eating disorders in adults
Health

Eating disorders in adults

Eating disorders have no boundaries when it comes to age. Arlene Harris examines why there are a growing number of older women suffering from food-related disorders.

Eating disorders are usually associated with teenage girls, but a new study in the US has revealed that 13% of women over the age of 50 also suffer with a food-related condition and 62% feel their weight has a negative impact on their lives. So eating disorders in adults are far more common than we may have believed.

Published in the International Journal of Eating Disorders, the study from the University of North Carolina questioned almost 2,000 older women and discovered many were battling with either an on-going or, in some cases, an entirely new obsession with food consumption.

Lead author Cindy Bulik, says this is a problem that needs to be addressed: “The disorders have serious physical as well as emotional consequences. And 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.”

A constant struggle – a real life story

Margaret Lynch has suffered from both anorexia nervosa and bulimia since she was a teenager. Now 51, the Waterford woman, who is married and has an 11-year-old daughter, is constantly aware of her condition and says that although she has been dangerously underweight in the past, she is doing her best to overcome the problem.

“I developed anorexia when I was 13,” she recalls. “I am the youngest of four girls and my older sisters were at the stage where they were wearing fashionable clothes and meeting boys – I felt that I didn’t match up to their glamour and even though I now know it was just puppy fat, I was convinced that I was hideously overweight, so did everything in my power to avoid food. “Although I felt permanently hungry and often quite weak at school, the feeling of control was wonderful and because both my parents worked and my sisters usually had friends eating dinner with us, no-one really noticed my weight loss until it was too late.”

By the age of 15, Margaret’s weight had plummeted to less than six stone and her parents decided to take drastic action. “Mum and Dad finally noticed how thin I was just after my 15th birthday,” she recalls. “I was taken into hospital and kept there until I gained half a stone. This is when the yo-yo cycle of my weight loss began and it continued for the next three decades. Throughout the years, I was hospitalised over 10 times. And each time I recovered, I vowed not to let myself get into that state again – but as soon as my spirits dropped, I started the process all over again.

Life continues

“I am luckier than a lot of women in my situation because I managed to get through college, find a job, fall in love and (shockingly, if truth be told) become a mother. There were times in my life when I never imagined I would have any of these normal things, but when I’ve been well, I’ve been able to overcome the enormity of anorexia for long periods of time. ”

“I will always be a skinny woman and am perpetually obsessed about how much I’m eating, but when times are good, I don’t get so hung up on it and manage to occupy myself with something else. Because my daughter is reaching puberty, I am terrified, that she will ‘inherit’ my condition so I am fighting extra hard not to fall back into the trap again. ”

eating disorders

“It is really difficult and there are times when I have had to force myself to go and see my counsellor because I know I should be eating more. But I have reached a good place now and I think my therapy is  beginning to work as I have maintained a modest weight (over 7 ½ stone) for the past two years and can now enjoy an occasional biscuit and have even been known to have an ice-cream during the summer.

“It’s been a long road and is an ongoing battle, but for the sake of my husband, my child and myself, I am determined not to be beaten by anorexia nervosa.”

Support

John has been married to Margaret for twenty years. They met at college where she opened up about her anorexia as soon as things began to get serious between them. But far from being afraid of her condition, the Dublin man knew he had met his soul mate and was prepared to do everything he could to help her maintain a healthy weight.

“When Margaret told me that she was anorexic I didn’t believe her at first,” he admits. “She was very slim but was so bubbly and happy that it didn’t seem to fit with the image I had of that condition. Once I discovered how she has been plagued by low self-esteem and feelings of worthlessness since she was a teenager, I vowed to help her to stay on top. And apart from a few extreme dieting episodes, she has been fine for most of our marriage.”

“She did fall apart slightly after our daughter was born because even though everyone told her she hadn’t gained weight during her pregnancy, she felt depressed and fat for a while and ate very little. She’s only had one other episode since then and we put that down to a family bereavement. ”

“For the past few years, everything has been fine and as Margaret is an extremely devoted and loving mother, she is determined our daughter won’t be exposed to any neuroses about food, so before she reaches rock bottom, she looks for help from me or from her counsellor.”

“Together we are going to fight this thing and ensure she realises how wonderful she is and how much we all love her.”

Different causes

Hannah Parsons of Bodywhys – the Eating Disorder Association of Ireland, says Margaret’s story is not uncommon, as people of any age can be afflicted with the condition.

“It is estimated that 200,000 people in Ireland have an eating disorder,” she says. “And although the average age of onset is between 15 and 24, this does not mean that someone younger or older will not be affected. In fact, the same percentage of over 24s called our helpline last year as under 24s. An eating disorder can develop at any age, for any number of reasons. They are not confined to one particular socio-economic group and can also affect males – in short; anyone can develop the condition.”

“Although it isn’t easy to pinpoint the reasons why so many people develop eating disorders, a number of characteristic factors seem to be consistently present on diagnosis. Everyone’s story is different but there are usually a number of triggering factors,” says Parsons.

“There is often an underlying core of low self-esteem, which may not be obvious because quite often, the people who develop eating disorders are focused and high achieving – and their sense of self-worthlessness is not obvious because they often achieve highly at anything they put their minds to. Significant moments such as first break-up, transition between schools or colleges, marriage, first baby and so on can also be triggers. But while these triggering factors are well documented and researched, it must be remembered that nobody knows what exactly causes an eating disorder. For some reason, for some people, controlling their body with food is a way of coping – and this is why the disorder is multi-layered and unique for each person.”

eating disorders

Encouraging openness Harriet and her colleagues at Bodywhys are aware of the secrecy surrounding eating disorders and believe we need to become more open about mental health issues if we are to have any chance of helping ourselves and loved-ones who may be suffering.

“There is a huge stigma still surrounding eating disorders, whereas with other mental health issues such as depression this stigma is reducing all the time,” she says. “Nobody chooses to have an eating disorder so it isn’t something that they can simply stop. Letting go of their eating disorder is an incredibly terrifying prospect and in order to foster a space where this can even be contemplated, takes understanding and patience from those around them.”

“The way we at Bodywhys encourage people to seek help and to talk about what is happening, is to assure them that if they contact us we will not talk about food or weight. We do not expect anyone to change as a result of their communication with us. We never assume we know what their experience is like – we simply try and get them to talk about what is happening to them and what they are experiencing. ”

“In doing this, anxiety is reduced and people find that they can begin to understand what is going on. Then if they choose to do so, they can move forward at a pace that suits them and we will help them to figure out how they want to do that. The key to being able to encourage a person to seek help, is to be open, accepting and have a genuine wish to provide them with a space to talk about what is happening to them. Without that, they can feel frightened and retreat further into the disorder because it is the thing that they feel will protect them.”

Symptoms of an eating disorder

Anorexia nervosa, bulimia, and overeating disorders can have numerous combinations of signs, symptoms and causes. The signs and symptoms of eating disorders vary with the specific disease and its stage of progression.

  • Increased pre-occupation with food:  dieting and weight resulting in extreme weight loss or gain.
  • Changes in eating habits: this often means that a person may avoid eating with others, or in the usual way.
  • Exercise addiction: pre-occupation with exercising and overexercising.
  • Skin problems: swollen glands and dry calluses on fingers.
  • The fear: fixation with thinness and a fear of fat.
  • Tooth decay: anorexia and bulimia can lead to significant tooth erosion and cavities.

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Ask Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.

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ASK LUCY

Q My son is 18 months old and has just started saying his first words. It is an extremely exciting time in our house and my husband and I are eager to encourage his speaking as much possible. What advice would you give us on how we can foster this without bombarding and confusing him?

AThere is nothing better than hearing your baby begin to talk. All the hard work you have put in over the last two years is coming back tenfold.
Toddlers will vary significantly with ability and speed of which they talk however a guide would be about 50 words by 2 years of age. The most important thing to watch for is that your baby/toddler is cooing and babbling and begins to string sounds together like “Mama/Dada” They should have a wide range of speech sounds and like to imitate you and things they hear.
There are many ways that you can promote Speech and Language development at home:
1. Slowing down your own speech and taking time over conversations with your little one. Every day is a new experience when you are 18 months, nappy changes, bath time, baking a cake brings endless opportunity for you to interact and offer new words for them to hear and repeat. Make eye contact, smile and use exaggerated tones to keep things interesting and fun for your tot.
2. Review the toys that you have on offer to your tot and ensure that they give plenty of open ended play opportunities. Role play is a wonderful way to allow children to take the lead. Kitchens with lots of plates, cups and pots. Fill the pots with dry pasta and allow your child to cook and serve you. Playdoh, painting, gardening and sandpits are also great for allowing your child to take the lead and babble about what they are doing. Read plenty of books together and point and allow them time to answer any questions that you ask.
3. Limit screen time. Overuse of televisions and iPads do not give your child opportunity to interact in a two way manner.
4. Ask your child lots of open ended questions “What’s that?” “Where are we?” Point at things they know the answer to for boosting confidence (Car/ Car, etc.) When they don’t know the answer, explain it to them. Limit baby talk and speak clearly with good pronunciation, remember you are the teacher and they will copy you.
If you are concerned about your child’s speech and language development, be sure to speak with your GP or developmental Health Nurse. They are very skilled at understanding the difference between speech delays and spotting something that may require professional attention.
Enjoy watching their little brains absorb the world around them and listen to what they have to say. It won’t be too long before they won’t stop talking to you, asking “Why Mummy/ Daddy?” every 5 minutes….