Jul 20th 2023
Research on eating disorder, shows that the average age of onset for anorexia and bulimia is around 18 years of age . While eating disorders are typically considered disorders of adolescence, this does not mean that midlife eating disorders are not a possibility.
It is difficult to determine the exact prevalence of eating disorders in midlife, as there has been limited data collected to determine prevalence. Other potential reasons could be that those with severe eating disorders who don’t find recovery will, most likely, pass away before the age of 40, while those who do receive treatment for their eating disorer earlier in life may enter partial recovery and no longer meet the diagnostic criteria.
Individuals who have an age of onset after 40 are rare, however, more reaserch and more awareness could lead to a higher understanding of what eating disorders in this age group look like.
Based upon the limited data available, the prevalence of anorexia nervosa in women aged 40 and above is 1.9 to 5.8 cases per 100,000 people, and for bulimia nervosa, the prevalence in midlife is 1.7 cases per 100,000 people . There is even less data available regarding eating disorders in middle aged and older men, but the limited research suggests a prevalence rate 0.2% to 1.6% .
It is important to understand that prevalence estimates can vary based upon the way eating disorders are defined. For example, prevalence rates are lower if an eating disorder is defined based upon a person meeting clinical diagnostic criteria. However, if we consider people who show some symptoms of disordered eating but do not meet criteria for a disorder like anorexia nervosa or bulimia nervosa, prevalence rates are higher.
For instance, research with middle-aged women has found that 73% of this group experiences depression symptoms related to weight and body dissatisfaction, and 62% of those aged 50 and older report that eating and weight concerns “occasionally to often” affect their lives negatively.
Finally, 13% of middle-aged women experience at least one core eating disorder symptom . While showing just one symptom would not fulfill diagnostic criteria for an eating disorder, the truth is that a significant number of middle-aged adults, women especially, struggle with some form of disordered eating.
The specific signs and symptoms of eating disorders in midlife can vary based upon the specific disorder a person experiences. Symptoms of anorexia nervosa, for instance, will differ from those of bulimia nervosa or binge eating disorder. However, the general signs below can indicate an eating disorder :
There is not one single cause of midlife eating disorders. Instead, a variety of factors can increase the risk that someone will develop an eating disorder. Risk factors for midlife eating disorders include :
While eating disorders can come with serious consequences at any age, older adults who struggle with eating disorders face unique challenges. First, if they have engaged in a lifetime of disordered eating, they may not recognize their behaviors as problematic. Furthermore, an eating disorder in middle or older adulthood can become a part of a person’s identity, making it less likely that they will seek treatment .
Other complications surround the health-related consequences of midlife eating disorders. Compared to younger adults, middle-aged and older adults with eating disorders may experience more dramatic health problems resulting from disordered eating. They may more quickly develop physical health problems, such as gastrointestinal issues, cardiovascular problems, osteoporosis, hearing loss, dental problems, and injuries from over exercising .
Older adults with eating disorders, especially those who have struggled with a distorted body image for most of their lives, are at risk of mental health disorders like depression and anxiety. They are also at higher risk of substance abuse .
The best treatment plan for each person will depend upon their individual needs, but in many cases, treatment involves one or several of the following options:
Another form of psychotherapy, called interpersonal psychotherapy (IPT), can reduce the use of unhealthy coping mechanisms. IPT does so by helping middle-aged adults to navigate changing roles in relationships with spouses, parents, and adult children. Given the importance of relationships, couples counseling and psychoeducation for both patient and family can also be beneficial .
An eating disorder professional can help you to determine the best form of treatment to meet your needs. Patients with severe medical complications may require inpatient hospitalization before transitioning to a lower level of care. Your treatment team may include a multi-disciplinary group of professionals, including counselors, psychiatrists, medical doctors, and dietitians.
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