For everyone that struggled as a teen, it is a comfort to know that there is life after adolescence, and it does get better. Although many of our youthful struggles subside by age 25 or 30, mid-life comes with a new set of stressors.
Eating disorders, for example, remain prevalent among women throughout their lives. Contrary to long-held beliefs that eating disorders are primarily a teenage problem, a recent study in the International Journal of Eating Disorders found that 13 percent of women ages 50 and older struggle with disordered eating, particularly purging and binge eating. Of the women surveyed:
• 79 percent said their weight or body shape affected their self-perception
• 41 percent checked their body daily
• 36 percent spent at least half of their time in the last five years dieting
The Challenges of Mid-Life
Why are so many older women engaging in these destructive behaviors? In many cases, older women struggled with eating disorders in adolescence and a stressful event precipitated a relapse or made their condition worse. Others may find that dieting or other situations trigger an eating disorder for the first time later in life.
Like teenagers, older women experience stressful life changes such as children leaving home, a death in the family, divorce, menopause or caring for older parents. These experiences can be equally (if not more) challenging as those faced in adolescence, but the rituals that mark the developmental milestones of youth are missing. Instead, women often find themselves dealing with these pressures in isolation, with little support or validation.
The so-called “deadline decade” (from ages 35 to 45) can be particularly stressful. Within a few years, there is pressure to make a series of major life decisions, ranging from choosing a relationship partner and having children to pursuing career goals and achieving personal fulfillment. Although this time is full of opportunities, it is also rife with stress and responsibility.
Women struggling with eating disorders in mid-life also may have physical and emotional issues that complicate diagnosis and treatment. Older women, especially those who have suffered from eating disorders since their youth, may have medical complications such as diabetes, high blood pressure, heart disease and osteoporosis that worsen as a result of the natural aging process.
Hormonal and lifestyle changes — along with decades of dieting — can make it more difficult to maintain a healthy weight as women age. Excessive dieting causes muscle wasting, which can lead to reduced metabolic rate, and can exacerbate the natural neuromuscular decline of aging. Studies show that the risk of dying from heart disease is 70 percent higher in people whose weight fluctuates than in those whose weight remains stable.
Despite the inevitable changes that occur with age, the media continues to bombard women with marketing for anti-aging products and images of ultra-thin, young-looking celebrities in roles for women over 50. Older women feel that they are in direct competition with younger women and have few realistic role models to help them navigate the challenges of modern womanhood.
Blending Conventional and Integrative Treatments
Although middle-aged women may understand that their eating disorder is a medical problem, it can be more difficult to recognize it as an emotional and psychological problem. Those who suffered from an eating disorder for a significant part of their lives may resist changing thoughts and behaviors that have become entrenched. If they have managed to maintain a family or career, they may not recognize the need for seeking help.
Denial is pervasive in older women with eating disorders. The general stigma of having an eating disorder is amplified by the misperception among health care providers and the public that older women don’t struggle with these problems. As a result of inadequate training, mid-life eating disorders have been overlooked and misdiagnosed as stress, a medication issue or some other problem. Believing that treatment will be geared toward younger women or that they won’t fit in at a treatment center, there is a serious risk that older women will leave treatment quickly if we do not react with the same sense of urgency and take them as seriously as we take adolescents with these problems.
The most effective treatments for eating disorders (among adolescents as well as older women) include a combination of conventional and natural therapies. Integrative medicine approaches such as plant-based diets, yoga, meditation and psychosocial support may stop or even reverse the progression of coronary heart disease, diabetes, hypertension, prostate cancer, obesity, hypercholesterolemia and other chronic conditions. Examples of integrative strategies include:
Not surprisingly, under- or malnourished people are prone to mood disorders and health problems. Addressing nutritional deficits can improve mood and health, which is an important first step for patients with eating disorders. Key nutrients include:
• The B vitamins (especially B-6, B-12 and folic acid), which help convert the amino acid tryptophan to serotonin, a mood-boosting neurotransmitter
• Omega-3 fatty acids, which may ease depression, reduce suicide risk and improve cardiovascular health
• Zinc, which can restore appetite and help normalize weight
• Magnesium and calcium, which help protect the bones from osteoporosis and improve bowel function, mood and sleep
• Theanine, valerian root and kava extracts, which may help reduce anxiety
• Probiotics and digestive enzymes, which may ease the digestive complaints common in early eating disorder recovery
Movement and Touch Therapies
Acupuncture, yoga, massage, meditation and other therapies can help reconnect patients with their bodies by promoting body awareness, improving body image and boosting mood.
Mind-body techniques, such as hypnotherapy, guided imagery, mindfulness meditation and cognitive-behavioral therapy, can help relieve stress and improve body image.
It’s never too late to heal from an eating disorder. Early intervention that includes a blend of conventional and integrative treatments gives all eating disorder patients, regardless of age, the best chance for a full and lasting recovery.
Carolyn Ross, M.D., specializes in Integrative Medicine and developed the eating disorder treatment program at The Ranch in Tennessee. You can follow Dr. Ross on Twitter