“You would think at 50 I wouldn’t be worried about my weight”. This comment speaks to why middle aged eating disorders are often cloaked in secrecy. In most people’s minds, an “eating disorder” conjures up images of thin, teenage girls. However, eating disorder demographics are changing. Over the past five to 10 years, we have seen a growing number of older women seeking treatment for eating disorders.
Middle aged eating disorders
Women in midlife and beyond, from all ethnic backgrounds, are struggling with Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder (BED). Some have experienced this since they were very young. Others have relapsed in midlife after a stressor such as a divorce, death of a loved one, or menopause. While others are experiencing an eating disorder for the first time in midlife.
Research indicates how misguided our generalisation about eating disorders is. A 2012 study published in the International Journal of Eating Disorders found that about 13 percent of women over 50 exhibit eating disorder symptoms. To put that in perspective: Breast cancer afflicts about 12 percent of women.
There was one common thread uniting most of the women in the study: Their illness was generally overlooked by doctors. While it seems unlikely that signs of an eating disorder would baffle doctors, the truth is, they can and do.
Women get a lot of positive feedback if they’ve lost weight or maintained a low weight, no matter how it’s achieved, so it goes unnoticed.
When many women enter a different chapter of life or encounter new hurdles—their sense of self can become disorganised.
The pressure for women is further compounded by societies mindset that it is not okay to age. There’s the whole 50 is the new 30 and 70 is the new 50 attitude. The burden to stay forever young and thin is intensifying.
Many women experiencing middle aged eating disorders won’t experience a dangerously low weight and that is key to understanding why eating disorders often go unnoticed. Anorexics aren’t always emaciated, and bulimics and binge eaters can be a healthy weight or even overweight. Furthermore, one of the classic symptoms of adolescent anorexia—loss of a period—doesn’t apply.
Accepting yourself at any age
With the increased recognition of eating disorders in middle aged women, treatment options are readily available and can be tailored to meet your unique needs.
If you or your loved one is struggling with an eating disorder, remember that it is never too late to seek the help you need and begin your recovery journey.
Many parents are not recognising the early eating disorder signs their child might be displaying. Read on to find out why parents typically miss these signs and what the signs actually are.
First of all, please do not beat yourself up. This is not untypical, as a recent study found one in three adults surveyed could not name any early signs of an eating disorder.
Dieting and Diet Culture.
Diet culture is a society that focuses on and values weight, shape, and size over health and well-being. Variations of diet culture also include rigid eating patterns that on the surface are in the name of health, but in reality are about weight, shape or size.
Furthermore, diet culture is very sneaky because as we have learned that diets don’t work, they (diet culture) have transformed their message to say that they are all about health (I’m looking at you Weight Watchers).
Their definition of health though, is one that is synonymous with weight – that when you lose weight (by any means necessary) then you will be healthier.
Dieting has become so pervasive. Almost religious. Our identity.
Dieting has become so common place, that we don’t know what “normal eating” looks like anymore.
Moreover, compounding the problem further is the common belief that all young girls will inevitably have “body image issues”.
Many parents don’t see this as a problem because it’s become “the norm”. And, it’s not their fault because that’s all they know.
Anyone who is concerned about a loved one should research the issues thoroughly and get help as soon as possible. A person who has an eating disorder is not always skinny. In fact, some people with eating disorders are living in larger bodies.
What are the signs to watch out for?
The main signs to watch out for are:
becoming obsessive about food
changes in behaviour
having distorted beliefs about their body size
often tired or struggling to concentrate
disappearing to the toilet after meals
starting to exercise excessively
Early intervention is absolutely key.
The key lies in preventative education for parents to increase their awareness of the early signs, so they can “nip it in the bud” BEFORE behaviours lead to illnesses such as Anorexia and Bulimia Nervosa or Binge Eating Disorder (BED).
And, prevention and early intervention education (such as the Body Project) that can deliver proven results in helping young people to increase their self-esteem and resilience, so they’re better equipt to understand the “costs” of pursuing unrealistic thinness and the pressures to conform to unrealistic standards of beauty.
If this is something you or your daughter struggles with, please don’t hesitate to get in touch with me here>>
Often when people hear the term “disordered eating,” they assume it’s another way of saying someone has an eating disorder. However, we are dealing with two very distinct disorders: “disordered eating” and “eating disorder.”
It’s pretty easy to diagnose a full-blown eating disorder like Anorexia or Bulimia Nervosa. But more subtle forms of disordered eating are difficult to pinpoint. Our culture is obsessed with size and weight, diet and exercise, to the point where disordered eating is very pervasive.
The research suggests that up to 50% of the population demonstrate a problematic or disordered relationship with food, body, and exercise. Whilst rates of clinical eating disorders are much lower, estimated from 1% to 3% of the general population.
They sound and look very similar, so what is the difference between “disordered eating” and “eating disorder?
Disordered Eating is generally having an unhealthy relationship with food and eating for reasons other than being physically hungry, such as when you’re bored, tired or stressed. Disordered Eating does not fall under the Eating Disorder set criteria.
Symptoms of disordered eating may include behaviours commonly associated with eating disorders, such as food restriction and body dissatisfaction. The difference lies in the frequency and severity of behaviours and the distress they cause to the individual.
Disordered Eating looks like:
Eat to cope with emotions
Periodic binge eating
Eating when bored, tired, angry, stressed
Focus on weight and calorie intake
Thinking that reaching a goal weight will make you happy
Consuming large amounts of food in secret
Self-worth or self-esteem based on body shape and weight
Orthorexic behaviours – ‘clean eating’
Rigid adherence to dietary paradigms
Anxiety about certain foods or food groups
Negative food talk and food shaming
Engaging in dieting or disordered eating is a risk factor for the development of an eating disorder.
An eating disorder is a psychological disorderofficially classified in the one document regarded as the world authority on mental disorders, the DSM.
The number of people in Australia with an eating disorder at any given time is estimated to be 913,986, or approximately 9% of the population (Butterfly Foundation, 2012). Due to the significant feelings of guilt and shame one experiences with an eating disorder, these are likely to be conservative figures. It is estimated that 20% of women have an undiagnosed eating disorder (NEDC, 2012b).
Of these people, 47% have Binge Eating Disorder, 12% Bulimia Nervosa, 3% Anorexia Nervosa and 38% other eating disorders (Butterfly Foundation, 2012)
There are four diagnoses of eating disorders in the DSM: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and eating disorder not otherwise specified. Each of these disorders has specific criteria.
Restriction of energy intake relative to requirements leading to a much low body weight in the context of age, sex, developmental trajectory, and physical health.
Intense fear of gaining weight or becoming fat, even though underweight.
Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
Recurrent episodes of binge eating characterized by BOTH of the following:
Eating in a discrete amount of time (within a 2-hour period) large amounts of food.
Sense of lack of control over eating during an episode.
Recurrent inappropriate compensatory behaviour to prevent weight gain (via self-induced vomiting or excessive exercise, and use of diet pills and/ or laxatives).
The binge eating and compensatory behaviours both occur, on average, at least once a week for three months.
Self-evaluation is unduly influenced by body shape and weight.
The disturbance does not occur exclusively during episodes of Anorexia Nervosa.
Binge Eating Disorder:
Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
Eating, in a discrete time (such as, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar time under similar circumstances
A sense of lack of control over eating during the episode (such as, a feeling that one cannot stop eating or control what or how much one is eating)
The binge-eating episodes are associated with three (or more) of the following:
Eating much more rapidly than normal
Eating until feeling uncomfortably full
Eating large amounts of food when not feeling physically hungry
Eating alone because of feeling embarrassed by how much one is eating
Feeling disgusted with oneself, depressed, or very guilty afterwards
Marked distress about binge eating is present.
The binge eating occurs, on average, at least once a week for three months.
The binge eating is not associated with the recurrent use of inappropriate compensatory behaviours and does not occur exclusively during the course Anorexia Nervosa, Bulimia Nervosa, or Avoidant/Restrictive Food Intake Disorder.
The motivations behind a person developing an eating disorder is highly complex.
Eating disorders are highly complex and are NOT a “lifestyle choice”. They have a variety of co-morbid psychological issues contributing, such as depression, anxiety and Obsessive Compulsive Disorder (OCD).
The aetiology of eating disorders is thought to be: significant trauma, childhood trauma, dysfunctional family behaviour, feelings of helplessness and lack of control, social anxiety, sexual and emotional abuse and many other problems. It is also often thought that genetics play a role in the development of eating disorders, making some people more susceptible to developing them than others.
These motivations result in behaviours that are mentally and physically harmful.
Significant nutrient depletion and caloric deprivation are problems for Anorexia, which has the highest mortality rates of any mental health issue. For Bulimia, metabolic imbalance may result, and several gastrointestinal disorders, stomach acid issues, and tooth decay. Binge Eating Disorder may also have significant physiological effects as binge cycles can seriously harm the gut and the body’s metabolism.
In a sense, you could say that the serious psychological issues and dangerous physical problems are what distinguish disordered eating from eating disorders.
Problems with eating exist on a spectrum. On one end of the spectrum you have people with severe eating disorders. On the other end of the spectrum you have people who are mentally happy and peaceful eaters. Then you have 50% of the population that uses food to cope with their emotions – the disordered eaters. All of us exist somewhere on this spectrum.
Why does this matter?
Even if someone does not technically have “disordered eating or an eating disorder,” they may be on the spectrum. This may be because they do not meet the strict DSM criteria of bingeing often enough, or in my case, my BMI was considered normal (I was on the lower end of normal) and “not sick enough”; even though I had been bingeing and purging multiple times a day and engaging in excessive exercise behaviours for almost 12 years at that time.
The strict BMI “rules” meant I did not qualify for hospitalisation. The only way I was going to get “proper help” was for my parents to re-mortgage their house (I wasn’t going to let that happen) and pay an astronomical amount for private hospitalisation. Both myself and others with an eating disorder were/are under a significant amount of emotional pain, and physical and mental harm.
Fortunately, even though I wasn’t “sick enough” I had the support of a private psychologist and psychiatrist. Most psychologists I believe understand the potential severity of mental pain regardless of whether someone meets a specific criteria, and will be able to help those who need it.
When to Seek Help?
Seeking treatment will usually be very challenging for people experiencing disordered eating or an eating disorder. Those who view their behaviours as essential to maintaining their preferred weight or shape, or fundamental to their sense of identity, may actively resist treatment.
The length of treatment required will vary considerably from individual to individual, and will depend on the number and seriousness of symptoms, and the complexity of the issues that initiated these behaviours in the first place. Eating Disorders take longer to treat than disordered eating.
You do not need to wait for a formal diagnosis. If your relationship with eating or your body is causing you pain and suffering, then it is worth getting treated. “Nipping it in the bud” with early intervention is the most effective strategy.
In the early days one of the best things you can do is get educated on eating and body issues – the National Eating Disorders Collaboration and the Butterfly Foundation websites contain more information on eating disorders, the warning signs that you can look for, and ways that you can support someone you know is experiencing eating and body issues. It can also be beneficial to speak with your doctor or psychologist about your concerns and get support for yourself.
Don’t hesitate to get in touch if this is something that you need help with. Contact me here and we’ll organise a call.
Body image refers to how people see themselves. Distorted body image (also called negative body image) refers to an unrealistic view of how someone sees their body. There are at least four signs of an unhealthy body image.
Like eating disorders, it is seen commonly in women, but many men also suffer from the disorder. One of the main symptoms of an eating disorder or disordered eating is an unhealthy relationship with one’s body.
You begin forming your perceptions of your body’s attractiveness, health, acceptability, and functionality in early childhood. This image then continues to form as you age and internalise feedback from peers, family members, and the media, etc.
Personality traits such as perfectionism and self-criticism can also influence the development of a negative internalised image of your body.
Here are four signs of an unhealthy body image:
Being preoccupied with your body’s weight, shape, or appearance
Having feelings of shame, anxiety, and self-consciousness about your body
Frequently comparing your body to others’ and feeling like your body is flawed in comparison to others
Struggling with feelings of depression, isolation, low self-esteem, and/or poor relationship with food due to body dissatisfaction
The relationship between weight and body image
A normally healthy weight range for an individual can be perceived as overweight by someone with a distorted body image. An anorexic person may look at themselves in the mirror and see a reflection that is much bigger than their actual size.
Conversely, it is not uncommon for women living in larger bodies to report that they did not realise they were as large as they are. They had perceived their body as much smaller until an occasion arises where they see a photograph or video.
The relationship between a poor relationship with food and body image
Body image concerns, chronic dieting and bingeing go hand in hand. Often, it is the early dissatisfaction with a person’s appearance that leads them to conclude that losing weight would improve their appearance, and make them feel better about themselves and their bodies.
Thus, restrictive eating and over-exercising are often next, frequently leading to patterns of disordered eating and weight obsession that can develop into Anorexia, Bulimia, Orthorexia, compulsive overeating or Binge Eating Disorder (BED).
Healing negative body image
Getting support for distorted body image is a critical step to repairing your relationship with food and self. The problem won’t just go away by itself.
Recognising and acknowledging your feelings and accompanying body sensations will help you become more comfortable in your body and lessens the tendency to suppress feelings and revert to unhealthy, negative inner criticisms to escape uncomfortable feelings.
Cognitive Behavioral Therapy is a frequently used approach. This tool helps a person to recognise, analyse and restructure negative self-talk to more rational, positive self-talk.
Additionally, yoga, dance and movement therapy are often employed to develop a greater trust and appreciation of one’s body based upon creating internal experiences, such as what the body can achieve; rather than simply evaluating the body aesthetically.
Losing weight does NOT heal negative body image.
An important note: unraveling and healing negative body image is an inside job. Nothing you do superficially will truly heal your self-belief system.
It’s important to embrace body diversity by recognising that bodies come in all shapes, sizes and colours. They always have and always will.
While we all have days when we feel uncomfortable and insecure in our bodies, the key to developing positive body image is to respect our natural shape and learn to quieten those negative thoughts and feelings with affirming and respectful ones.
Only once we have accepted our bodies as they are can we begin to appreciate and love them. Maybe then we will fully acknowledge that losing weight does not cure negative body image.
The sooner we acknowledge and accept that, the sooner we can heal our broken relationships with our bodies and develop a stronger and more positive self-image.
All bodies as good bodies.
If you recognise yourself in any of the four signs of an unhealthy body image, please don’t hesitate to get in touch with me here>>