How eating disorders differ in mid-life
Full-fledged eating disorders are rare at any age, affecting fewer than 3% of teenagers and 1% of adults at any given time, according to government estimates. (An overwhelming majority of cases occur in women.) However, a smattering of data from around the world suggests the behaviors associated with bulimia and anorexia may be more common in mid-life than previously believed.
The most recent evidence comes from a survey of 1,849 women age 50 and up, the results of which were published last week in the International Journal of Eating Disorders. Eight percent of the respondents reported purging in the previous five years, and 7% said their efforts to control their weight led them to exercise so much that it had begun to interfere with their daily functioning.
The survey, which was conducted online, isn’t a reliable gauge of how common these behaviors are among adult women in the general population. But the results do provide a glimpse into disordered eating in middle age that rings true with the growing anecdotal evidence, the researchers say.
“My gut says this is pretty on-target,” says Cynthia Bulik, Ph.D., the lead researcher of the survey and the director of the eating disorders program at the University of North Carolina at Chapel Hill.
What’s driving these women to purge or work out excessively? Although the survey didn’t examine this question in detail, a majority of the survey respondents said they felt dissatisfied with their bodies—a hallmark of eating disorders across all age groups.
Indeed, previous research suggests that many of the factors that underlie eating disorders in young people may contribute to similar problems in older populations. According to a 2008 study in the Journal of General Psychology, the most common drivers include stress, depression, perfectionism, and social pressure to be thin, in addition to body dissatisfaction.
Butrym’s story is unusual in that most middle-aged women with eating disorders do not become ill for the first time as adults, Maine says. But there is some evidence that certain stressful experiences that are more common in middle age—such as divorce, the death of a spouse, or medical scares like Butrym’s—may help trigger, or reawaken, an eating disorder.
Weight gain and body changes related to aging likely play a role as well. As menopause approaches, metabolism slows and estrogen production drops, causing shifts in fat distribution that can lead to a thicker middle, even for women who are eating healthy and exercising regularly. Most women gain eight to 10 pounds during the transition through menopause, which could aggravate any predispositions for disordered eating, Maine says.
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