The alarming rise in midlife eating disorders

When Margaret Bradley started worrying about the extra kilos she might put on at Christmas, she decided to take care of any holiday weight-gain ahead of time, by reducing her calorie intake in the lead up to the festive season. Her rationale was simple: she would diet now, so that she could feast without fear later.

But as the kilos began to melt away, Margaret found herself anxious that the weight was not coming off quickly enough. She further reduced her calorie intake and began hiding her restrictive-eating habits from her family, often pretending to have eaten earlier in the day.

When Christmas came and went, Margaret’s restrictive dieting only continued. Before long, she found herself in the grips of a devastating eating disorder.

Like so many others who have walked a similar path, Margaret’s journey with anorexia is an all too familiar one: a person starts dieting for a concise and well understood set of reasons, but then the behaviour takes hold, and continues to accelerate for a completely different, and much more complex (and poorly understood) set of reasons.

However what some readers may find surprising about Margaret’s experience, is the age at which she first developed anorexia: Margaret was 54-years old.

Indeed while anorexia and other eating disorders continue to be depicted as illnesses which primarily impact upon teen girls and young women (particularly those who are white and middle class), research now shows that eating disorders are common in many other populations, although they often go undetected, especially if the people they afflict do not meet with the unhelpful, conventional stereotype of the image-conscious teen girl.

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According to Cynthia Bulik, author of Midlife Eating Disorders, stereotypes which focus on teen girls tend to skew the public perception of who is at risk, and may present an overly simplistic, trivialised view of the causes of eating disorders (especially since teen girls motives are already routinely simplified down to fit uncomplicated narratives about their lives).

Not only do these stereotypes alienate many individuals who suffer from eating disorders, but they also confuse the public understanding of the issue, causing some sufferers and their families to overlook symptoms and common triggers associated with eating disorders (such as a pronounced personal trauma or a loss of control over a significant aspect of one’s life).

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Now, research shows that ‘midlife eating disorders’ (eating disorders which commence in a person’s 30’s, 40’s, 50’s or beyond) are rapidly increasing in number for both women and men. Between 2001 and 2012, midlife eating disorders increased by 42 percent and even more staggering is the fact that 78 percent of deaths from anorexia occur in women over the age of 50.

Based on Bulik’s research, there are various triggers associated with midlife eating disorders which are highly common to those stages of life: divorce, partner infidelity, sudden unemployment, an empty nest, financial insecurity, or the changes associated with retirement, all have the potential to upset a person’s sense of order and control, and can be the catalyst for an eating disorder. The death of a parent or loved one is another significant trigger for midlife eating disorders as are major injuries, illnesses, or the onset of perimenopause, (all of which can highlight a person’s mortality). Likewise, an unresolved trauma- including the trauma of a prior eating disorder- can be a triggering event for some.

So why do we hear so little about midlife eating disorders and do they carry any additional risks?

According to Bulik’s research, those who suffer from midlife eating disorders may be more vulnerable to physical problems because their bodies are older and less resilient. They may also be more effective at concealing their behaviours for far longer, because as adults, they are more independent and have greater financial and physical access to various substances associated with eating disorders – such as laxatives, diuretics, purgatives and binge supplies.

“Very practical differences between adulthood and childhood make it easier for an eating disorder to go undetected. An adult can drive to a grocery store, get food in a drive- through, binge in the car, be alone at home after work, or work alone at home— all of which can conceal disordered eating behaviour. Coupled with the fact that eating disorders aren’t on the midlife radar screen, people might observe suspicious patterns and even wonder about them but, because they are unsuspecting, never put two and two together”.

Bulik also notes that a pharmacist won’t look twice at an adult who purchases dieting products, or other products that can be abused by those attempting to lose weight, and that adults can easily go online and use credit cards to purchase such items. Adults can also exercise in secret if necessary, whereas teens tend to rely on being chauffeured about by their parents to gyms and other exercise venues.

But there is another more controversial reason why so many midlife eating disorders in women go undetected and it is because – whether we like it or not- there are a number of behaviours associated with conventional motherhood which enable an eating-disordered woman to conceal her struggle. For example, when a woman insists on spending hours in the kitchen preparing meals for other people to eat, it is easy to chalk this up to her being a good hostess or a maternal nurturer. And when a woman expends time, energy, and finances buying ingredients, checking recipes, preparing baked goods, and religiously consuming food blogs and cooking shows, it is easy to attribute this to a traditionally ‘feminine’ interest in all things cooking and homemaking.

But these behaviours are also typical of many people who suffer from eating disorders. As evidence suggests, when we vigorously repress any natural appetite, the appetite doesn’t simply disappear and may instead bubble up and express itself in peculiar and borderline perverse ways (such as cooking lavish amounts of food, and watching other people consume it while denying oneself any; or developing an intense fascination with ‘food-porn’ blogs while rejecting all actual food).

In her book How To Be A Woman, Caitlin Moran advances a similar theory, arguing that eating disorders (and especially Binge Eating Disorder) are often suffered by caregivers, and mothers especially, because these disorders interfere less with a person’s ability to perform their care-giving duties, compared to other forms of addiction. Moran argues that women who choose food as their drug (as opposed to other substances) can “still make the packed lunches, do the school run, look after the baby, pop in on [their] mum, and then stay up all night with an ill five-year-old”, things which other drugs may render near impossible. “[People with Binge Eating Disorder] are slowly self-destructing in a way that doesn’t inconvenience anyone. And that’s why it’s so often a woman’s addiction of choice,” writes Moran, who also posits that these disorders attract additional stigma, precisely because they are often associated with women.

It’s an extremely guarded subject and until recently there has been a marked lack of research and writing on the topic of middleaged women (and men) who suffer from these diseases. But hopefully, as more women like Margaret begin to tell their stories, and as more research on the subject comes to light, we may also begin to break down stereotypes and become one step closer to finding effective forms of treatment and recovery.