Harvard Mental Health Letter

Eating disorders in adult women

For some, aging may bring on — or rekindle — an eating disorder. Most people who develop eating disorders — an estimated 90% — are female. Typically associated with adolescents and young women, eating disorders also affect middle-aged or elderly women — although, until fairly recently, not much was known about prevalence in this older age group. Secrecy and shame are part of the disorder, and women may not seek help. This is particularly true if they fear being forced to gain unwanted weight or stigmatized as an older woman with a "teenager's disease." Despite underdiagnosis of eating disorders in older people, clinicians at treatment centers specializing in such issues report that they've seen an upswing in requests for help from older women. Some of these women have struggled with disordered eating for decades, while for others the problem is new. The limited amount of research on this topic suggests that such anecdotal reports may reflect a trend. In community surveys conducted in 1995 and again in 2005, for example, Australian researchers found that while younger women reported eating disorder behaviors more often than older women did, the rate of these disorders in older women increased dramatically between the two surveys, while it remained stable for young women. In women ages 65 and over, strict dieting, fasting, and binge eating all tripled, while purging quadrupled. In the same surveys, rates of strict dieting or fasting and purging also increased dramatically in women ages 45 to 64. A study of Canadian women surveyed in the general population likewise found that women ages 45 to 64 were more likely to binge on food, feel guilty about eating, and be preoccupied with food compared with younger women.
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