Eating Disorders in Women at Mid-Life
By: Danielle Michaud, Project HEAL Social Media Intern
The literature on eating disorders in middle aged women (40-60 years) is scant. However, the number of women seeking treatment in this age group has significantly risen over the past decade. Eating disorders know no age boundaries (or gender! More to come on that later); the prevalence of eating disorders in middle aged women may be similar to that of young adults (18-39). Research demonstrates that younger adults and middle aged women face similar biopsychosocial factors for developing an eating disorder: a tendency toward perfectionism, low self-esteem, and cultural messages pressuring the drive toward thinness.
Studies have shown that middle aged women are more likely to struggle with binge eating disorder, EDNOS (Eating Disorder Otherwise Not Specified) or subthreshold eating disorders, meaning that the afflicted individual demonstrates certain characteristics or symptoms of a more “classical” eating disorder but does not meet full diagnostic criteria. Research on inpatient admissions shows that middle aged women are more likely to have an older age of onset than are their younger counterparts. However, women at midlife also tend to have a longer disorder history. We must consider that although late age onset eating disorders do occur, this is not as likely as the idea that many of these cases have been life-long without prior treatment. In some situations, the woman has experienced a period of recovery from her ED from youth, but has relapsed, deciding to seek help.
Middle aged women also face unique factors rendering them vulnerable to struggling with eating disorders. One study reports that middle aged women must also contend with approaching menopause and aging anxieties. Perimenopausal women scored higher than pre- and post- menopausal women on measures predicting negative body image. This subgroup might be more vulnerable because of hormonal changes, weight gain due to menopause, and their core beliefs about womanhood. They might also feel “out of control” as their body changes, leaving them at greater risk for using disordered eating as a coping mechanism. Additionally, women today face the pressure to “do it all”- juggling a family and a career, in a pressure cooker environment to maintain a youthful appearance and to fit into society’s ideal of beauty. Midlife also poses a major transition period for women, often marked by children leaving the home, loss of a parent, pressure to meet internalized career deadlines, or possible divorce.
For a woman with a predisposition to an eating disorder, these events may act as the trigger that unloads the gun. Most women are unlikely to speak up about their struggles during their visits to a health care provider. However, since the signs are not always obvious, the clinician may not be looking for them, many people continue to go undiagnosed and untreated. Some treatment facilities believe that patients of all ages have more in common than they do not regarding symptomology and body image, and thus promote treating age groups together. On the other hand, some treatment centers believe that women have different needs at mid-life, and thus have implemented special programming geared toward an older demographic, like the Renfrew Center and Laureate Psychiatric Hospital. Although a person who has struggled with an eating disorder for a greater length might face a longer road to emotional, mental, and physical stability, full recovery is still possible with appropriate treatment.