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Why Eating Disorders Are a Concern for Adults, Too

Research shows anorexia, bulimia and binge eating are on the rise among older people

By Linda Melone

Few would question the benefit of being able to feel younger than one's chronological age. And, fortunately, many people in middle age feel exactly that way. In a 2009 Pew Research Center survey, nearly half of all respondents age 50 and older reported feeling at least 10 years younger than their actual age.

But when one doesn't like what he or she sees in the mirror, because of real or imagined weight gain, it could lead to drastic and dangerous action. While some people in middle age and older take positive steps to change their diets and their fitness regimens to ward off extra pounds, others channel their concerns in an unhealthy, obsessive direction, and fall victim to an eating disorder.

(MORE: The Fiftysomething Diet)

Eating Disorders Develop in Different Ways

There are three main types of eating disorders: Anorexia nervosa, whose sufferers have an extreme fear of gaining weight and a distorted body image, and practice drastically restricted eating habits; bulimia nervosa, whose symptoms include recurrent, frequent episodes of binge eating followed by forced vomiting, excessive use of laxatives or excessive exercise to compensate for the excess intake; and binge eating disorder, in which a person loses control over his or her eating but does not follow with any type of purging, and can become overweight. Eating disorders can destroy an individual's health and in some cases be fatal.
Eating disorders affect teenagers more than adults, but their prevalence in older people is on the rise. Studies conducted in Australia in 1995 and 2005 found that while a higher percentage of younger people had eating disorders than adults, the rate of eating disorder incidence rose far more dramatically in older people — the percentage of people 65 and older who engaged in anorexic behavior or binge eating tripled during the 10-year-period.
Among people who suffer from adult-onset eating disorders, says Carolyn Jones, director of nursing at the Eating Recovery Center in Denver, some may have had the disorders all their lives with symptoms either previously undiagnosed or not manifested; others may have had an eating disorder in the past, underwent treatment, and then relapsed in adulthood; and another group experienced their first onset in middle life.

The Causes of Eating Disorders

Eating disorders, whether in teenagers or adults, may be triggered by a variety of factors including low self-esteem, depression, troubled relationships, physical or sexual abuse, cultural pressures to be thin, and a genetic predisposition, according to Dr. Kathryn Zerbe, a professor of psychiatry at Oregon Health and Science University and the author of Integrated Treatment of Eating Disorders: Beyond the Body Betrayed (2008), says: "The over-50 population differs in that they also have a fear of getting older. Plus, stressful life events, such as loss, difficulty handling transitions, medical problems and other psychiatric issues like depression and anxiety, may also come into play."

(MORE: Does Weight Loss Require Help From Above?)

An eating disorder that arises for the first time after age 50 always demands a full medical workup, Zerbe says, "because loss of weight at this age, depression, poor appetite and cognitive changes may represent a manifestation of a physical, not a psychiatric, illness, such as cancer or dementia."
Symptoms of Eating Disorders
Symptoms of eating disorders may not always be obvious. People with binge-eating disorder or bulimia nervosa may be of normal weight or even overweight. If you're concerned that a friend or loved one may have an eating disorder, watch for these signs:


  • A refusal to eat or a denial of hunger.
  • An intense fear of gaining weight.
  • A negative or distorted body image.
  • Excessive exercise.
  • Fear of eating in public.
  • A withdrawal from social activities.
  • Preoccupation with food.
  • Very thin appearance.




  • Self-induced vomiting.
  • Excessive exercise.
  • Going to the bathroom after eating or during meals.
  • Damaged teeth or gums.
  • Constant dieting or fasting.
  • Possible drug or alcohol abuse.


Binge eating:

  • Frequently eating alone.
  • Eating to the point of discomfort or pain.
  • Feeling depressed or disgusted over the amount eaten.


Getting Help
If you or a loved one exhibits these symptoms, it's important that he or she consult with a doctor or psychiatrist who specializes in eating disorders, although it may be difficult to convince the person to go along. "One of the hallmarks of an eating disorder is an ambivalence," Jones says. "One day they know they need help and the next day they don't. They're often in denial." Expressing your concern and a sincere desire to listen may help.

A friend or relative, Zerbe says, can help the affected individual begin to see the risks in valuing having an "ideal body" more than their health, so that they can get the help they need and make the most of the years ahead of them.

Linda Melone is a freelance writer based in southern California. Read More
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