Wednesday 25/09/2024
PHOTO: taken from Pexels
TEXT: María Sabaté and Lina Camacho
Eating disorders (EDs), such as anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), are not exclusive to adolescents and young adults. Recent studies show that both women and men in middle and older age can also suffer from these disorders. Although the prevalence decreases with age, it does not disappear completely. Women transitioning to menopause are particularly prone to developing or worsening an ED, while men, though less frequently affected, may experience symptoms starting in their 50s.
How do EDs manifest in older adults?
In women, symptoms can be confused with the effects of menopause or aging, while in men, societal stigma and the perception that these disorders primarily affect women make identification and treatment more difficult.
Older women tend to present with AN, BED, and BN, often with a marked concern for body image and restrictive behaviors. In men, BED is the most common, and many resort to excessive exercise to control their weight. The perceived difference between men and women is that while some older women use exercise as a compensatory mechanism, it is more common for men to use excessive exercise as a form of purging, meaning they engage in extreme physical activity to counteract caloric intake.
Why do EDs appear in older adults?
In some cases, EDs in older adults can trace back to adolescence or early adulthood but have remained untreated for decades. This complicates treatment, as the individual has adapted to living with the disorder.
Nonetheless, aging brings many physical and emotional changes that can trigger or worsen EDs. The loss of loved ones, retirement, and chronic health problems are factors that increase vulnerability. For women, menopause is a particularly critical time, as hormonal changes can heighten ED symptoms. Men, on the other hand, can also be affected by hormonal changes associated with aging, such as decreased testosterone levels, and societal pressure to maintain a youthful appearance. In many cases, eating disorders become a way to cope with the loss of control they feel as they age, exacerbating the situation.
However, women tend to feel more distressed by the changes in their bodies due to aging, while men are more concerned with the loss of strength and vitality. Additionally, we live in a society that glorifies youth and thinness, which fosters body dissatisfaction in many older adults. This cultural pressure can lead to unhealthy eating behaviors in an attempt to meet those standards.
The Impact of Anorexia and Other Eating Disorders on Adults
EDs in older adults have severe physical consequences. Malnutrition, electrolyte imbalances, and bone loss (osteoporosis) are common complications that can worsen pre existing aging conditions and increase the risk of mortality. For example, women with EDs often experience heart problems and bone loss due to dietary restriction. Men, on the other hand, face a greater risk of muscle and joint injuries, dehydration, and fatigue, especially if they use excessive exercise as a method to control their weight.
On an emotional level, EDs can lead to social isolation, feelings of shame, and low self-esteem.
Challenges in Diagnosing and Treating Adult Eating Disorders
One of the main obstacles is delayed or incorrect diagnosis. In older adults, ED symptoms are often mistaken for other conditions related to aging, such as loss of appetite or weight due to chronic illnesses. Additionally, the stigma and belief that EDs are “young people’s problems” prevent many older individuals from recognizing their condition or seeking help.
It is essential that the healthcare system and mental health professionals recognize that EDs affect people of all ages, including older adults. Aging does not “automatically cure” eating disorders, and they remain a significant issue that requires specialized attention. Although gaps still exist in research and treatment for this age group, early recognition and access to appropriate treatments can significantly improve the quality of life for those affected by these disorders.
With greater awareness and understanding, we can break down the barriers of stigma, ensuring that older adults receive the support and treatment they need to overcome EDs.
References
- Mangweth-Matzek, B., Kummer, K. K., & Hoek, H. W. (2023). Update on the epidemiology and treatment of eating disorders among older people. Current opinion in psychiatry, 36(6), 405-411.