Adult Eating Disorders: Treatment & Help

Once considered a disease of teenage girls, eating disorders often affect adult women, too. How to stop the cycle for good.

By Andrea Atkins

June Alexander would not eat anything till 6 p.m. If she could avoid food till that hour, she reasoned, then she wouldn’t overeat. By dinner time, when hunger was overtaking her, she’d nibble some vegetables, some yogurt, and maybe some ice cream, never exceeding 1,200 calories. “But it had to be one particular ice cream because I knew how many calories were in it,” she says. 

Alexander had been following such unhealthy food rules since she was 11 years old, but this 62-year-old grandmother didn’t give up on her anorexic and bulimic ways until seven years ago, when she was 55. Bingeing, purging, and restricting calories to dangerously low levels are behaviors most of us associate with teenage girls who have “eating disorders.” But a recent study shows that Alexander is not alone--a growing number of women over the age of 50 attempt to control their weight with such extreme behavior.

A 2012 study published in the International Journal of Eating Disorders estimates that 13 percent of women over 50 exhibit symptoms of eating disorders. This includes bingeing (eating huge amounts of food at a single sitting), purging (forcing yourself to throw up), and calorie restriction (anorexia). Alexander admits that over a lifetime, she has tried all of these behaviors.

Cynthia M. Bulik, Ph.D., author of the study and of a new book called Midlife Eating Disorders: Journey to Recovery, says Alexander’s story is not unique. “We are seeing this in our offices and my colleagues around the world have been seeing it in their clinics,” says Bulik, who is the director of the University of North Carolina Center of Excellence for Eating Disorders. “What we don’t know—because there really is no data in the U.S.—is whether this is a true change in incidence and prevalence or if more women are seeking treatment. It is a sad state of affairs.”

Alexander, author of a memoir on eating disorders called A Girl Named Tim (her mother wanted a son), says only years of therapy released her from the grips of her disease. 

“The eating disorder thoughts take over your own thoughts and become entrenched in your brain,” Alexander says. “It’s like having a bully in your brain—the eating disorder is telling you that you can trust it, and that it’s your friend, when it is your worst enemy…it eats up your self esteem.”

Alexander says she missed out on the best years of her children’s lives, because she was so obsessed with food. She also became skilled at keeping her disorder under wraps. Unlike teenagers whose eating disorders are often detected when they stop menstruating, older women are able to hide their illness and may even be congratulated for looking so thin or maintaining a low weight. But eating disorders can lead to serious medical issues, Bulik says. “Many of these women have multiple and severe medical problems—gastrointestinal, cardiac, bone, dental problems. Yet many just accommodate the pain.”

Bulik says older women who are anorexic or bulimic or both often fall into one of three categories:

  • Women who relapse into eating disorders they experienced as adolescents
  • Those, like Alexander, who never really recovered from those adolescent problems
  • Those who develop disorders later in life.

The greatest number of patients are women who relapse into behaviors they practiced as teens or young adults (with the second group close behind.) While full recovery from an eating disorder is possible, many women struggle with it for their whole lives.

“Some women find that at various stress or transition points in their life, the symptoms might return so they need to remain vigilant for signs of relapse,” Bulik says. When women face an empty nest, the loss of a job, a divorce, or other trauma, they revert to a long-ago disorder as a way to cope.

Women also need to recognize that the media's images of "healthy aging" just aren’t accurate. “We do change in shape and size when we age,” Bulik says. “We change our glasses prescriptions as we age, we need to have the same sort of acceptance for the changes in our body-fat distributions as well."

For Alexander, she says her grandchildren changed her life. “My oldest grandson, now seven, just loves me for who I am. There’s no judging with him. I’m totally accepted, and with him, I’m able to be a child myself.”

As for passing on her habit to her grandchildren, Alexander says she happily watches her five grandchildren eat ice cream, cookies, and other treats. She also watches them eat healthy foods. 

“I am not too concerned about what they eat,” she says. “I am more concerned that they are not feeling anxious—that they are happy and that they feel they can talk to me about anything. I don’t want them to be afraid of being told that they are silly for having the thoughts and fears that they have. I’m focusing on feelings, because I’ve learned that if you focus on how you’re feeling, the food will take care of itself.” 

If you think you have an eating disorder:

Watching your weight and eating healthfully are admirable goals, and can keep you healthy in the long run. But, says Bulik, when food begins interfering with your life, then you should take note. Women who can’t be flexible about what and how they eat, those who freak out when they gain a couple of pounds and those who set out to lose 10 pounds, but then find that they’ve lost 15, 20, or 25 pounds, should seek help. 

Talk to a nutritionist or ask your physician to refer you to a psychologist who specializes in eating disorders. Unfortunately, Bulik’s research has shown that many general physicians don’t know how to help women with eating disorders, so if your doctor dismisses your concerns, seek help from another source, like the National Eating Disorders Association.

Comments

Is an eating disorder only about binging and purging? I have always had this appetite that is insatiable...I can go to all you can eat places (yes, I know I shouldn't) eat til I can not move and by the time I get to the car feel like I am starving again...It's almost as if my mind can not agree with the reality of my stomach. I drink tons of water and just get thirstier...in the past 5 years my life has had a huge change and I have gained 60 lbs...I am 55, but I really can't see it being my metabolism. I have tried everything to curb the hunger...any suggestions? I went to an overeaters meeting years ago, but most of those women sat with 2 liter bottles of diet drinks and weighed a huge amount more than I did...felt at the time I had nothing I could relate with them about...still not sure I could relate...I mean, these women were 400 lbs or more...If I were on the other end of the table, I would want to punch me for coming in and complaining about "my eating disorder"....Help, before the next 5 years add another 60 lbs. Thank you.

mamapapaagain on 2013-06-12 02:29:51

Eating disorders are not about food. It is time that we cultivate anxiety awareness and the tools to handle anxiety the moment it arises. That is the root of addiction.....food or lack thereof is simply the medication we use to feel better. We all feel anxious at some point. We can not be "happy" all the time. The key is teaching our children at a young age the healthy way to handle anxiety instead of self medicating with food ,drugs or other addictive habits. When we know better, we do better, as Maya Angelou has so truly stated. It is so easy for parents in their busy lives not to notice that their children feel neglected, unimportant, powerless or deprived. It is time for each of us to take responsibility for raising children that have the emotional tools they need (not meds) to be healthy.

transzendance on 2013-05-31 05:21:29

I extend heartfelt appreciation to Andrea Atkins for so accurately reporting the interview she conducted with me. I also would like to thank Prof. Cynthia Bulik, and her team of researchers, who are doing all they can to find new treatments and to educate both the medical profession and the public about eating disorders.

junealexander on 2013-05-29 20:27:12

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