Body image can affect more than just teens
A first-of-a-kind study looking at older women finds that eating disorders are common -- and 62% of those surveyed say their weight or shape has damaged their lives.
Historically, eating disorder research has focused on teens and young women. But a study last week in the International Journal of Eating Disorders shows 13% of women ages 50 and older struggle with the problem -- some for the first time in their lives. Eating disorders are more common in women than men and include purging, binge eating, excessive dieting and excessive exercising.
The researchers surveyed 1,849 women online from across the nation in an attempt to find out how older women feel about their bodies and to estimate the prevalence of eating disorders. There are 53 million women in the USA older than 50, the authors write, and they note that previous studies have reported a lower risk for eating disorders as women mature.
"The disorders have serious physical as well as emotional consequences," says Cynthia Bulik, director of the eating disorders program at the University of North Carolina and lead author of the study. "Part of my goal is to make this an issue all doctors need to be aware of regardless of a woman's age. Many think eating disorders end at age 25. They exist at every age, we're finding."
A 'bombardment' of messages
The average age in the study was 59. Seventy-nine percent in the study said their weight or shape affected their self-perception, 41% checked their body daily, and 36% spent at least half their time in the past five years dieting. Such behaviors and attitudes put women at higher risk for "full-blown eating disorders," authors write.
In addition, 13% reported symptoms of eating disorders. The report found purging and binge eating in all ages among those 50 and older. The reasons for eating disorders are complex, Bulik says, but one reason is crystal-clear.
"We have that constant bombardment of messages to look perfect, to be skinny and to be in control," says Janice Bremis, executive director of the Eating Disorders Resource Center in Campbell, Calif. "It's on television, in magazines, and women wonder, 'How can I ever be perfect like that?'"
One misguided "solution" is purging: eliminating food by vomiting or other means, which was reported by 8% in the absence of binge eating within the past five years.
"It's an extreme behavior," Bulik says. "Even after age 50, they're desperately trying to control their weight. What really surprised me is that even in the 75-84 age group, they were still endorsing purging."
Bulik says the disorders might be more dangerous in older women than in the young "because the body is less resilient as we age." The disorders cause cardiovascular, musculoskeletal and gastrointestinal problems and can lead to obesity, which also is linked to cancers and other health problems.
Identifying the triggers
Life changes could be a cause for late-onset problems, says Bulik, author of The Woman in the Mirror: How to Stop Confusing What You Look Like With Who You Are. Some, but not all, in the study acknowledged having had eating disorders when they were younger.
"We ask the question, 'What are the triggers to mid- and late-life eating disorders?'" Bulik says. "They're talking about divorce, loss, children leaving home, children coming home, being in the sandwich generation when you're taking care of children and your parents. Food can be seen as a way to regulate mood during these times."
The most common current symptom was binge eating (3.5%), a figure that is the same in younger people, Bulik says. Binging (eating a large amount of food in a short time and feeling out of control) differs from overeating, she says. But on top of making you feel bad about yourself, binge eating causes swings in blood pressure and glucose levels and can lead to obesity. More than half in the study (56%) were obese or overweight, 42% were normal weight and 2% were underweight.
"It's not uncommon for us to get calls from older people looking for help," says William Walters, the help line manager for the National Eating Disorders Association. "It can be more challenging for some of the older patients to come forward. Often, we'll hear from their family members or friends."
Bulik says some women reach a stage of "enlightenment," where "they're not concerned about how they look in the mirror and they get past that number on the scale. They are concerned with healthy eating, getting enough exercise, being happy. We need to get more women headed in that direction."
The findings are important for physicians to grasp, says Nada Stotland, a professor of psychiatry at Rush Medical College in Chicago.
"Few people and few physicians think of eating disorders in women beyond their teens or early 20s," says Stotland, former president of the American Psychiatric Association. "The struggle with weight and body image, as exemplified by the responses of the women in this study, is serious and life-long. I wish middle age could bring us more acceptance of who we are and what we look like."
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