Older Adults & Eating Disorders

Longitudinal research suggests that clinically significant disordered eating found in young adult women may, in some instances, continue into later life. The duration of the illness may be longer in older adults and some older men may also be affected by this issue.

Research indicates that eating disorders may present in a number of ways in older adults:

  • Severe cases of an earlier onset eating disorder without a period of recovery
  • A relapse of a past eating disorder
  • Late onset

Potential background factors

– Sexual abuse

– Non-sexual trauma or abuse such as having experienced violence in childhood

– Major depression, depressive symptoms or past depression

– Stress

– Negative body image

– Health and medical problems

– The loss of loved ones due to death or divorce

– Reduced social activities, changes in relationships with family and friends

– Marked biological and developmental changes – menopausal status and ageing anxiety

– A fear of being overweight

– A higher frequency of dieting behaviours

– Distorted daily thoughts about food

– Weight-related teasing in childhood and adulthood

– Weight dissatisfaction

– Binge eating, extreme weight control and body checking behaviours

Impact and quality of life

In addition to the medical, physical and psychological issues associated with eating disorders, individuals may experience:

– Difficulties in relationships, limited contact with friends and extended family

– Difficulties confiding in others and in talking openly about feelings

– Limited time devoted to leisure activity

Treatment issues

Treating older adult women affected by eating disorders may involve education about the ageing process and how to manage unresolved issues. Denial of symptoms may be a feature in some cases, and as such, a challenge in the treatment process. Low body image and disordered eating in middle-aged and younger people should be not be viewed as support for a ‘one size fits all’, treatment approach.
References:

Ackard, D.M., Richter, S., Frisch, M.J. et al. (2013) Eating disorder treatment among women forty and older: Increases in prevalence over time and comparisons to young adult patients. Journal of Psychosomatic Research, 74(2), 175-8.

Baker, J.H. & Runfola, C.D. (2016) Eating disorders in midlife women: A perimenopausal eating disorder? Maturitas, 85, 112-6

Beck, D., Casper. R. & Andersen, A. (1996) Truly late onset of eating disorders: a study of 11 cases averaging 60 years of age at presentation. International Journal of Eating Disorders, 20(4), 389-95.

Cumella, E.J. & Kally, Z. (2008) Profile of 50 women with midlife-onset eating disorders. Eating Disorders: The Journal of Treatment and Prevention, 16(3), 193-203.

Fairweather-Schmidt, A.K., Lee, C. & Wade, T.D. (2015) A longitudinal study of midage women with indicators of disordered eating. Developmental Psychology, 51(5), 722-9.

Gagne, D.A., Von Holle, A., Brownley, K. et al. (2012) Eating disorder symptoms and weight and shape concerns in a large web-based convenience sample of women ages 50 and above: Results of the Gender and Body Image Study (GABI). International Journal of Eating Disorders, 45(7), 832-844.

Forman, M. & Davis, W.N. (2005) Characteristics of middle-aged women in inpatient treatment for eating disorders. Eating Disorders, 13(3), 231-43.

Forrester-Knauss, C. & Zemp Stutz, E. (2012) Gender differences in disordered eating and weight dissatisfaction in Swiss adults: Which factors matter? BMC Public Health, 12:809

Gadalla, T.M. (2008) Eating disorders and associated psychiatric comorbidity in elderly Canadian women. Archives of Women’s Mental Health, 11(5-6), 357-62.

Joughin, N.A., Crisp, A.H., Gowers, S.G. et al. (1991) The clinical features of late onset anorexia nervosa. Postgraduate Medical Journal, 67(793), 973-7.

Kally, Z. & Cumella, E.J. (2008) 100 Midlife women with eating disorders: A phenomenological analysis of etiology. Journal of General Psychology, 135(4), 359-77.

Keel, P.K., Gravener, J.A., Joiner, T.E. Jr. et al.  (2010) Twenty-year follow-up of bulimia nervosa and related eating disorders not otherwise specified. International Journal of Eating Disorders, 43(6), 492-7.

Lapid, M.I., Prom, M.C., Burton, M.C. et al. (2010) Eating disorders in the elderly. International Psychogeriatrics, 22(4), 523-36.

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Midlarsky, E. & Nitzburg, G. (2008) Eating disorders in middle-aged women. The Journal of General Psychology, 135(4), 393-407.

Miller, D.K., Morley, J.E., Rubenstein, L.Z. et al. (1991) Abnormal eating attitudes and body image in older undernourished individuals. Journal of the American Geriatrics Society, 39(5), 462-466.

Mangweth-Matzek, B., Kummer. K.K. & Pope, H.G. (2016) Eating disorder symptoms in middle-aged and older men. International Journal of Eating Disorders, doi: 10.1002/eat.22550.

Reas, D.L. & Stedal, K. (2015) Eating disorders in men aged midlife and beyond. Maturitas, 81(2), 248-255.

Rodin, J., Silberstein, L. & Striegel-Moore, R. (1984) Women and weight: a normative discontent. Nebraska Symposium Motivation, 32:267-307.

Scholtz, S., Hill, L.S. & Lacey, H. (2010) Eating disorders in older women: Does late onset anorexia nervosa exist? International Journal of Eating Disorders, 43(5), 393-7.

Slevec, J.H. & Tiggemann, M. (2011) Predictors of body dissatisfaction and disordered eating in middle-aged women. Clinical Psychology Review, 31(4), 515-24.

Tiggemann, M. (1999) Body Image Research Summary: Body Image and Ageing. Body Image & Health Inc. Research Summaries.

Zerbe, K. & Domnitei, D. (2004) Eating disorders at middle age, part 2. Eating Disorders Review, 15(3)

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