Midlife eating disorders are on the rise. Treatment centers around the country, and the world, are reporting a rise in the number of women and men over 35 who are presenting for treatment for eating disorders. Since only a fraction of people with eating disorders ever seek treatment, that means there are even more people in the community who are suffering than we are aware of. The number one topic people ask me about when I discuss midlife eating disorders is what the triggers are in midlife that might send someone down the path of an eating disorder. So the next few blog posts will present excerpts from Midlife Eating Disorders: Your Journey to Recovery that discuss the most common triggers that we see for midlife eating disorders. I’ll start with infidelity.
Between adolescence and midlife, your genes don't change (although how they are expressed can change), but what does differ to some extent are the environmental triggers that can set off, reignite, or sustain eating disorders at different stages of life. Although just about any major stressor could trigger an underlying predisposition to an eating disorder, there are a few that are making a recurrent appearance in midlife women and men who are presenting for treatment. Some of these represent reignited old traumas or experiences that were associated with disordered eating in the past. Some of them are unique to adulthood and may trigger an eating disorder for the first time, or re-trigger a dormant eating disorder in a new way. Here are the most common ones that we have encountered in the clinic.
Infidelity. Liza never thought it would happen to her. She had counseled countless friends whose husbands had strayed, but she and David had been together for almost 25 years—they met in high school, started dating right away, and everyone knew that they would always be together. They had recently been planning a vacation and doing Internet searches for unique destinations. David had identified some cool places on the coast, but Liza couldn’t remember the names. He was out on a bike ride, so she decided to just check his browser’s history. As she scrolled down the list, Liza found some vacation spots and some work-related websites, but then she found a whole list of Internet sex sites. This wasn’t just porn—they were interactive sex sites. She started shaking and thought she was going to throw up. Nobody else used this computer. David was betraying her with Internet sex. Her first thought was that she wanted to kill him. Her second thought was to wonder whether it was her fault. Her interest in sex had gone down precipitously during perimenopause—was this his way of getting back at her for not wanting to have sex as often? She ran downstairs, downed an entire half-gallon of ice cream, then went to the bathroom and vomited everything up. She hadn’t done that in 30 years.
Don Baucom, Ph.D., Distinguished Professor of Psychology at the University of North Carolina at Chapel Hill, expert on couple interactions states, “Finding out that your partner was unfaithful creates a deeply visceral sense of shock, disgust, and disbelief. All that you believe about your partner and your relationship is destroyed. Your sense of control is gone, and there is nothing safe left to cling to. Most people experience a desperate urge to escape from the horror and feel better immediately. For some people, that sought-after comfort comes in the form of an out-of-control binge that might bring momentary pleasure or distraction from the interpersonal nightmare. Of course, it is destined to fail beyond the moment, because the road to recovery from an affair is a long and complex process that does not start in the refrigerator.”
It is not just the aggrieved party who can be at risk for disordered eating.
Dawn thought she was happily married and had always believed that once you make that lifelong commitment, no one else can open your heart. But then she was working at the community garden one afternoon and found herself staring at a young man who, from across the field, made her heart flutter. She worked her way over to his side of the garden just to get a closer look, and when he turned around to smile, she felt like she was back in high school with an adolescent crush. Dawn found herself chatting him up, and the conversation flowed easily from one topic to another. They worked side-by-side in the garden for two hours, and she heard herself asking him out for coffee afterwards. Had she really done that? Did that invitation just come out of her mouth? He was at least 15 years younger than she! That coffee was the first step towards a sordid affair.
Although their connection was positively electric, Dawn was always painfully aware of the 15 years that separated them. Was he really attracted to her older body? How could she compete with women his age? She joined a gym, started doing hot yoga, went on a diet, and became determined to lose 10 pounds. The 10 pounds became 20, and she became increasingly convinced that the way to keep their affair alive was to slim down.
He started worrying about her health and found that whatever spark they had was fading. He worried that it was his fault that Dawn was losing so much weight and decided that the dishonesty of their affair was driving her down this dangerous path. He broke things off, which devastated her. She was convinced it was because of her age, and her weight. Dawn buried her heartbreak in further weight loss until she reached a dangerously low weight and was rushed to the emergency room by her husband, who had found her unconscious on the bathroom floor.
Dr. Baucom relates how infidelity in midlife can be a major stressor on both the relationship and on the individual level and can be a prominent trigger for midlife eating disorders. “’If only—if only I were younger; if only I were petite; if only I could make myself more appealing, people would love me and wouldn’t leave me.’ Affairs often hurt everyone involved, even the person who initiates them. They often feel bad about themselves for getting involved since the majority of people, even those who have affairs, agree that affairs are wrong. And when they don’t work out, people often feel like failures in the realm of love and intimacy. So why starve yourself in response to having an affair? For Dawn, there were lots of reasons—to be thinner and more appealing; to distract herself from the loss of her lover with a concrete goal of losing weight; and to punish herself for this exciting yet loathsome affair when she already had a loving husband.”
Next trigger: Divorce
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