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Aging and Anorexia Part
II: Advice on Eating Disorders in Midlife and
Beyond
Pamela Cytrynbaum, Family Goes
Strong
February 29, 2012
It's National Eating
Disorders Awareness Week and I started asking around
for information on older women and eating disorders.
Turns out it's an increasing trend with very little
information or study. Hopefully we can change that.
To get educated, I asked the folks at Eating Recovery
Center, where they are seeing a real upswing in cases
of older women struggling with eating disorders and
thought it was a great topic to explore.
In a recent post: Anorexia and Aging: Is There a
Silent Crisis of Eating Disorders in Older Women? I
began a conversation with Dr. Emmett Bishop, MD, FAED,
CEDS, founding partner and medical director of adult
services atEating Recovery Center.
Q: Can you make
distinctions between two populations — midlifers
with eating disorders and elderly with eating
disorders?
Dr. Bishop: "Distinctions
between the two groups really have not been studied.
However, in my clinical experience, many of the eating
disorders I have seen in older women – versus those in
midlife – are atypical. In older women, I have seen
more eating disorders develop not from dieting, but
rather, from intense food phobias."
Q: Does the disease
look or progress differently in the aging
population? If so, how?
Dr. Bishop: "This
needs to be studied more carefully. However, from my
clinical impression, we see a lot of medical
complications, such as kidney dysfunction, cardiac
issues and other medical problems, in the elderly
group that we do not see in the younger group."
Q: What are the
differences between an adolescent with an eating
disorder and an older person?
Dr. Bishop:
"In my experience, adolescents tend to display more
denial and have less self-awareness about their eating
disorders. Adolescents do not have the motivation to
get out of their eating disorder because they do not
see a reason to. Whereas, older individuals generally
are very aware of their eating disorders and they do
not want to have the disease, but they do not see a
way out."
Q: What triggers
eating disorders among older women? Are the triggers
different than younger people?
Dr. Bishop: "A
great deal of older women were triggered by an
activity such as dieting when they were younger and
have been suffering with their eating disorders for
years and years. However, it is not out of the realm
of possibility to see an older woman develop an eating
disorder for the first time at an older age.
Generally, I see late onset eating disorders more
related to a medical condition; for example, a
physical illness that has induced weight loss. The
common factor is weight loss, but what precipitated
the weight loss is different."
Q: I would assume
most elderly people with eating disorders had them
when they were younger too. Is that a myth?
Dr. Bishop:
"Late onset is probably very rare. The individuals we
typically see are those who have had an eating
disorder for a long time and have relapsed from prior
treatment or are entering treatment for the first
time."
Q: What are the
additional health issues/risks in play for older
people with eating disorders?
Dr. Bishop:
"Older individuals have much less resilience when it
comes to physical damage from eating disorders. A lot
of things can go wrong with vital organs, bone density
can be impacted, dental health can suffer, and as
tissues become less elastic, I've seen people aspirate
from purging. A whole host of medical issues can arise
as people abuse their bodies over time. Eating
disorders are the deadliest mental illnesses and
premature death is very common."
Q: Are there books,
articles, websites, resources you can recommend to
our readers?
Dr. Bishop: "Related
to middle aged and elderly individuals, there is not a
lot of age-specific information out there. The
National Eating Disorders Association offers a wealth
of general information about eating disorders and
access to resources on its website, Eating Recovery
Center additionally offers a number of resources, as
well as confidential online chat with our intake team
at Eating Recovery Center."
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