A first-of-a-kind study looking at older women finds damaging eating disorders are common - and 62% of those surveyed say their weight or shape has a negative impact on their lives.
Historically, eating disorder research has focused on teens and young women, but the study out Thursday in the International Journal of Eating Disorders shows 13% of women ages 50 and older struggle with the problem - some for the first time in their lives. Eating disorders are more common in women than men and include purging, binge eating, excessive dieting and excessive exercising.
The researchers surveyed 1,849 women online from across the nation in attempt to find out how older women feel about their bodies and to estimate the prevalence of eating disorders. There are 53 million women in the USA older than age 50, the authors write, noting previous studies have reported a lower risk for eating disorders as women mature.
"The disorders have serious physical as well as emotional consequences," says lead author Cindy Bulik, director of the eating disorders program at the University of North Carolina. "Part of my goal is to make this an issue all doctors need to be aware of regardless of a women's age. Many think eating disorders end at age 25. They exist at every age, we're finding."
The average age of the current study participant was 59. The survey consisted of multiple choice, fill-in, and open-ended questions on body image, aging, eating, and weight-loss attitudes and behaviors.
Among the findings showing how weight issues can impact life negatively: A whopping 79% said their weight or shape affected their self-perception, 41% checked their body daily, and 36% spent at least half of their time in the last five years dieting. These behaviors and attitudes put women at higher risk for "full-blown eating disorders," the authors write.
In addition, 13.3% reported having symptoms of eating disorders. The report finds purging and binge eating were occurring in all ages among those 50 and older. The reasons for eating disorders are complex, Bulik says, but one reason is crystal clear.
"We have that constant bombardment of messages to look perfect, to be skinny and to be in control," says Janice Bremis, executive director of the Eating Disorders Resource Center in Campbell, Calif. "It's on television, in magazines, and women wonder 'How can I ever be perfect like that.' "
One misguided "solution" is purging - eliminating food through vomiting or other means. Among all participants, 8% reported purging (in the absence of binge eating) within the past five years.
"The purging number screams out desperation in my mind," says Bulik. "It's an extreme behavior. Even after age 50, they're desperately trying to control their weight. What really surprised me is that even in the 75-84 age group, they were still endorsing purging."
Women used a variety of unhealthy methods to drop pounds, including diet pills (7.5%), excessive exercise (7%), diuretics (2.5%), laxatives (2%) and vomiting (1%).
Bulik says the disorders might be more dangerous in older women than in the young "because the body is less resilient as we age." The disorders cause cardiovascular, musculoskeletal and gastrointestinal problems and can lead to obesity, which also is linked to cancers and other health problems.
Major life changes could be responsible for late-onset problems, says Bulik, author of The Woman in the Mirror: How to Stop Confusing What You Look Like With Who You Are. While some study participants acknowledged having eating disorders when they were younger, the problems did not develop in others until they got older.
"We ask the question, what are the triggers to mid- and late- life eating disorders?" says Bulik. "They're talking about divorce, loss, children leaving home, children coming home, being in the sandwich generation when you're taking care of children and your parents," she says. "Food can be seen as a way to regulate mood during these times."
The most common current symptom was binge eating (3.5%), a figure that is the same in younger people, Bulik says. Binge eating - characterized by eating a large amount of food in a short period of time and feeling out of control - differs from overeating, she says.
But on top of making you feel badly about yourself, binge eating causes swings in blood pressure and glucose levels and can lead to obesity. More than half of the study participants (56%) were obese or overweight, 42% were normal weight and 2% were underweight.
Having a higher BMI, body mass index, was associated with more disordered eating, increased body dissatisfaction, dieting behaviors, preoccupation with food and a drive for thinness, the authors write.
"It's not uncommon for us to get calls from older people looking for help," says William Walters, the help line manager for the National Eating Disorders Association, a national group that identifies local resources for callers.
"There is plenty of help out there, but it can be more challenging for some of the older patients to come forward because they might have a stereotype that it's younger people who are affected," he says. "They're afraid of the added stigma of being older. Often, we'll hear from their family members or friends."
Bulik says there's a stage of "enlightenment" some women reach.
"They're not concerned about how they look in the mirror and they get past that number on the scale,'' she says. "They are concerned with healthy eating, getting enough exercise and being happy. We need to get more women headed in that direction."