When you close your eyes and picture someone who is struggling with an eating disorder, it’s likely the image of a young woman will come to mind for most people. Statistically, there is a high prevalence of young people who struggle with disordered eating, but that doesn’t mean it’s not a problem that doesn’t affect older adults.
The Agency for Healthcare Research and Quality, part of the Department of Health and Human Services, found that the number of instances of eating disorders is increasing in the 45-65 age group. From the years 1999-2000, compared to the years 2005-2006, the number of adults with eating disorders jumped by 48 percent. For adults over the age of 65, the increase was 24 percent. The study also reported that people ages 30 and older accounted for 46 percent of all hospital stays for eating disorders.
This little-known societal trend is concerning. Eating disorders in older adults is an issue that requires increased awareness and research from the medical field. Moreover, there is a lack of services and support for friends and family of older adults who struggle to have a positive relationship with nutrition.
In this guide, we’ll explore the most common diagnoses and signs of eating disorders in older adults that you can keep an eye out for.
Types of eating disorders in older adults
The tool medical and mental health professionals use to diagnose and treat eating disorders in the Diagnostic and Statistical Manual of Mental Disorders, or the DSM. This manual lists the most common conditions, symptoms of each and an overview of effective and available treatments. Here are the eating disorders that most often affect older adults.
Anorexia nervosa presents as an obsession with food intake that leads to extreme avoidance of eating. Older adults struggling with anorexia often have a warped perception of their body image, causing them to believe they are overweight regardless of how they actually look or how much they weigh.
Avoidant restrictive food intake disorder (ARFID)
This disorder was previously thought to occur mainly in infants and young children, but has commonly been observed in older adults, too. ARFID is often mischaracterized as picky eating, but the reality of it is much more serious. ARFID occurs when an individual avoids a significant number of foods and causes a person nutritional deficits.
ARFID is not a matter of preference but rather compulsions based on the food’s texture, color, taste or other particular criteria. ARFID is dangerous because it can lead to malnutrition, loss of muscle and bone density, heart failure and other complications in older adults.
Binge eating disorder
Binge eating disorder causes an individual to consume food in excessive amounts in short bursts of time, typically feeling out of control while doing so. After binging, older adults who struggle with binge eating will often feel overcome with feelings of guilt, shame or disgust with themselves.
Common symptoms of binge eating disorder include weight fluctuations or avoiding eating with others.
Older adults facing bulimia experience periods of binge eating, usually uncontrollably, that they then try to “make up for” by purging. Purging could involve vomiting, taking laxatives or exercising excessively. There is a fear of gaining weight regardless of actual body size present in those who struggle with bulimia.
Other specified feeding and eating disorders (OSFED)
The diagnosis of other specified feeding and eating disorders is often used when an individual does not meet all the criteria for another eating disorder or has an atypical form of an eating disorder. Older adults with OSFED can experience any of the symptoms associated with these other types of eating disorders.
Triggers for eating disorders in older adults
Older adults who find themselves affected by an eating disorder may have unique situations that contributed to the onset of the disorder that differ from common triggers for young adults and children. Below are triggers for eating disorders in older adults.
- Pregnancy and childbirth;
- Challenges with parenting;
- Becoming a grandparent;
- Death of a loved one, grief or loss;
- Children moving out of the house;
- Pressure at work;
- Challenges of maintaining a work-life balance;
- Aging parents.
There is no single underlying cause of eating disorders, but there are certain triggers that are common among older adults in particular.
Signs of eating disorders in older adults
Similarly to facing unique triggers, older adults often manifest unique signs and symptoms of eating disorders. Here are some things to watch for if your or a loved one may be struggling to have a wholesome view of food and eating.
- Refusing to eat in front of people;
- Retreating to the bathroom to purge after eating;
- Sudden or extreme changes in diet;
- Changes in emotional state;
- An obsession with appearance;
- Exercising in a way that is more intense or frequent than is healthy for a particular age group;
- Quick changes in weight;
- Complaining or making negative comments about one’s own appearance;
- Trying severe dieting;
- Boxes of laxatives or diet pills;
- Hair loss, dental issues or other physical changes that cannot be attributed to another condition.
Spotting signs of eating disorders in older adults is a matter of paying attention, listening for cues and having important conversations about health, body image, stress and emotional wellness.
Treatment for eating disorders in older adults
Eating disorders are treatable medical illnesses, however if treatment is not sought then the symptoms can become life-threatening. Anorexia is associated with the highest fatality rate of any psychiatric disorder.
The goals of treating adult eating disorders include providing adequate nutrition, helping the person reach a healthy weight, decreasing excessive workouts and stopping binging and purging cycles.
Eating disorders are fundamentally characterized by challenges with eating—whether those challenges be under-eating or overeating—and the body can eventually develop health complications as a result of disordered eating patterns. Clinicians must monitor their patients’ medical conditions to ensure the negative impacts of eating disorders on physical health are minimized, as well as provide medical care for existing physical issues.
If you or someone you know is experiencing an adult eating disorder, it’s key to seek help as soon as possible to avoid serious complications. Hospitalization may be needed to treat problems caused by malnutrition or morbid obesity and to ensure proper nutrition. Once a person is stabilized, therapy and counseling can make complete recovery possible.
Psychotherapy is used to talk to clients about their emotions and behaviors to explore the root causes of their disorders. Cognitive behavioral therapy is used to modify the destructive behaviors of adult eating disorders and to encourage healthy, positive behaviors.
Eating disorders can affect anyone, young or old. Seeds of Hope offers outpatient and residential eating disorder treatment for older adults. Evidence-based practices incorporate mind, body and spirit to promote whole-person recovery.
Call Seeds of Hope to get started with life-saving treatment today.