There are many misconceptions about what eating disorders are and who is likely to develop them.
Statistically speaking, eating disorders are most likely to impact children and young adults, and are more prevalent in women than in men. As a result, many people assume that these are the only people who can develop these kind of conditions. The fact of the matter, however, is that eating disorders can affect anyone, regardless of age, race or gender. The stigmas around eating disorders and the myth that they don't impact older adults means that when seniors do develop one, they aren't often getting the diagnosis and treatment that they need.
As a caregiver, you should be on the lookout for signs of disordered eating in your loved one and know how to address it.
Eating disorders and seniors
According to the National Association of Anorexia Nervosa and Associated Disorders, 30 million Americans of varying ages have an eating disorder, including 13 percent of women over the age of 50.
U.S. News & World Report says life changes that occur during older age can cause a spike in disordered eating. Retirement, loss of loved ones, illnesses or feelings of reduced independence can trigger eating disorders for seniors. It's hard to diagnose, however, as many older people may experience changes in their diets and appetites as they age. The misconception that eating disorders only impact young girls also means that fewer caregivers and doctors are looking for signs of eating disorders in older people.
Older adults may also develop eating disorders because of uncontrollable changes to their bodies that comes with age. As people begin to show visible signs of aging, they may become more self-conscious and long for a youthful look. They might see losing weight as a tangible way to impact something about their appearance, which can lead to a warped sense of self that causes an eating disorder.
"We think body image concerns and dieting is something more recent, but women have been living with this pressure to look a certain way and to be in control of their bodies for over a century," Margo Maine, clinical psychologist told U.S. News & World Report.
Spotting the signs of an eating disorder
It's important that if you notice your loved one is losing weight or suddenly not eating as they once did to not automatically assume an eating disorder is the culprit. Stay positive and non-judgmental when speaking to your loved one about their eating habits. Share a meal with them, and if they refuse to eat, ask if they're feeling alright. Illness, medications and a decrease in physical activity can limit people's appetites or dull their taste buds, making it harder to eat. Approach them with concern and let them explain the changes before you accuse them of having a disorder.
"Stay positive and non-judgmental when speaking to your loved one about their eating habits."
If your loved one frequently skips meals, makes excuses for not eating, often comments on their weight in a negative way, excuses themselves to go to the bathroom right after or during a meal or is frequently vomiting and denying it, then you may want to consider the possibility of an eating disorder. Tell your loved one that you're concerned they aren't eating enough and ask them to speak to their doctor about a healthy nutrition plan. If your loved one often comments on their desire to lose weight, offer to fix them healthier meals and go for walks with them to encourage healthy weight loss.
If you can't get your loved one to talk to you about your concerns or they insist that there's nothing wrong, try talking to your own doctor or find a local support group for help. You may need the assistance of a professional to find the right way to approach your loved one and ensure they get the diagnosis and treatment that they need to get better. Eating disorders can be fatal if they aren't addressed, but recovery is possible with the right support.
What are eating disorders?
Eating disorders are all forms of mental illness. They're often comorbid with other conditions like depression, anxiety or obsessive compulsive disorder. There are many different ways that eating disorders can manifest and different triggers than may contribute to their development, according to the Mayo Clinic. Some of the most prominent conditions include:
- Anorexia nervosa. People who have anorexia severely restrict their food intake, typically to the point of starving themselves. They may limit themselves to only a fraction of the calories they need each day, or will fast and abstain from food entirely for days at a time. People may develop anorexia because they have a body dysmorphic disorder - they often see themselves as overweight even as they drop down to dangerously low weights. Anorexia can be an extreme reaction to this perceived body image and an uncontrollable attempt to lose weight. In some cases, weight and body image may play no role at all. Instead, people restrict their food because they feel they don't have any control in their lives, and view their food intake as one thing they can have a say in and manage.
- Bulimia nervosa. Bulimia has many of the same causes as anorexia - it's often about attaining a desired body image or a means of taking control of something when a person otherwise feels they have no authority. With bulimia, instead of restricting the amount of food they eat, a person will still eat but then try to purge the food from their bodies, typically by using laxatives or forcing themselves to vomit. This in turn goes in cycles of binging and purging, according to the National Eating Disorders Association. People may try to fast as is seen in anorexia but then succumb to their hunger and eat an excessive amount of food to satiate it. Or, people may feel they lack the willpower to avoid foods they deem unhealthy and binge on large amounts of junk food, then purge out of guilt and shame.
- Binge-eating disorder. People with a binge-eating disorder other than bulimia overeat, either occasionally or frequently. Unlike bulimia, however, people in this category typically don't purge afterward. Instead they may just feel a great deal of shame about their perceived lack of discipline. People may find comfort in food and react positively to enjoyable tastes or the physical feelings of fullness. In some cases, people have such low self-esteem that they simply think they lack the control to be discerning about what they eat, so they indulge at all times. Sometimes people do indeed have the discipline to monitor what they eat, but are so convinced they can't that they don't even try.
- Other Specified Feeding or Eating Disorder. OSFED conditions encompass other forms of disordered eating that don't meet all the requirements of specific diagnoses. From restricting all foods to very specific foods, amounts of food or binging in nontraditional ways, OSFED is the umbrella term for any unnamed case of disrupted eating.
It's important to remember that eating disorders are not just extreme diets. People who have eating disorders often can't see that what they are doing is atypical, or may feel completely unable to stop. In some cases, people with anorexia, for example, may want to eat regularly, but their mental condition makes it impossible for them to physically force themselves to ingest food. Eating disorders must be taken seriously and treated with compassion in order to protect your loved one.