Eating Disorders: An Ageless Affliction

Corinne was 13 years old when her struggle with disordered eating began. After gaining weight at summer camp, she starting obsessively biking to burn calories and making herself vomit. Corinne kept these behaviors hidden for decades, but when she was 56 years old, low potassium levels caught a doctor’s attention. “She wanted to put me in the hospital to find out what was wrong,” says Corinne. “I told her I had a feeling I already knew.”

Corinne’s story began in a typical manner for eating disorder patients: normal-weight female develops an eating disorder in her early teens after pre-pubescent weight gain and social disapproval. Although she had been treated for bone loss in her jaw, osteoporosis and had most of her teeth replaced, Corinne’s eating disorder remained under the radar for 43 years.

It has only been in the past few years that eating disorder research has included the baby boomer population. The results of these recent studies shatter the belief that eating disorders only afflict the young and reveal that boomers have eating disorders at the same rate as teenagers — nearly 4 percent. And an additional 13 percent of boomers partake in at least one core eating disorder behavior such as binge eating, self-induced vomiting, excessive exercise or laxative abuse.

Eating Disorders in the Boomer Population
Eating disorders appear to stem from a constellation of factors that may include a genetic predisposition, a biochemical response to stress, an appearance-focused environment, low self-esteem, food insecurity and dysfunctional eating behaviors modeled in the home.

Some boomers harbor eating disorders nearly their entire lives. Others experience a midlife relapse of a dormant disorder and still others develop eating disorders for the first time in middle age. Late-onset eating disorders are often triggered by stress and baby boomers face many life changes associated with stress: divorce, empty nest syndrome, financial pressures, aging parents, illness and more. Boomers whose parents lived through the Great Depression, the Holocaust or other times of instability may have been raised to associate food with love, security or even punishment.

Physically, changes associated with menopause can intensify body dissatisfaction and fear of aging, even before menopause occurs. Research shows that perimenopausal women have more eating disorders than premenopausal women. Boomers who make disparaging comments about aging have higher eating pathology than those who only engage in negative comments about weight.

Identifying Eating Disorders in Boomer Clients
One might think that someone who is decades deep into disordered eating would be easy to spot, but this is not always the case. The human body has a remarkable ability for homeostasis, and eating disorders are often undetectable in blood tests or diagnostics. The shame associated with out-of-control eating or self-induced vomiting knows no age, and boomers may be embarrassed to admit what they consider to be “immature” behavior. Boomer eating disorders are also hidden in plain sight because of the misconception that eating disorders cause emaciation; multiple studies have shown that baby boomers with eating disorders are more likely to be overweight.

RDNs can play a critical role in helping these patients. In one study of hospitalized patients who had developed an eating disorder for the first time after age 40, 25 percent appeared to be reacting to health or medical problems that affected their eating, weight or exercise routines. RDNs should be particularly alert for dysfunctional eating behaviors in boomers who are told to lose weight for medical reasons, are former bariatric surgery patients, are prescribed medication known to cause weight gain or are unable to exercise because of illness or injury.

By adding two basic questions to a standard adult nutrition assessment, RDNs can help identify eating disorders in baby boomers:

  • Are you comfortable with the way you eat?
  • Do you eat differently when you’re alone?

Reports of dysfunctional eating behaviors should serve as a launching point for evaluation and referral. It’s never too late to make a difference in someone’s life.

Jessica Setnick
Jessica Setnick, MS, RD, CEDRD, is a Senior Fellow at Remuda Ranch at The Meadows, and owner of Congruence Consulting and EatingDisorderJobs.com.