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Eating disorders such as anorexia and bulimia are typically thought to be diseases of young women and men. But researchers are finding that the personal demons that drive a young person to an eating disorder may linger into adulthood.
More and more middle-aged and older people are coming forward to receive treatment for eating problems that began in their youth and have been reignited by adult stress or personal crises.
"Some had actual eating disorders" when they were younger, and "others had aspects of an eating disorder but were never fully treated," said Dr Ed Tyson, an eating disorders specialist in Austin, Texas. "Then something happens later in life that stresses them to a point where the eating disorder becomes engaged."
The Renfrew Centre, which operates a number of eating disorder clinics in the United States, has seen a 42% increase in middle-aged female clients since 2001, said Holly Grishkat, senior director of clinical operations for the centre's northeast region.
Unhealthy eating patterns adopted in adolescence or teen years often continue into adulthood, according to a University of Minnesota study published in the Journal of the American Dietetic Association. The study, which followed 2 287 kids as they grew into young adults, found that more than half of the girls had unhealthy eating patterns that continued into their mid- to late 20s.
Case example
That was the case with Alison Smela, 49, who lives in the Chicago area. When she was 12, she was given a weight plan to follow over the summer because she was considered overweight. Smela said she went back to school thinner, and people noticed approvingly.
"I got all kinds of attention, and I liked that," she said. "I equated losing weight with gaining attention."
Controlling her eating also helped Smela feel better when things seemed too much to handle. "When life got tough, I always knew I could control the scale," she said.
But as she grew more successful and climbed the corporate ladder, her anorexia spiralled out of control. So did her problem with heavy drinking.
"The more pressure I was under, the more titles I had, I wasn't dealing with the pressures of the job and of life in a healthy manner," she said.
Devastating effects
Tyson said that eating disorders can be very devastating to the bodies at middle-age, when osteoporosis, chemical imbalances and other health issues crop up more easily and have an even more lasting impact on health.
"Older bodies do not have the plasticity that younger bodies do," he explained. "They can't tolerate the stresses and risks."
When Smela turned 40, she said, she decided to receive treatment for her alcoholism. She's now nearly a decade sober. But her eating disorder remained untreated, even though she knew she had a problem.
"I presumed alcoholism was more acceptable to society at my age," she said. "Having an eating disorder wasn't."
That's not an uncommon perception for middle-aged people with an eating disorder, Tyson said.
"They feel more peculiar because they're older," he said. "They think this is something for younger people, not for them. There's some shame associated with it."
Diane Butrym, 50, of Schenectady, NY, said such concerns are justified but must be surmounted. When Butrym went to the Renfrew Centre for treatment eight years ago, she said, she found herself uncomfortable in the presence of the younger women struggling with the same problem she had.
“One of the parents said, ‘aren’t you a little too old to be going through this?’” recalled Butrym, who still struggles with her eating disorder. "That was very embarrassing for me. It was really hard to overcome that."
Program designed for specific needs
The specific problems faced by middle-aged people with eating disorders prompted the Renfrew Centre to create a separate treatment program specifically tailored to their needs, Grishkat said.
"The older women tend to mother the younger women and take care of the younger women in the group rather than taking care of themselves," Grishkat said. "The other thing we've noticed, the older women have a tendency to sit back and not say anything because they're ashamed. They feel like they should be the role models for the younger women."
What drives someone in midlife to seek help for an eating disorder varies. For Smela, who was 46 at the time she first went to the Renfrew Centre, it was her reflection, she said.
"The summer before I went for treatment, I started catching glimpses of myself in a mirror or reflection, and I was scared," she said. "I saw my body as a whole, and it scared me."
But no matter what age they are people who feel they have an eating disorder need to seek help, Grishkat and Tyson said.
Treatment is particularly vital if the person has children, even if treatment will temporarily take them away from their responsibilities at home, Tyson said.
"Having an eating disorder makes their children have a 12- to 15-fold greater risk of having an eating disorder," he said. "They need to do the work and get better, or their children could be at risk."
(HealthDay News, Dennis Thompson, December 2011)
