Diane, a soft-spoken woman from upstate New York, has had bulimia for nearly eight years. She’s been treated as an inpatient six times and an outpatient seven times—all with limited success.
But unlike the other patients, who are mostly in their teens and 20s, Diane is 50.
Eating disorders are increasingly common among older women, and eating disorder clinics have seen an influx of older patients. “My oldest client is a woman who is 74,” says Jeanne Rust, Ph.D., founder of Mirasol treatment clinic in Tucson, AZ.
While most of us might associate grandma with her gingerbread cookies and cushy lap, we’d be wrong to assume she no longer cares about her looks.
A survey of 475 women, ages 60-70, found that 90 percent felt moderately or very fat, though their average BMI was 25, right on the border between healthy and overweight. A full 60 percent felt dissatisfied with their bodies.
The Start of a Deadly Disease
For Diane, the onset of her bulimia was riddled with stress and change.
In 2002, Diane was diagnosed with breast cancer, launching a fight that ended “triumphantly” when she walked in a Susan G. Komen Race for the Cure.
A week later, a car struck Diane as she was leaving the hospital where she worked, leaving her seriously injured. “Overnight, I was just taken out of everything,” she says. “I went from being very productive to homebound.”
Faced with a court battle, limited mobility and an extended absence from work, Diane started restricting her eating. At first, she didn’t see the harm. “I just thought it was a way to maintain my weight,” she recalls.
Soon, her behavior grew much more concerning. Some days, she’d eat no more than a pack of mustard for lunch, and when she binged, she’d “eat anything I had in the house,” which could mean five slices of pizza and four bagels with cream cheese in a single sitting (that’s about 3,000 calories). Her life revolved around when she could binge and purge.
Slammed with so many stresses at once, Kimberly Pearson, M.D., a psychiatrist at Massachusetts General Hospital, says it’s no surprise that Diane used bulimia as a coping mechanism.
Psychologists use a stress-diathesis model to explain the onset of eating disorders, meaning that a genetic vulnerability combined with a stressful environment triggers the disease. “You can skate through with genes that predispose you if the environment is friendly,” says Pearson. But if life takes a turn for the worse, an eating disorder can rear its ugly head.
For some, the disease is a recurrence of an earlier struggle with weight issues, but for others, like Diane, it’s new.
Even then, the disease doesn’t come out of nowhere. “If one presents with an eating disorder in midlife, there is usually a history of some abnormal eating,” says Pearson. “To say that they have always had a healthy attitude toward eating and body image then suddenly develop an eating disorder later on would be extraordinarily rare.”
Shifting relationships in midlife—like divorce, empty nest syndrome or responsibility for aging parents—are common triggers for late-onset eating disorders. Add onto that the stress of dating in midlife and media images of vivacious, youthful older women (Demi Moore, anyone?) and you get a perfect storm. “Women in midlife are under a tremendous amount of stress,” says Rust.
By the time Diane returned to work, she’d lost quite a bit of weight and had difficulty concentrating. Tasks that used to be easy for her were suddenly enormously challenging and she had to take frequent breaks. She eventually lost her job.
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