Contributor: Staff at Carolina House
It is no surprise that women from all backgrounds may go through a period of disordered eating and body dissatisfaction at some point in their life. Historically, therapists have been aware of disordered eating among adolescents and young adults, but now clinicians are facing increased instances of disordered eating among women of all ages due to the rising number of women who are seeking treatment even beyond emerging adulthood.
There is a unique intersection between age and gender as they relate to disordered eating and body dissatisfaction. Both are increasingly common among all ages and have an adverse effect on wellness throughout the lifespan. Some of the disordered eating behaviors women develop include restrictive, chronic, and extreme dieting and excessive exercise that one might see in an individual diagnosed with anorexia nervosa or orthorexia.
Women find themselves with such behaviors because of weight concerns, body dissatisfaction, and misguided beliefs about eating and weight. Furthermore, the Western ideal of beauty, as defined by thinness, drives women to conform, and they develop maladaptive coping skills in order to do so.
The consequence of such disordered eating attitudes and behaviors tends to be psychological distress and an increased risk for comorbid conditions of depression, anxiety, and substance abuse, which often pave the way for medical complications and even death.
While in today’s culture, it seems that men are valued for their money and intelligence, women and girls appear to be valued solely for their physical attractiveness, which makes them vulnerable to misguided beliefs regarding weight and food. Moreover, the physical changes that women go through during menstruation, pregnancy, and aging only further increase their dissatisfaction with their bodies.
Adolescent girls and young female adults are the most likely to have disordered eating and body dissatisfaction. Nevertheless, these conditions are becoming more prevalent among women across the lifespan.
Who does Disordered Eating Affect?
It is difficult to determine the true prevalence of disordered eating across the lifespan because there is little evidence, and different studies present differing prevalence rates. But generally, it appears that women across the lifespan may exhibit disordered eating rates that are similar to or greater than the rates of the overall female population in the U.S. .
When it comes to prevalence during specific life events like pregnancy and menopause, research is sparse. Historically, disordered eating rates are thought to be lower during pregnancy, but we do a disservice to not consider this population when looking at prevalence rates.
In fact, among pregnant women sampled in their first trimester, 7.5% met full diagnostic criteria for an eating disorder, and as many as 23.4% reported shape and weight concerns. Additionally, 2.3% engaged in compulsive behaviors such as excessive exercise, fasting, and laxative misuse .
How is it Changing?
There are two eating disorder trends across the lifespan that are worth noting:
There has been a steep rise in the number of midlife and older clients who have been admitted for treatment of eating disorders in the past 10 years. In the past decade, the number of women over the age of 35 who have been admitted to eating disorder treatment has increased by 42% .
In addition, middle-aged women who are being treated for eating disorders are reporting a later onset of symptoms and a longer duration of the illness. Surprisingly, the greatest increase in eating disorder-related hospitalizations is among women ages 45-65, and the number continues to grow .
In 2010, the age of onset and progression of disordered eating among older women was found to be age 15, but older women reported seeking their first treatment services when they were much older, at age 31 . While in the past, late-onset eating disorders were considered rare, today, they seem to be increasing in number.
It is also clear that, despite the early onset of their symptoms, some women still wait years before seeking treatment.
What do we know about Disordered Eating?
It is well-known that youth and young adults are prone to dieting, extreme weight-loss behaviors, and body dissatisfaction, but how are these behaviors affecting older and middle-aged women?
Dieting. It was reported in a longitudinal study that 35% of women with normal dieting practices progressed to pathological dieting, and 20-30% of those dieters progressed to meeting partial or full criteria for an eating disorder . This demonstrates that the effects of dieting often lead to low self-esteem, poor body image, weight cycling, weight gain, obesity, and eating disorders.
Although dieting itself does not cause an eating disorder, it is an indicator that a person may be at risk for developing one. Further, in 2014, 54% of women reported current weight loss efforts, with 35% endorsing “serious” means of weight loss .
Body dissatisfaction is very high among all women, at 91%, with women ages 35-55 reporting the highest body dissatisfaction levels across all age groups . It is often thought that body dissatisfaction declines with age, but this was not found to be consistent with the research.
Women over 50 are presented with unique challenges related to aging as their body changes, and they begin to compare their current body with their younger self. As women grow older, new body concerns appear to only increase body dissatisfaction.
Disordered eating is no longer only an adolescent problem. Women across the lifespan are vulnerable to cultural expectations of thinness and beauty, which makes them just as predisposed to the temptation of disordered eating as adolescents are. An exploration into the practices of self-kindness and mindfulness, as well as therapist assessment for these issues across all women, has shown promise in helping to reduce the likelihood of developing disordered eating.
 Smolak, L. (2015). Eating Disorders Across the Lifespan. The Wiley Handbook of Eating Disorders,479-491. doi:10.1002/9781118574089.ch36
 Easter, A., Bye, A., Taborelli, E., Corfield, F., Schmidt, U., Treasure, J., & Micali, N. (2013). Recognizing the symptoms: How common are eating disorders in pregnancy? European Eating Disorders Review, 21(4), 340–344.
 Deam, J. (2012). The scary rise in adult eating disorders. Women’s Health, 9(3), 118–123.
 Shisslak, C. M., Crago, M., & Estes, L. S. (1995). The spectrum of eating disturbances. International Journal of Eating Disorders, 18, 209–219.
 Wilke, J. (2014). Nearly half in U.S. remain worried about their weight. Retrieved from Gallup web site: http://www.gallup.com/poll/174089/nearly-half-remain-worried-weight.aspx
 Runfola, C. D., Von Holle, A., Trace, S. E., Brownley, K. A., Hofmeier, S. M., Gagne, D. A., & Bulik, C. M. (2013). Body dissatisfaction in women across the lifespan: Results of the UNC-SELF and Gender and Body Image (GABI) Studies. European Eating Disorders Review, 21(1), 52–59.
About the Sponsor:
Carolina House is an eating disorder treatment center that serves people of all genders, ages 17 and older. Within our residential and outpatient programs, we offer a range of services such as LGBTQ- and male-inclusive programming to help individuals who are struggling with eating disorders and co-occurring mental health conditions. Our treatment connects men and women with the care they need to achieve long-term recovery from eating disorders and other mental health concerns.
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 a 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.
Published on September 21, 2020. Published on EatingDisorderHope.com
Reviewed & Approved on September 21, 2020, by Jacquelyn Ekern, MS, LPC