HEALTH & WELLNESS Middle Age Maladies  >  Eating Disorders Strike Older Women Too

Eating Disorders Strike Older Women Too

Eating Disorders Strike Older Women Too
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By Holly St. Lifer

“I can go all day, every day without eating and be perfectly happy,” says 63 year-old Mary Sponhaltz.  Since she was diagnosed with anorexia nervosa three years ago and went through residential treatment, the retired elementary school teacher still has no appetite. “I’m back to eating three meals a day and a snack but I really have to work at it. If I’m mad or sad, it’s hard to resist the urge to restrict.”

With help from her son, husband, psychiatrist, therapist, dietician, internist, and support group, Sponhaltz has been successfully battling an illness that is associated more with teenage girls than menopausal women. No one has precise figures on who is affected by eating disorders like anorexia nervosa and bulimia, but experts say more and more women are showing up in their clinics in midlife or even older. Cynthia M. Bulik, director of the Eating Disorders Program at the University of North Carolina at Chapel Hill, said her clinic used to have about one older patient at a time. Now, about half the inpatients are women over 30.

“Eating disorders sneak up during emotional and physical transitions, which is why we most often see them peak during adolescence. Now, we are seeing them again as older women hit other life phases, such as empty nesting, failed marriages, career reinvention and caring for aging parents,” says Tamara Pryor, clinical director of the Eating Disorder Center of Denver, who has been studying about 200 cases of midlife eating disorders.

For Sponhaltz, the trigger was her father’s death after she spent three years making routine eight-hour round trips to supervise his cancer treatment and gradual decline, leaving her husband and two sons for weeks at a time. “I was already worn thin emotionally and losing weight drastically when he was alive because I wasn’t taking care of myself. But once he died, the eating disorder kicked in. It numbed me so I wouldn’t have to feel.”

Although the cause of eating disorders is unknown, Bulik says some people have a biological predisposition to food restricting. “For most of us, when we skip a meal, we get antsy and irritable. But for these women, the opposite it true; it calms them and makes them feel better.”

Often, eating disorders in older women are hard to detect because they appear in control of their lives, multi-tasking successfully, and some signs can be attributed to aging.   For instance, in Sponhaltz’s case, she says “a leading psychiatrist in the field,” originally misdiagnosed her because he assumed she had stopped menstruating due to early menopause. But missed periods are a symptom.

On the surface, embracing a healthy lifestyle can mask symptoms, particularly in a culture that’s battling obesity and touts fitness as a panacea for every ill. “The rituals of dieting and exercising can feel grounding and soothing, but these women take it too far,” says Margo Maine, co-author of The Body Myth: Adult Women and the Pressure to Be Perfect.  “I’ve always worked out for my mental health but this time it turned into a crazy obsession. Seven days a week, I’d take an aerobics class, go for a 30-minute bike ride and then walk the dog for an hour,” says Sponhaltz. Her husband and son intervened when the 5’10 San Antonio resident continued losing more and more weight.

An avid runner and Tai Kwon Do black belt, Juliann Cook-Ly also started exercising and nibbling on a raw food-only diet as a healthy way to cope with a physically and emotionally abusive husband. “It was the ugliest kind of ugly you can imagine,” says the 43 year-old. After joining a marathon team, Cook-Ly began running 90 miles a week and then training at a martial arts studio most nights. She also felt more in charge when she severely restricted her eating. “I thought, these are the only parts of my life I can control.”

Another major trigger for women of a certain age is their thickening waistlines. In fact experts say the disorder and fear of aging go hand in hand. “Overly focusing on their bodies is a way to feel like they’re in control in the fight against old age since thinness is associated with youth,” says Maine. “You’ve heard of the freshman 15. Now older women are obsessing about the menopause 15.  For those women who are going through multiple transitions and never had trouble losing weight before, those extra pounds that just won’t budge can push them over the edge into full-blown restricting and purging.”

When asked about her body image, Cook-Ly, who is now recovering and will be divorced in June, says she looks at it this way: “When we begin to evaluate our self-worth based on our appearance, we need to ask ourselves, ‘Would I love my mom, daughter, aunt, friend, any more or less based on her physical appearance or weight?’ For me, the answer is unequivocally no. So then, why would they devalue me based on my appearance?  They wouldn’t, and they don’t. Therefore, I can love and respect myself just as my family and friends do.”

Sponhaltz says she recently told her therapist it’s easy to spot the women who look too thin or obsess over how much they weigh, and she hopes telling her story will encourage others to seek help. “What we do is isolate completely. We don’t want to hear from friends for fear they’ll invite us out to lunch for instance. But you have to reach out and seek help.  Let people know you have a problem.”

 Signs of an eating disorder:

If you or someone you know exhibits any of these symptoms, get help by going to the National Eating Disorders Association ( www.nationaleatingdisorder.org) or call their hotline at 1.800.931.2237.

Social withdrawal because of restricted diet.

Constant focus on weight and body image.

Impose dietary habits on friends and family.

Constant talk of food and diet.

Discomfort around food.

Excessive exercising.

Irregular or missed periods.

Dizziness or fainting.

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Holly St. Lifer
Holly St. Lifer was a television producer and writer before transitioning to health journalism 12 years ago. Now she writes for More, AARP, goodhousekeeping.com, and Shape, among many other publications. She is a journalism instructor at New York University and is the editor of YCteen a non-profit magazine that publishes true stories written by at-risk teens.