It's National Eating Disorders Awareness Week and I started asking around for information on older women and eating disorders. Turns out it's an increasing trend with very little information or study. Hopefully we can change that.
To get educated, I asked the folks at Eating Recovery Center, where they are seeing a real upswing in cases of older women struggling with eating disorders and thought it was a great topic to explore.
In a recent post: Anorexia and Aging: Is There a Silent Crisis of Eating Disorders in Older Women? I began a conversation with Dr. Emmett Bishop, MD, FAED, CEDS, founding partner and medical director of adult services at Eating Recovery Center.
Q: Can you make distinctions between two populations — midlifers with eating disorders and elderly with eating disorders?
Dr. Bishop: "Distinctions between the two groups really have not been studied. However, in my clinical experience, many of the eating disorders I have seen in older women – versus those in midlife – are atypical. In older women, I have seen more eating disorders develop not from dieting, but rather, from intense food phobias."
Q: Does the disease look or progress differently in the aging population? If so, how?
Dr. Bishop: "This needs to be studied more carefully. However, from my clinical impression, we see a lot of medical complications, such as kidney dysfunction, cardiac issues and other medical problems, in the elderly group that we do not see in the younger group."
Q: What are the differences between an adolescent with an eating disorder and an older person?
Dr. Bishop: "In my experience, adolescents tend to display more denial and have less self-awareness about their eating disorders. Adolescents do not have the motivation to get out of their eating disorder because they do not see a reason to. Whereas, older individuals generally are very aware of their eating disorders and they do not want to have the disease, but they do not see a way out."
Q: What triggers eating disorders among older women? Are the triggers different than younger people?
Dr. Bishop: "A great deal of older women were triggered by an activity such as dieting when they were younger and have been suffering with their eating disorders for years and years. However, it is not out of the realm of possibility to see an older woman develop an eating disorder for the first time at an older age. Generally, I see late onset eating disorders more related to a medical condition; for example, a physical illness that has induced weight loss. The common factor is weight loss, but what precipitated the weight loss is different."
Q: I would assume most elderly people with eating disorders had them when they were younger too. Is that a myth?
Dr. Bishop: "Late onset is probably very rare. The individuals we typically see are those who have had an eating disorder for a long time and have relapsed from prior treatment or are entering treatment for the first time."
Q: What are the additional health issues/risks in play for older people with eating disorders?
Dr. Bishop: "Older individuals have much less resilience when it comes to physical damage from eating disorders. A lot of things can go wrong with vital organs, bone density can be impacted, dental health can suffer, and as tissues become less elastic, I've seen people aspirate from purging. A whole host of medical issues can arise as people abuse their bodies over time. Eating disorders are the deadliest mental illnesses and premature death is very common."
Q: Are there books, articles, websites, resources you can recommend to our readers?
Dr. Bishop: "Related to middle aged and elderly individuals, there is not a lot of age-specific information out there. The National Eating Disorders Association offers a wealth of general information about eating disorders and access to resources on its website, Eating Recovery Center additionally offers a number of resources, as well as confidential online chat with our intake team at Eating Recovery Center."
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