Eating disorders like anorexia and bulimia are frequently associated with teenagers and young adults. In recent years, however, experts have noticed an increasing trend among perimenopausal and menopausal women.

Body-Image and Older Women

Like teenagers, women in their 40s, 50s and 60s experience significant changes to their bodies. These can be the result of shifting hormone levels, slower metabolism, weight gain and changes in body fat distribution.

Many women struggle with the natural changes that occur with age. A societal focus on youth may cause them to have unrealistic expectations, which can lead to feelings of inadequacy and low self-esteem. In addition, there are several life events that may cause distress and set the stage for eating disorders in older women, including:

• Divorce
• Death of a family member, friend or spouse
• Age-related health issues (self and others)
• Changing family dynamics (aging parents, children leaving home)

These changes can be overwhelming for some women, causing them to feel anxious, depressed, out-of-control and, ultimately, making them vulnerable to developing an eating disorder. A history of eating disorders in adolescence is another risk factor. Women who have a history of disordered eating are more likely to relapse in midlife – returning to the eating behaviors they used to cope as teenagers.

Common Eating Disorders

Disordered eating behaviors typically occur on a spectrum. The most common eating disorders include:

• Anorexia Nervosa. A behavioral disorder in which a person severely restricts their food intake to the point of starvation. Exercise abuse is often a feature of this illness.
• Bulimia Nervosa. An eating disorder that compels a person to eat large amounts of food and then purge the calories through self-induced vomiting and/or laxative use.
• Binge Eating Disorder. A disorder characterized by the frequent consumption of large amounts of food in one sitting and feeling unable to stop or control the behavior. Binge eating disorder does not typically include purging.

The Health Risks of Disordered Eating

Dangerous at any age, eating disorders pose a serious threat to physical, psychological and social well-being. In older women, however, it can be more difficult to recover from the stress that an eating disorder puts on the body. Potential negative effects may include:

• Cardiovascular damage putting one at higher risk for heart attack
• Gastrointestinal problems including pancreatitis
• Malnutrition and/or anemia
• Confusion and less ability to concentrate
• Weakened immune response
• Sleep disturbances
• Hormone imbalances which can lead to or accelerate bone loss
• Dental problems caused by repeated vomiting and malnutrition
• Increased insulin resistance, leading to type 2 diabetes
• Dry or brittle hair, skin and nails
• Social isolation due to feelings of shame or fear

Diagnosis and Treatment

Eating disorders often go undiagnosed and untreated because people resist seeking treatment. Older women may feel embarrassed by their inability to control their behavior, thinking they should be able to manage it on their own. Or, they don’t recognize that they have a treatable problem and continue the unhealthy eating habits.

Fortunately, effective treatments are available. In many cases, outpatient cognitive behavioral therapy (CBT), nutritional counseling and medication can help restore healthier eating habits. In severe or chronic cases, hospitalization or treatment at a residential facility may be necessary. The important thing to remember is that eating disorders can occur at any age and there are treatment options that offer hope.