Eating Disorders: No Longer Just for Young Females

Eating Disorders: No Longer Just For Young Females

Risk Factors for Middle-Aged Women

In general, an eating disorder is rarely the result of one isolated event or life situation. Certain factors can contribute to the development of an eating disorder, such as genetics, dieting, perfectionism, trauma, or the influence of media. However, the development, re-appearance or escalation of an eating disorder in midlife is thought to be triggered by drastic or unexpected life transitions. These catalysts can include:

Divorce/Separation
Divorce or separation, regardless of the whys behind it, is a difficult transition time. Women may struggle with fears of spending the remainder of their lives alone. Returning to the world of dating may cause extreme anxiety and insecurity. After all, every day women are confronted with media messages telling them that females must be rail thin to achieve success and receive love. Under such an onslaught, a woman's self-esteem diminishes, while her body dissatisfaction escalates. In order to achieve a younger, thinner, and more desirable body, she may turn to extreme measures to lose weight. Her dieting and/or exercising could easily get out of control.

Aging body
Clearly, the American culture is obsessed with youth, which places extreme pressure on women as they age. Fountain of youth fixes such Botox injections, fillers and cosmetic surgery are a multi-million dollar industry. Remaining slender is part of this youth obsession, even though it's abnormal for women over 30 to have the same bodies as they did at 18. The necessity to maintain a certain weight is particularly critical when a woman's identity and self-esteem is wrapped up in her appearance. This may galvanize her to seek a thin, youthful body through unhealthy behaviors, such as food restriction, diet pills, extreme exercise, illicit drugs, laxatives, or even purging.

Empty Nest
Children leaving home can prove highly traumatic for some mothers. This is especially true when a woman is defined by her children and her primary identity is that of being a mother. Without children to validate her role as mother, she may feel worthless. Focusing on appearance, diets, health, and exercise can fill that empty space and provide new identity.

Parent's Death
The illness or death of a parent has a profound effect on adult women especially when the death is sudden and the woman is not prepared for the loss. Some women may feel unable to manage the feelings of sadness, grief or shock. Some may feel unable to meet the demands of adulthood in the midst of their loss. For predisposed women, an eating disorder may develop or re-emerge as a means to cope with the intense feelings associated with death of a loved one. Eating disorders may also provide these women a way to escape from real-life responsibilities, which persist in the face of life's ups and downs.

Unexpected Illness
No one is immune from illness. A disease such as breast cancer can result in a drastically impaired body image and difficulty accepting an altered shape. A woman may turn to extraordinary weight loss to reclaim lost youth or reshape her body.

For decades, the topic of eating disorders conjured an immediate stereotype. The individual was female, beautiful, a high achiever, affluent, often the first-born, and above all, young. She might be the high school prom queen, or the college cheerleader, but never was she a middle-aged mother of three. Indeed, the very idea that a woman in midlife could suffer from anorexia or bulimia was nearly unimaginable.

We now know that eating disorders occur across the lifespan. Experts in the field report that in the past 10 years they are treating an increasing number of women in their 30s, 40s and 50s who are starving themselves, abusing laxatives, binging and purging, exercising to dangerous extremes and self harming. In other words, they are engaging in all the behaviors traditionally viewed as exclusive to the younger generation.

Older women currently seeking treatment fall into three categories: those who have secretly struggled with an eating disorder for many years, yet did not receive treatment; those who were treated for an eating disorder in younger years; and those who developed an eating disorder as an adult. Onset in middle-age typically results from difficult or unforeseen life transitions.

Timberline Knolls has experienced a steady rise in middle-aged residents with food-related disorders. In 2007, 14% of eating disordered residents were 35 or older, while in 2011, that number has escalated to 17.5%.

Older women are coming to us with anorexia, bulimia and binge eating disorder and they often have co-occurring disorders such as addiction, anxiety and depression, said Dr. Kim Dennis, Medical Director at Timberline Knolls. Self-injury is also common in this group. Many of those who begin to engage in self-injurious behavior (SIB) for the first time as adult women and mothers feel a tremendous amount of shame. This is due to the perception that SIB only occurs in adolescent girls.

To better serve this population and provide the best possible care, TK opened a new lodge in 2010 and enhanced its programming to reflect the specific needs of older women with eating disorders. Specialized groups such as Moms in Recovery were created to facilitate growth and healing. This group provides time for women to share insights with other mothers, consider how their addictions have impacted their families, and explore how to live a life of recovery as a mother. The Relationship Addictions group also provides an opportunity for older women to investigate how relationships across their lifespan have positively or negatively impacted them and why.

Girls as young as 12 and women as old as 66 have come to TK seeking treatment for eating disorders. All of our groups allow each one of them to critically look at themselves in whatever stage of life they are in, said Melissa Rocchi, program development coordinator and manager of expressive therapies at Timberline Knolls.

The profile of the average eating disordered individual continues to change. As such, Timberline Knolls Residential treatment Center continues to make the programmatic changes required to accommodate the distinct needs of each resident and her family.

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