The Mail Online today featured a report from the Renfrew Centre, New Jersey, of an alarming rise in the number of middle-aged women seeking eating disorder treatment. Douglas Bunnell, vice president and director of out-patient clinical services at the Renfrew Centre, echo our experience at Life Works, that eating disorders rarely show up out of the blue in mid-life, but are more likely a resurgence of a life-long issue.
What can cause eating disorders in middle-age?
While the aetiology and maintaining factors of an eating disorder are complex and subjective, most eating disorders develop in adolescence. Adolescence and middle-age are both transitional stages in a person’s life, during which a lot of change tends to occur. Bodily changes sees the adolescent develop from a girl to a woman, and for the middle-aged woman, the changes related to menopause can feel equally significant. Besides the physiological changes, both life stages potentially carry significant stressors, parental divorce, and in middle-age one’s own divorce, death of a parent, loss of job etc.
According to associate professor of psychology at the University of Pennsylvania School of Medicine, David Sarwer, many who seek eating disorder treatment in mid-life have typically struggled throughout adolescence and early childhood. As Sarwer puts it; ‘They may have always been lean and very careful about what they ate. Then there is some major stressor that becomes a tipping point and this kind of sub-clinical disorder becomes full-blown’.
Eating disorders as a form of control
Whichever form the eating disorder takes, issues around eating ordinarily speak of an underlying mental health issue, be it depression, anxiety, or obsessive compulsive disorder (OCD). An eating disorder is thus embedded in how the person manages anxiety, and can be thought of as a coping strategy. During particularly challenging times when everything can feel very out of control, the last line of defence is literally to control what enters the mouth. Thus the anorexic woman’s need to strictly control what and how much is consumed, comes to offer a sense of safety and comfort.
An eating disorder-free life IS possible
Those that have not been treated for issues around eating in adolescence and young adulthood, will be particularly vulnerable to resorting to these old and detrimental coping strategies, in times of personal distress in later life. And although the eating disorder might provide what is perceived as a sense of control, ironically the disorder comes to control the person and greatly diminish their quality of life. An eating disorder can render the person so sick that hospitalization and re-feeding is the only way to manage the strong internal eating disordered voice which will invariably disagree with any attempt at maintaining a healthy body weight. Because a central aspect of the illness is a profound inability to acknowledge the severity of the problem, it is immensely important that a person with an eating disorder is not left to suffer in silence.