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David Baxter

Mar 26, 2004
Eating Disorders: A Midlife Crisis for Some Women
by Dennis Thompson, HealthDay Reporter
Mar 18th 2007

SUNDAY, March 18 (HealthDay News) -- You starve yourself, shedding pounds, and it feels too good to ever stop.

Or you eat lots -- as much as you want, more than you want -- and then sneak away from your loved ones to purge it all.

But you're not 16, not 19, not 21. Not a young woman at all. You're in your 30s, 40s, or 50s. And you can't stop.

Anorexia and bulimia used to be considered health problems that afflicted teenage girls. But doctors are finding that a growing number of older women are now being diagnosed with some sort of eating disorder.

"It can happen to anybody at any stage of their life," said Dr. Alexander Sackeyfio, a psychiatrist and eating-disorder specialist at the Beaumont Hospital in Royal Oak, Mich. "I think we're becoming more aware of it and are better at diagnosing it."

People tend to make another mistake in their perception of eating disorders -- they assume they are relatively benign psychological problems that are easily treated and without lasting physical effects, said Doug Bunnell, clinical director of the Renfrew Center in Wilton, Conn.

"People are surprised when they learn these have the highest mortality rate of any psychiatric diagnosis, somewhere between 10 and 15 percent," said Bunnell, who's also a member of the National Eating Disorders Association board of directors.

Anorexia produces dramatic weight loss caused by excessive or compulsive dieting. An estimated 0.5 percent to 3.7 percent of women suffer from anorexia nervosa at some point in their lifetime, according to the National Institute of Mental Health.

Anorexics see themselves as overweight even though they're dangerously thin. The process of eating becomes an obsessive minefield and unusual eating habits develop, such as picking out just a few foods and eating them in tiny, carefully measured quantities.

Bulimia is characterized by excessive binge eating followed by purging the food through vomiting, laxatives or over-exercising. An estimated 1.1 percent to 4.2 percent of American females will struggle with bulimia nervosa in their lifetime.

Because of the purging, people with bulimia usually weigh within the normal range for their age and height. But they still suffer the same fears about weight gain as anorexics. So, they often perform bulimic behaviors in secret, feeling disgusted and ashamed when they binge, yet relieved once they purge.

Bunnell said he's seeing more middle-age or even older women coming in for treatment of an eating disorder. But, he's not sure that all of these are new cases developing later in life.

"My experience is that virtually all the women we've seen with eating-disorder symptoms in their 30s or 40s had some prior activity in the more typical age range," Bunnell said. "It may not have been diagnosed, or just short of being serious, but there was a period when they were really struggling with it. We've not seen a lot of brand new, out-of-the-blue eating disorder cases in older women."

Other doctors believe that hormonal fluctuations that occur near menopause could set off an eating disorder, as could mid-life changes like divorce or the departure of grown children. As the family changes, some women find themselves grasping for some semblance of control -- one of the needs that an eating disorder can fulfill.

Complicating matters for the older patient is the fact that women coming in for treatment later in life may find it harder to get the help they need. For decades, the focus has been young women, and only recently has the therapeutic field begun to expand into treatment for older women -- and men, Sackeyfio said.

"No one is catering to their needs," he said. "That's the same problem that gentlemen had for a while."

Bunnell said anorexics tend to be preoccupied with their body shape or weight, and often suffer from anxiety, perfectionism and obsessive-compulsive disorder. By contrast, bulimics tend to be depressed and impulsive, often struggling with substance-abuse issues.

"The anorexic style is more overly controlled, tense and rigid, while the bulemic style is less controlled, impulsive or disregulated," Bunnell said.

Treatment for eating disorders has evolved as well, with doctors now emphasizing a team-based approach, Sackeyfio said.

"Originally, what people would look at was that it is a psychological problem, but it quickly becomes a physical problem," he said. "You need somebody who's aware of those physical changes to work with you if you're a therapist."

Ideally, someone with an eating disorder should be working with a team that includes a psychiatrist, a nutritionist and a physician, Sackeyfio said.

Most important, the people surrounding someone with an eating disorder need to understand that the patient truly is out of control and needs help, Sackeyfio said.

"They aren't spoiled brats who are trying to make people's lives harder," he said. "They really have very little control over the physical changes that they cause in their own bodies."


Jul 19, 2005
Other doctors believe that hormonal fluctuations that occur near menopause could set off an eating disorder, as could mid-life changes like divorce or the departure of grown children. As the family changes, some women find themselves grasping for some semblance of control -- one of the needs that an eating disorder can fulfill

I found this portion of the article to be quite interesting. Great post, David :)


Nov 21, 2005
This article is very interesting. I have had an eating disorder since the age of 13, and still it haunts my every day existance. Through drugs and therapy I doing well and stay on top of it- but the mind set is there beneath the woodwork.

It is sad because I see so many other women around me that I know of who fall into this category. It is very scary and frightening. The sad thing is, there is little to do as they are in pure denial and just think 'it is a diet' but in reality it is not.

So well said.

Thank you for sharing. :)



Oct 4, 2006
Great article, Doc...
I really hope that last statement in the article wasn't meant to imply that the teenage girls ARE spoiled brats trying to be difficult... :confused:

But aside from that....In my experience, anorexia and bulimia are not exclusively teen disorders. We have people on my unit from 14-65. And if you look at the disorder as a combination of social, biological, psychological, genetic, and whatever else have you, factors, it only makes sense that all ages would be affected.

What I think is sad is that this is being presented as "something new." It has always been like this. The positive, I suppose, is that now things are changing, and it is being acknowledged that older women (and men)legitimately struggle with eating disorders, making it acceptable for them to seek treatment alongside the teenagers.

There is so much social stigma and charge around the issues presented by eating disorders. But slowly, with steps like this, people of all ages, genders, etc. are finding the freedom to find recovery.


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