Eating disorders experts in the United Kingdom are treating growing numbers of women who are developing anorexia or bulimia well into adulthood, far beyond the teenage years when the conditions usually emerge.
Psychiatrists are seeing more patients who have become seriously ill with either of the crippling conditions for the first time in their 30s, 40s, 50s and occasionally 60s.
In many cases it has been triggered by the trauma of a relationship breakdown, unemployment, the menopause, losing a parent or seeing children leave home.
Some working in the area claim that the apparent rise in what are called late-onset eating disorders is linked to some women in their 40s and 50s feeling under pressure to look young because of the prominence of age-defying older female celebrities such as Madonna and Sharon Stone.
“Five or 10 years ago I would have seen one case of an older person developing an eating disorder about once every year or two. But now I see them more often — about five new patients a year with late onset anorexia nervosa or bulimia,” said Dr Sylvia Dahabra, a psychiatrist in Newcastle who works for the regional specialist eating disorders service.
Sian, who didn’t want to be fully identified, tells the story of her mother Fiona, who died of anorexia in 20 08 aged 48.
“The trauma of me moving out of the family home at 18 to live nearby, and then relocating further away when I was 21, triggered her serious decline. I was pretty much mom’s life and me leaving meant she was alone. She ended up weighing just 39kg when she passed away when I was 23,” said Sian.
Fiona died in her sleep after contracting bronchial pneumonia.
“The first cause of death was the pneumonia and the second was anorexia,” said Sian. “Once she got the pneumonia, she couldn’t fight it because her body was so weak from the anorexia.”
Major life events are usually the cause
“The person can lose their job, suffer a bereavement, have a child or see their relationship break down and, as a result, their mood deteriorates and often they develop a depressive illness. As a result they lose their appetite and then lose weight,” said Dahabra.
“They then notice that they feel better when they don’t eat, that they look ‘better’ and might even get compliments and this then distracts them from what really bothers them and gives them a new focus.”
Dahabra has helped several women who have developed dysfunctional eating behaviours after their husbands left them.
“In one case the husband’s parting words to her were a derogatory comment about her weight. She associated the break-up with being overweight, began dieting and lost control completely. She was found unconscious at home and hospitalised because her blood-sugar level had fallen very dangerously low.”
Dr Adrienne Key, the lead clinician for eating disorders treatment at the Priory clinic in Roehampton, south-west London, said: “In the past 18 months I’ve seen 10 women in their mid to late 30s, mainly with bulimia, who have had a baby in the previous few years and have had increased body dissatisfaction.
They start dieting but then try more drastic measures such as skipping meals or going on these strange protein, no-carbs diets, and then their starvation triggers the biology of an eating disorder.”
Why only some women who do that then develop anorexia or bulimia is not fully understood but may be because of their brains functioning slightly differently under the pressure of food deprivation, said Key.
“Growing numbers of women in their 30s and 40s are dissatisfied with their bodies because they are presented with visual imagery of perfect bodies and unobtainable body ideals, especially in magazines due to airbrushing, and feel under pressure to try to achieve that.”
Mental health experts within the British Dietetic Association, which represents dietitians, have noticed the same trend. Beat, the UK’s main eating disorders charity, is getting more calls from adults, mainly women.
Men can succumb too
Dahabra has treated a man who developed depression and then anorexia in his 40s amid grief at losing his mother and another man the same age who was under severe stress first at work and then after losing his job and also supporting his partner through a serious illness.
Lee Powell, a 37-year-old civil servant in Gloucester, southwest England, saw his weight drop from more than 65kg to just over 45kg when obsessive exercise led him to start trying even harder to lose weight.
“I used to have a cereal bar for breakfast and another for lunch and then some proper food in the evenings, but that quickly became just a salad. My wife, Annette, once said I looked like something out of a prisoner-of-war camp and broke down crying.”
Experts are unsure whether the growing number of older-onset cases indicates a real change in behaviour or simply doctors becoming better at identifying eating disorders. —