would live nor understand.
Eating Disorders and Dental Exams
Did you know that an eating disorder can be diagnosed from the dental chair? According to the Institute of Dental Research, 28% of bulimia cases are first diagnosed during a visit to the dentist. Our mouths reveal a tremendous amount of information about our overall health. Dentists may be among the first professionals to notice something that is indicative of a more serious issue.
Eating disorders in men are on the rise. According to the National Association of Anorexia Nervosa and Associated Disorders, an estimated 10-15% of people with anorexia or bulimia are male. The National Eating Disorders Association reports that 1/3 of teenage boys use unhealthy weight control behaviors such as skipping meals fasting, and taking laxatives.
A new study from the University of Montreal researched the similarities between male and female anorexia in order to improve awareness of the disorder as it presents in males. The study found that behavioral symptoms are similar between males and females, but that male symptoms in particular seem to be related to personality, gender identification, and sexual orientation. The study also found, according to Nauert (2014), that although males and females seem to share the same fears about weight gain, body image dissatisfaction for males was more connected to muscle mass. For males, excessive exercise was more common that other rituals such as restricting food and vomiting.
Nauert further reports that the rate of homosexuality among study participants was higher than the general population, leading researchers to hypothesize that anorexia may delay the processing of questioning sexual orientation and restrictive food behaviors may delay sexual maturation.
Further research must be done to fully understand anorexia in males and the special issues that create anxiety and stress in the male population. To support men who are struggling with eating disorders, some treatment centers, Center for Discovery among them, have committed to providing treatment options and programming for males who are suffering from an eating disorder.
Nauert, R. (2014). Study probes anorexia in males. PsychCentral, retrieved from www.psychcentral.com
National Eating Disorders Association: www.nationaleatingdisorders.org
National Association of Anorexia Nervosa and Associated Disorders: www.anad.org
Overcoming Eating Disorder Challenges During the Holidays
It seems like the holiday season is completely centered around food and eating. The holiday season kicks off with Halloween, a holiday filled with candy, caramel apples, and sweet ciders. Then we move into Thanksgiving, an even more extensive food holiday. Every food imaginable is set in front of you, with plenty to spare. And then comes Christmas, where the eggnog and cookies seem to be endless. By the time New Years rolls around and you head out for an evening full of eating and drinking, you are usually at your breaking point and about ready to swear off food all together. This is typical of anyone during the holiday season, let alone if you have an Eating Disorder. There are many eating disorder challenges during the holidays. When the holidays are filled with food it can often cause your stress level and anxieties to sky rocket, potentially leading to eating disorders.
What Accounts for the Rise of Eating Disorders in Midlife?
We often think of eating disorders as illnesses that afflict adolescents and young adults. A 2012 study sheds light on the alarming prevalence of eating disorders in women 50 and over: 13% experience eating disorder symptoms, 60% report that their body image concerns negatively affect their lives, and 70% are actively trying to lose weight.
What accounts for the rise in eating disorders at midlife? According to an article from AARP, menopause echoes puberty with regard to the physical and psychological changes women experience.
We are overwhelmed with advice about healthy eating, clean foods, and cleansing diets almost daily. Some people take this information to heart and begin a special diet meant to improve overall health or add or remove certain foods from their diets to improve a health condition. While it’s true that there are many foods that are considered particularly healthy or therapeutic for certain conditions, it is important to pay attention to when healthy eating is taken too far. In fact, there is a name for healthy eating that becomes an obsession: orthorexia nervosa.
The term orthorexia was named by Dr. Stephen Bratman to describe his own personal experiences with food (Kratina, n.d.). The term literally means “fixation on righteous eating” and is characterized by rigid attachment to food quality and purity. People who struggle with orthorexia become fixated on maintaining very strict diets. For example, a person who takes up a raw or vegan diet may become addicted to maintaining strict eating habits- which can ultimately, and ironically, result in health consequences.
It is important to understand that orthorexia is not considered an eating disorder in the Diagnostic and Statistical Manual, Fifth Edition (DSM-V). While individuals struggling with anorexia or bulimia have a focus on weight loss and calories, those with orthorexia become obsessed with healthy eating. And it is when healthy eating becomes an all-consuming activity that an individual is considered to be orthorexic.
Orthorexia is supremely isolating. Important social interactions occur around meals, and individuals who are focused on extremely rigid food habits often may withdraw and prefer to eat alone because of the anxiety they feel around foods that may not fit into their diet.
Orthorexia is a disordered eating pattern that can have serious health consequences. Recovery includes therapy and consultation with a registered dietitian to assess current eating habits and address the individual’s inaccurate beliefs about healthy eating (Marcason, 2013).
Kratina, K.(n.d.). Orthorexia nervosa. National Eating Disorders Association. Retrieved from www.nationaleatingdisorders.org.
Marcason, W. (2013). Orthorexia: An obsession with eating “pure.” Retrieved from www.eatright.org.
Taking an Eating Disorder Seriously
It may not seem like eating disorder behavior is something that you should take seriously at first. Your adolescent may claim to want to lose some weight, or that they are eating someplace else, not at home. There are plenty of excuses that may allow you and your teen to pass it off as nothing, until the eating disorder behavior becomes a serious threat to your teen’s health and well-being.