Eating disorders exact a toll on older women, too

Molly Woolsey was 19 when her anorexia was diagnosed. Once she passed her 20s, the St. Paul woman said, passers-by assumed she had cancer or another terminal illness because she was so thin.

“It doesn't occur to them that someone my age could have an eating disorder,” said Woolsey, now 45.

Anorexia, binge eating and bulimia are considered afflictions of teenage girls or women in their 20s. But increasingly, older women are admitting to eating disorder symptoms, which put them at higher risk for a wide range of health problems.

“Nine years ago, the mean age for anorexia nervosa was reported to be between 15 and 19 and the mean age for bulimia presentation was 23,” said Cynthia Bulik, director of the University of North Carolina Eating Disorders Program. “Now, over half of the women presenting for treatment in our program are over the age of 30.”

Bulik led a study, described in the International Journal of Eating Disorders, which showed more than 13 percent of women 50 and older have reported eating disorder symptoms. Eight percent reported purging; nearly 4 percent binge eating. And 12 percent admitted to using unhealthful methods of dieting to lose weight, such as laxatives or diet pills.

Bulik said eating disorders in older women primarily could be traced to a culture that “doesn't allow us to look our age. Now that 70 is the new 50, women feel pressure to keep up their appearance.”

Repeatedly engaging in bingeing weakens bodies young and old, but eating disorders exact greater punishments on women who may already be physically declining because of aging.

Older women with eating disorders are often at higher risk for osteoporosis, gastrointestinal ailments, heart and dental problems. “These disorders wreak such havoc on younger bodies, and older bodies are less resilient,” Bulik said.

While older women with eating disorders are more likely to seek treatment on their own, doctors are sometimes missing diagnoses because they aren't looking for it in middle-age patients, Bulik said. “I have had women tell me they got up the courage to go to their doctor and say, ‘I think I have bulimia,' only to have him tell her, no, that's a young woman's disorder.”

Woolsey said she's feeling the effects on her body more intensely than she did in her teens.

“I get tired so much more easily now,” she said. “I just don't have the stamina. I'm also a compulsive exerciser, so I have to remind myself I'm not lazy — I have a disorder.”

The survey didn't collect data on whether it was the first time the women had developed symptoms. Based on clinical observation, Bulik estimates a majority had problems as teens or young adults, got better and then relapsed later in life. About 20 percent have suffered chronically their entire lives, and 10 percent were developing symptoms for the first time.

The study's results don't surprise Jillian Lampert, director of the Emily Program in St. Paul. In the past four years, 10 percent to 15 percent of the eating disorder treatment center's 8,300-plus clients have been between ages 50 and 87.

“It is common that they have been dealing, alone, with an illness ... for a significant amount of time because they're reluctant, at their age, to disclose struggles with food and body image,” Lampert said.

Sometimes people are unaware of treatment resources, or that the problem they have even has a name, Lampert said. “Some worry that they will be ‘too old' for treatment, or fear stigma if they disclose struggling with an eating disorder.”

Some people have a genetic predisposition to eating disorders, Bulik said, “but it doesn't act alone. It's pals with environmental triggers.”

In older women, those triggers might be a major change such as empty nest or divorce, especially if a husband has left her for a younger woman. Financial uncertainty also can cause major stress.

Lampert said the growing number of older women with eating disorders is doubly concerning because the anxieties that cause one generation to develop an eating disorder can be passed to the next.

A woman named Ann, who met with a nutritionist this month to start her treatment plan, said she thinks her two daughters have food issues related to her own.

“It was always an issue in our household,” she said. “If you're thinking about food all the time, it takes a lot of time and energy away from normal living. Now that I'm getting help, I hope I can lead by example.”