***Eating Disorders in Older Women

There are now more overweight people in the US than any time in history. Obesity is costing our healthcare system over $147 billion annually (Finkelstein, Trogdon, Cohen & Dietz, 2009). We have 12.5 million children who are overweight or obese and twelve million people in the U.S. with an eating disorder. Something is drastically wrong!

Eating disorders most often start between the ages of 11 and 15 years old. Eighty-six percent of people with eating disorders report that the onset of the disorder started by the age of 20 (ANAD, 2011). It is reported that 50% of girls ages 12-14 say they are unhappy because they “feel fat” and 45% of elementary age children report wanting to be thinner. This sends some into the abyss of an eating disorder.

But today we have more and more older women being admitted to our eating disorder treatment center. The U.S. Census Bureau (2010), reported that 46.3% of the US population is women age 40 and over. Older women often fly under the radar with an eating disorder. They may not seek help because they fear they will be forced to gain weight or be stigmatized as having a teenager's disease.

At a more mature age there are many additional stressors that may trigger an eating disorder. One study showed that among women, 42.3% of those aged 60 and over were obese compared with 31.9% of women aged 20–39 (Cynthia, Carroll, Kit, & Flegal, 2012). The stressors include body changes, divorces, financial strains, blended families, career changes, parenting young adults, caring for older parents, empty nest, and health problems. Sometimes an eating disorder can be camouflaged during earlier years because the focus is put on being a wife and mother, child rearing, and/or climbing the corporate ladder. When these activities diminish the eating disorder will resurface or appear for appear for the first time.

The International Journal of Eating Disorders (Gagne, Holle, Brownley, Runfola, Hofmeier, Branch, & Bulik, 2012) reports 13% of women ages 50 and older struggle with an eating disorder — some for the first time in their lives. In this on-line study of 1849 women 79% said their weight or shape affected their self-perception, 71% said they are trying to lose weight, 41% checked their body daily, and 40% weigh themselves a couple of times a week or more. This is not normal behavior, their disordered eating and thinking is affecting their quality of life in many ways.

Researchers from the University of Carolina (2012), conducted a similar survey showing that 62 percent of the women reported that their weight negatively impacted their lives, 8% reported purging and 70% said they were in the process of dieting or trying to lose weight.

Often-neglected symptoms for some patients suffering from obesity or eating disorders are food sensitivities or food addictions. The most common being sugar. Scientific evidenced-based studies have shown commonalities between overconsumption of sugars and drug addiction (Volkow and Wise, 2005; Kelley, 2004; Levine, Kotz, & Gosnell, 2003). French Scientists’ research demonstrated that intense sweetness can surpass cocaine reward, even in a drug-sensitized and addicted subjects (Lenoir, Serre, Cantin, & Ahmed, 2007).

Our food supply has so many different types of sugars and artificial sweeteners. Even health conscious people who read the labels on processed foods need to take into account that the first few ingredients on the label may not be the ingredients with the most volume. The label may include ten or more different ingredients that are all a form of sugar. If all those ingredients were combined many processed foods would be required to list sugar as the first ingredient. The best foods to buy do not require labels or at least we should be able to understand the words on the label. “If we do not understand the ingredients, our body does not either.”

People are becoming more aware of the effects that sugar is having on them by abstaining from sugar for 5 days or more. For some people this is no problem, but for others they will experience headaches, mood swings, and flu like symptoms. People with sugar sensitivities experience cravings to eat more even when full. At Rebecca’s House Eating Disorder Treatment Programs we have seen some patients obtain recovery from their eating disorder after omitting this one substance from their diet. Many have tried to recover for years without knowing that sugar was causing their cravings to binge. There is much deliberation about sugar being addictive right now. It is important to remember that not everyone has this reaction to sugar. But some people have a reaction similar to an alcoholic having one drink. The person with alcoholism would have a different reaction to the drink than a non-alcoholic.

In January there will be a Sugar Awareness Week where people will be commenting on their experience of omitting sugar from their diet for 5 days. You can also take the challenge and record your experience at www.SugarAwareness.com. You can also read about other people’s experience with the sugar awareness challenge.

There are also dire medical consequences for the older woman with an eating disorder including severe osteoporosis, cardiomyopathy leading to sudden cardiac death, muscle wasting and gastro esophageal reflux disease. An older person who forceful vomits may rupture the esophagus resulting in a medical emergency or even death.

Now we are seeing patients admit to our eating disorder programs who have had gastro-bypass surgery. Some are experiencing weight gain 18+ months post surgery. They report that the obsessive thoughts of food, weight, diets, and body image still occupied 90% of their waking moments. They are also experiencing medical complications and suppressed immune systems due to the malabsorption of vitamins. Thirty percent of post-bariatric patients develop substance addiction (Moorehead and Alexander, 2007). It is so important that the underlying reasons for developing obesity are addressed in conjunction with this type of surgery or dealt with before the surgery.

Eating Disorders affect every social economic status, gender, and age. It is important to recognize the signs of eating disorders and seek professional help. Eating disorders do not just go away. Once in the destructive cycle of an eating disorder it is very hard to break out of the disorder.