Unique Challenges for the Clinician Treating an Elderly Eating Disorder Patient

Elderly Adult Struggling With an Eating Disorder

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

Thought by many to only affect young people, eating disorders in the middle-aged and elderly are often misdiagnosed or simply ignored. Eating disorders can develop for the first time in an individual’s elder years or resurface from earlier in his or her life. Regardless, geriatric eating disorders pose various challenges to clinicians in the field.

What Triggers Eating Disorders in the Elderly?

Eating disorders in the elderly are often triggered by similar emotional issues that lead to the development of these conditions in younger populations. The difference lies in the specific nature of these triggers, such as divorce or serious health issues. Even potentially positive life changes that come with age, including retirement or becoming a grandparent, can prove to be unexpected triggers.

The loss of a spouse can often trigger unusual eating patterns. Not only do naturally strong emotions during this time play a factor in decreased appetite, but this individual was likely the person with whom the elderly patient prepared and ate meals. The loss of a spouse can increase anxiety around food and meal times, which has the potential to snowball into an eating disorder.

Additionally, the middle-aged and elderly have typically seen their bodies undergo lots of changes throughout the years. With these changes might come increased anxiety and a distorted body image, which are common contributing factors to the development of eating disorders.

When Control Plays a Role

Grandma-441405_640x480Geriatric eating disorders can develop as a means of gaining control over an individual’s life. This desire for control is a common theme among eating disorder patients of all ages, though different factors play a role in the lives of the elderly.

Elderly patients might have felt in control their entire lives (i.e. holding a steady job, raising a family, etc.) but have recently lost independence. This newfound dependence can include the inability to drive, being confined to a wheelchair, and/or moving into a nursing home.

Those with eating disorders often feel that food is the only thing in their lives they have control over. Whether or not this is true, using disordered behaviors to self-soothe or gain a false sense of control can have devastating consequences.

The stigma surrounding eating disorders can be even more prevalent in the elderly population. Men and women in their older years typically deny the presence of an eating disorder, believing it is a “teenager’s issue.” Clinicians treating an older patient who denies there is a problem but might be seeking help at the insistence of a loved one face the same issues that come with treating a teenager unwilling to accept that he or she has an eating disorder.

How Medical Issues Affect Recovery

grandparents-1054311_640x443Various health issues affecting an elderly individual with an eating disorder can complicate the recovery process from beginning to end. Existing medical issues can make eating disorders difficult to detect, while eating disorders typically come with a host of additional health complications, ranging from low blood pressure to cardiac arrest.

Older individuals faced with cognitive impairment, memory loss, and dementia can be more susceptible to skipping meals or engaging in disordered behaviors. In some cases, this is purely a result of the condition and does not reflect an eating disorder. However, this makes it difficult for clinicians to determine when an eating disorder is truly present. Therapists can work with a treatment team of professionals, including a physician and dietician, to assess, diagnose, and treat these individuals.

Certain medical conditions can result in changes in appetite, loss of taste, and trouble swallowing, all of which affect an elderly individual’s desire and ability to eat. Though eating disorders are more complex than a simple loss of appetite, this can pave the way for disordered eating and behaviors.

Why it Isn’t “Too Late” For Help

DoctorSome elderly patients might feel that it is too late for help, particularly those who have been struggling with an eating disorder their entire lives. This unwillingness to accept that recovery, or even an improvement, is possible can be an obstacle for a treating clinician. In reality, it is never too late to reduce disordered behaviors and improve mental health.

Clinicians can support an elderly patient in his or her recovery while ensuring that all medical issues are treated concurrently to best address all physical and mental health needs of the individual. Maintaining realistic expectations is essential for clinicians treating elderly patients with co-occurring dementia or other serious health issues, while instilling a sense of hope and purpose.

Community Discussion – Share your thoughts here!

Have you or your loved one been touched by the effects of an eating disorder within the geriatric population? What important variances were made in the treatment program?


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 January 26, 2016
Published on EatingDisorderHope.com

About Baxter Ekern

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