Never Too Old for an Eating Disorder?

Although eating disorders and body dissatisfaction are most often described among women from 18-25 years of age, there is evidence that both also occur at midlife and later.

Barbara Mangweth-Matzek, PhD and colleagues at Innsbruck Medical University, Innsbruck, Austria, evaluated a random sample of 1,000 women 60-70 years old from the general population of Innsbruck (Int J Eat Disord 2006; 39:583). This age range was selected because this is the first decade of retirement in Austria. The women were asked to fill out a self-report questionnaire, and 475 responded.

The group profile included some eating disorders

Most of the respondents were married and had at least two children; only 38% had graduated from college. Most described a healthy eating pattern and more than two-thirds said they regularly ate at least three meals a day. More than half said they restricted their eating to prevent weight gain, and 88% evaluated their eating behavior as normal and healthy.

On further evaluation, the authors found that 18 women met the criteria for an eating disorder: 1 had anorexia nervosa (AN), 2 had bulimia nervosa, and 15 had eating disorders not otherwise specified (5 had binge eating disorder). The woman with AN first developed symptoms of the illness in her late 50s. The two bulimic women reported vomiting and use of laxatives.

The majority of the women reported being dissatisfied with their weight and shape, no matter what their body mass index was. The authors note that this finding goes along with other studies that describe a pattern of body dissatisfaction across the life span, regardless of actual weight. It also correlated with the higher percentage of women who were trying to control their weight (86%).

Thus, even though most women in the sample had healthy eating behaviors and normal body weights, most also were dissatisfied with their shape and weight. Although eating disorders are reported much more commonly among young women, the authors suggest that eating disorders be included in the differential diagnosis of elderly women who present with weight loss, weight phobia, and/or vomiting.