Q: I’ve heard a lot about anorexic teenagers, but I think my 40-year-old sister-in-law is becoming anorexic. She’s obsessed with dieting and is terribly thin. Does this happen to older women?
A: “A growing number of older women are developing eating disorders or have hidden them for years,” confirms Lauren Solotar, Ph.D., chief psychologist for May Counseling Center in Walpole. Dr. Solotar specializes in eating and anxiety disorders.
“Since approximately 45 percent of American women (and 25 percent of American men) are on a diet on any given day, it’s not surprising that some dieters cross over the line from normal weight-watching to abnormal eating obsessions,” Solotar said. “In fact, a study published in the International Journal of Eating Disorders reported that 35 percent of normal dieters progress to pathological dieting, and 20 to 25 percent of those progress to partial or full-syndrome eating disorders.”
—Anorexia nervosa, a life-threatening disorder in which the individual practices self-starvation;
—Bulimia, or bulimia nervosa, characterized by a cycle of binge eating and then purging with self-induced vomiting and/or laxative abuse or starvation; and
—Binge eating disorder (BED), a type of eating disorder characterized by recurrent binge eating without regular “purging” behaviors such as vomiting or laxative use.
It is estimated that more than 10 million females in the United States have either anorexia or bulimia. About 25 million more are struggling with binge eating disorder. Although most of these individuals are teenagers or young adults, some are older women. (Approximately one million males are also struggling with eating disorders.)
According to the National Eating Disorders Association, eating disorders are complex conditions that develop due to a variety of factors, including physical, psychological, interpersonal, and social issues. Scientists are still researching possible biochemical or biological causes.
The average weight of the American woman has increased over the past 15 years, while the desired body size has decreased. This widening discrepancy between actual weight and ideal weight may be a contributing factor to the development of eating disorders.
Psychological factors that affect eating disorders include: low self-esteem, feelings of inadequacy or lack of control, depression, anxiety, anger, and/or loneliness.
Interpersonal factors include: troubled family and personal relationships, difficulty expressing emotions and feelings, history of being teased about size or weight, and history of physical and/or sexual abuse.
Social factors include cultural pressures to be thin and “perfect” and cultural norms that value people on the basis of physical appearance rather than inner qualities. In addition, over the past 10 years, the societal pressure not only to be thin, but also to be physically fit has contributed to the increased prevalence of eating disorders.
To avoid dire health consequences, a person with a life-threatening eating disorder needs a strong medical team, consisting of a physician with experience in eating disorders, a psychiatrist, a nutritionist, and a therapist.
“A good therapist will work closely with the treatment team, develop a plan to restore the client to a healthy weight, and establish firm limits,” Solotar said. “He or she will make sure the patient is eating and arrange for hospitalization, if the case is severe."
According to Solotar, the best therapeutic approach for serious eating disorders is the cognitive behavioral approach that assesses and monitors thoughts, feelings, and behaviors that lead to mental health illnesses such as anorexia. Adjunct family therapy and psychopharmacology may also be necessary.
Patricia Ladew is a writer for the May Institute. She can be reached at pladew@mayinstitute.org. Dr. Lauren Solotar is the chief psychologist at the May Counseling Center in Walpole. She can be contacted at 508-660-1510.
