Bulimia Nervosa in the Elderly

Grandmother and grandchild smiling

Contributor: Courtney Howard, BA, writer for Eating Disorder Hope

One of the many misconceptions surrounding eating disorders is that they only occur in young people. For this reason, eating disorders in the middle-aged or elderly are often ignored or misdiagnosed. Many times, those with bulimia nervosa late in life have been wrestling with the disorder for decades.

The most common trigger for eating disorders is stress, which all ages are faced with in different forms. Older populations might be coping with menopause, divorce, declining health, or other triggers that lead to feeling out of control. When someone tries to numb these feelings or regain control through binging and purging, among other disordered food behaviors, this constitutes as bulimia nervosa.

Bulimia nervosa is highly dangerous at any age, though it can pose more of a threat to people later in life who might already be experiencing peripheral health problems. Binging and purging, particularly purging through vomiting or use of laxatives, can lead to irregular heartbeat, palpitations, heart attack, gastrointestinal problems, and tooth decay.

Martina M. Cartwright, Ph.D., R.D., notes that older individuals with bulimia, especially those who abuse laxatives, run a high risk of heart issues. If a teenager or young adult has such severe medical conditions as those listed above, he or she would most likely be prompted with questions that might help a doctor uncover that an eating disorder is the root cause. The same is rarely true of a middle-aged or elderly person with the same conditions.

Red Flags at Any Age

cheerful women in yoga classThough bulimic behaviors do not always result in weight loss, any substantial changes in weight are red flags for disordered eating at any age. A 2010 meta-analysis[1] led by researchers from the Mayo Clinic found that approximately 10 percent of men and women over the age of 50 who had an eating disorder were diagnosed with bulimia nervosa.

Though less common than anorexia nervosa among this population, it poses just as many serious health risks. The publication notes, “Eating disorders do occur in the elderly and should be included in the differential diagnosis of unexplained weight loss in the elderly.”

Holly Grishkat, Ph.D., runs a specialized treatment program at The Renfrew Center in Radnor, Pennsylvania, for people over the age of 30 who are struggling with an eating disorder. She notes that these individuals typically fall into three different sectors, including those who had an untreated eating disorder in their youth, those who were treated but have relapsed, and those whose disordered behaviors recently surfaced for the first time.

Dr. Grishkat explains, “The largest of the three categories are those women who have had an eating disorder their entire lives. The smallest group includes those who have only recently developed an eating disorder. Even with this group, we look more closely at the history of these women, most of them have had some type of disordered eating throughout most of their lives, although it may not have risen to the point of a formal eating disorder diagnosis.”

Many Males go Undiagnosed

Old CoupleAccording to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), males represent one in every 10 cases of eating disorders. Due to the stigma and misunderstandings surrounding these disorders, many go undiagnosed. Middle-aged or elderly men face both gender and age barriers to diagnosis and treatment.

Though no exact numbers exist on the rates of eating disorders found in elderly men, a 2006 case report[2] conducted by researchers at the University of Kansas School of Medicine followed an elderly male diagnosed with bulimia nervosa. The report concluded that medical professionals need to be aware of the possibility of the disorder in any individuals with “unexplained nausea, abdominal pain, or vomiting.”

While treating someone who has had an eating disorder for decades can be challenging, it can also prove highly successful. The same treatment modalities implemented for young people can be just as effective in older populations, such as cognitive behavioral therapy (CBT), group sessions, family therapy, and medications to manage co-occurring anxiety or depression, as needed.

The longer the disorder has taken hold of a person’s life, the better he or she is at hiding it and the more reluctant the individual will be to let it go. This is not reason to give up hope or deny treatment, as full recovery is possible.

Community Discussion – Share your thoughts here!

Have you or your loved one struggled with disordered eating later in life? What advice do you have to share?


[1]: Lapid, M.I., et al. “Eating disorders in the elderly.” Int Psychogeriatr. 2010 Jun;22(4):523-36. doi: 10.1017/S1041610210000104. Epub 2010 Feb 22.
[2]: Morgan, C.D., & Marsh, C. “Bulimia nervosa in an elderly male: a case report.” Int J Eat Disord. 2006 Mar;39(2):170-1.

Courtney Howard photoAbout the Author: Courtney Howard is a Certified Life Coach specializing in eating disorders through Lionheart Eating Disorder Recovery Coaching. As a content writer at The Sovereign Health Group while writing freelance through Eating Disorder Hope, Courtney is a passionate advocate for recovery and works to fight the stigma surrounding all mental health disorders. She graduated summa cum laude with a Bachelor of Arts (B.A.) from San Diego State University, holds a paralegal certificate in Family Law, and is a Certified Domestic Violence Advocate.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on December 19, 2015
Published on EatingDisorderHope.com

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