Are Adult Onset Eating Disorders the New Midlife Crisis?

By www.medcitynews.com

Each year, pediatricians see increasing numbers of very young children, who have fallen prey to eating disorders (EDs), in their clinics and hospitals. But the specter of anorexia, bulimia, and other eating-related disorders can manifest in people of any age. Increasingly, women in their thirties and forties fall prey to these devastating psychological disorders.

Starving in Midlife

Psychiatrists and mental health professionals are reporting steadily increasing numbers of fully adult women presenting with these disorders, which usually develop in the preteen or teenage years. For these people, a major life change or crisis serves as the catalyst for the development of eating disorders. Divorce and loss of a loved one or job represent events that can trigger deterioration of psychological well being leading to the initial appetite and weight loss. The control these women feel, due to the weight loss, can then develop into a serious illness, such as anorexia or bulimia nervosa. These dysfunctional eating patterns can lead to death in many cases for these patients. Some physicians theorize that hormonal imbalances occurring around the time of perimenopause may trigger behaviors that lead to full blown EDs in susceptible women.

How Prevalent Are Adult Onset Eating Disorders?

The National Eating Disorders Association (NEDA) estimates that 56 percent of women in midlife had a clinical eating disorder in 1997 ’ a significant jump from the 25 percent of women in this age group with an ED in 1972. Experts fear that the actual percentage of midlife women with ED is higher than 56 percent. Mature women conceal their illnesses longer and more effectively than younger, less experienced women. Many of these women probably struggled with an ED at some point in their younger years, but overcame them at some point. Mental health professionals blame societal pressures and ubiquitous media promotion of unrealistic, and even fictional, body types and eating behaviors.

Not a 'Women Only’ Disorder

Men, especially those approaching midlife and beyond, fall prey to EDs as well. The same triggers ’ job loss, loss of a loved one, dissolution of a primary relationship ’ cause certain males to experience mood deterioration that results in obsessive and dysfunctional eating habits. Men engage in the same self-destructive behavior as women, such as over-exercising and extremely controlled eating rituals.

Treatment Options

Many people perceive EDs as a benign psychological condition that will resolve on its own or with minimal intervention by mental health professionals. In reality, the underlying causes are far more complex. Studies point to a genetic link; approximately 10 percent of those with clinical eating disorders have an immediate family member with an ED as well. The most successful courses of treatment involve the entire family as well as individual therapy sessions and pharmaceutical interventions. Eating disorders kill ’ slowly ’ tragically ’ painfully. If you have an eating disorder or suspect someone you know has one, get help immediately. Contact the NEDA for free, confidential advice about professional help in your area.

How to talk about an eating disorder

By Dr. David Prescott, The Acadia Hospital

How do I start a discussion about a possible eating disorder? The first time you raise a concern about an eating disorder with a family member or friend, realize that the conversation may be a starting point rather than an ending point.  Some useful strategies for having the first conversation include:

1. Learn about eating disorders and treatment options before you talk. Having an understanding of the behaviors, feelings and treatment options for eating disorders will help you to feel more confident and supportive.
2. Express your concerns without focusing on the eating behavior. Statements like “you are putting on weight” or “you are getting too thin” may backfire quickly. Rather, statements about your experience of what it is like to be around them (“a lot of times I think you are sad or unhappy”) may be a good starting point.
3. Gently asking whether a person has considered that they might have a problem or if they have thought about talking to a health professional will often yield surprising answers. Typically, people with eating disorders have given the issue a great deal of private thought.
4. Take a break if things get too stressful. Remember that control is usually an important issue in eating disorders.  Insisting that a difficult conversation be finished “here and now” can often lead to a control battle.  Coming back to the conversation later in a supportive way shows your commitment and willingness to have some give and take.

What are the types of eating disorders? There are three major types of eating disorders:

1. Anorexia nervosa involves having a distorted body image where a person sees themselves as overweight even when they are dangerously thin.  People with anorexia have an intense fear of gaining weight, and often develop unusual habits such as refusing to eat around other people.  Anorexia usually occurs in women, and is often accompanied by infrequent or absent menstrual periods.
2. Bulimia nervosa involves eating excessive quantities of food, sometimes in secret, then trying to purge the body of the food and calories by using laxatives, vomiting, exercise or diuretics.  People with bulimia nervosa usually feel ashamed and disgusted as they binge and purge, yet also feel relieved of tension once the cycle is complete.
3. Binge eating disorder involves frequent episodes of excessive, out-of-control eating. However, there is no attempt to purge the body of excess calories.

How do I know if I am at risk for an eating disorder?  The determination of when issues of food, eating and body image cross the line from “normal concern” to “psychological problem” varies from person to person.  However, if you answer “yes” to any of the following questions, it may suggest that you are at risk for an eating disorder:

1. Are you constantly preoccupied with weight and an intense fear of becoming fat?
2. Do you believe that your body weight needs to be below what is recommended by physician or dietitian?
3. If you are a woman, have you skipped or stopped a menstrual period when you were losing weight?
4. Do you frequently feel out of control when you eat?
5. How much of your eating is secretive or hidden from others?
6. Have you tried, or strongly considered, trying to lose weight by vomiting, using laxatives, or exercising according to how much you eat?