Eating Disorders in Older Adults
There are many stereotypes that feed into society’s perception of the type of people afflicted by eating disorders. If we could, those of us at The Emily Program would scream it from the rooftops: Eating disorders do not discriminate! A person’s sex, race, age, socioeconomic status, and culture don’t matter when it comes to disordered thinking about food! In this post, we focus on age and the similarities and differences of eating disorders in older adults compared to young and middle-aged adults. We will also cover the importance of seeking help, no matter a person’s life stage.
Setting the record straight on eating disorders and age
Many people think eating disorders only affect young or middle-aged adults and that beyond those years, the disorders disappear. Unfortunately, that is not the case. Eating disorders do primarily affect younger populations, and they often manifest in younger adults. According to the National Comorbidity Survey Replication (NCS-R), it is true that eating disorders appear in early adulthood: the median age of onset for bulimia and anorexia is 18, while the median age of onset for Binge Eating Disorder (BED) is 21. However, if one of those eating disorders—or any disordered eating—goes untreated early on, that simply means that those with the eating disorder will likely continue to suffer into late adulthood. In other words, if an older adult is suffering from an eating disorder, that person has been plagued with the symptoms for decades. Adding to that heartbreak, because these adults have suffered for so long, it’s less likely that they will seek help during their golden years.
In many ways, those who have been afflicted for so long get used to the symptoms of their eating disorder—the actions, thoughts, and behaviors are simply a part of life. Beyond that, because society tends to focus on eating disorder treatment for adolescents and young adults, older adults are essentially marginalized as they grow older. The idea that people should “grow out of” eating disorders at a certain age isn’t just what society thinks, but that notion is drilled into the minds of those afflicted, making it more difficult for them to accept their reality and seek treatment.
Furthermore, many of the symptoms are mistaken for other illnesses, or as a common part of the aging process, which makes the issue even more elusive. Family members might attribute malnutrition, diarrhea, vomiting, hair loss, or overeating to prescription medication, or to the natural progression of aging when in reality, these very well could be the side-effects of a serious mental health disorder.
This can be tricky, especially if certain family members have never seen their loved one display these side effects. In some cases, an older adult may have suffered from an eating disorder early in life and made a full recovery at that time. But as that person grew older, they may have relapsed, and their children or spouse didn’t recognize the symptoms. In other cases, the family might be so conditioned to the symptoms that seeing their loved ones in that state is a completely normal part of their family dynamic. These are two extreme examples, but eating disorders can deceptive in many ways.
Triggers for eating disorders during middle adulthood
“Sometimes eating disorders develop during mid-adulthood and follow a person through older adulthood,” says Robyn Janssen, Senior Clinical Director at The Emily Program. Janssen goes on to explain that eating disorders in mid-adulthood can sometimes be attributed to fad diets. Some men and women will try just about anything to control their weight as their bodies undergo natural changes as they grow older. Years of yo-yo dieting and jumping on the latest fad diet train can lead to eating disorders like Binge Eating Disorder, which commonly develops later in life (during early adulthood as opposed to a person’s teen years). Also, Binge Eating Disorder in older adults can be tough to pinpoint as an eating disorder because many of the symptoms of the disorder are done privately, and weight gain can be easily attributed to a slowing metabolism or lack of exercise due to painful joints.
Another culprit of eating disorders that develop in early to mid-adulthood and follow men and women into older adulthood is the added external pressure to look younger because of social media platforms like Instagram, Facebook, and the plethora of dating apps on the market. Single adults or those becoming grandparents for the first time might dread the idea of a changing body, so as a means to take control, they might put their bodies through extreme dieting, which later develops into a full-blown eating disorder, a mental health disorder which left untreated will follow that person throughout life.
Eating disorders can stick throughout life if not treated
As mentioned above, eating disorders are often triggered when people feel a lack of control over their lives. And as most adults can attest, significant life changes in which a person feels a loss of control tend to happen during middle adulthood. Eating disorders are often used as a coping mechanism, so when a person loses a job, is forced to file bankruptcy, goes through a divorce, or loses a parent or other loved one, they might turn to the old behaviors and actions of their eating disorders to regain control over a situation that is completely out of their control.
And as adults grow older, beyond middle adulthood, they often have to give up control over very basic aspects of their lives—they may have to give up driving, or move into an assisted living facility where they cannot make their own food choices. These examples depict a loss of independence, essentially a loss of control over their own lives. In an attempt to regain some of that control, some may turn to past (or current) eating disorder behaviors to cope.
Some may argue that older adults are less likely to seek help and continue to battle their symptoms because they don’t want to burden family members or caregivers. Others believe that older individuals have less motivation to heal themselves. As quoted in an article published in Medical News Today, some older individuals may not try to fight their EDs because they have fewer motivations or goals for the future. Others might already see themselves in an “end-of-life” phase and they don’t want to put in the work or burden their families if they are nearing the end of their lives.
Seeking treatment for this mental disorder that has such an immense impact on a person’s physical health could actually help older adults live longer, more fulfilled lives, no matter where they are in their life. Eating disorders—especially in older adults with weakened immune systems, bone structures, and other weakened bodily systems—can, and likely will, lead to further health complications. Obesity caused by BED can lead to heart disease, diabetes, hypertension and other related issues. On the other hand, anorexia can bring about arrhythmia, bone loss (which can develop into osteoporosis), anemia, and even heart failure.
Treatment for those who need it most
The coping strategies, motivations, and potential side-effects outlined above are only examples of how an eating disorder might look in an older adult. However, it’s important to remember that these disorders are different for everybody. As loved ones, friends, coworkers, caregivers, or even strangers, you must never minimize the illness; and especially pertinent for those caring for older adults, it’s important that you don’t discount the possibility of an eating disorder because, as discussed above, disorders in older adults can be tricky to spot.
Here at The Emily Program, roughly 13 percent of our clients are ages 41-55. However, we don’t have firm statistics on how many clients we serve over the age of 55. That’s because the number of older adults seeking treatment past 55 drops dramatically. We don’t want that to be the case—we strive to serve all those afflicted by eating disorders. So if you think your loved one might be suffering, please take a look at The Emily Program’s Guide for Families for ideas on how to help your mother, sister, uncle, friend, neighbor, or anyone else get the treatment they deserve. And if you or someone you know is struggling with an eating disorder, reach out to us today.