On Eating Disorders In Older People
How do you feel about food, your body or eating with others? How many diets have you been on in the last 5 years / 10 years / ever? Those are the questions. The ones that matter. Not because it’s the most important topic, certainly on a global scale, but because they have the potential to impact our daily lives in the most unimaginable ways.
Research suggests that 25% of those who calorie count go on to develop eating disorders. There are many contributing factors to the development of eating disorders, not just diets, but this is nevertheless a staggering statistic and one which I know many readers will be able to relate to.
With 1 in 5 women and 1 in 8 men screening positive for a possible eating disorder, it’s quite possible you will know at least one or two people who are struggling with this. You may not necessarily be aware of it though because when most of us think of eating disorders, we think of white, teenage, middle class, underweight girls.
The reality is only 6% of those with eating disorders are underweight. Yes you read that right, anorexia only accounts for 6% of all eating disorders yet this is the eating disorder films are made of, memoirs are written, journalists love telling stories about; ideally with shocking pictures of someone when they were extremely unwell. I know of far too many cases where stories have been pulled because the individual has, rightly, refused to show before and after photos. Anorexia has, for too long, been normalised and glamourised. What about the remaining 94%? All these people are at normal or higher weights but suffering as much if not more so because of the added stigma, certainly in the case of binge eating disorder. Here people are labelled greedy, lazy or both. They are neither.
My focus here, however, is not so much about what eating disorder we, or someone we know, may have but rather how we feel about having it later on in life. There are many reasons why we can find ourselves “still” struggling with this.
Maybe we never had the opportunity or access to treatment due to societal (this is normal) or generational (pull your socks up) views. Maybe we tried and we were turned away from services (you’re not ill enough or, even, you’re too ill).
Perhaps due to a lack of NHS resources (there’s a wait list, we’ll see you in 2 years’ time). Perhaps due to a lack of financial means (if the NHS can’t help, the only alternative is to go private).
Maybe we tried one approach, it didn’t work and we assumed or were told, there are no other options (this would never happen with non-psychiatric conditions). Maybe we thought we weren’t really ill (lies fed to us by the eating disorder in order to keep us trapped).
Perhaps we thought we could do recovery on our own. Spoiler alert: that’s rarely, if ever, possible.
Perhaps we thought there were others who needed help more than us (see previous bracket). Perhaps we fell for the myth that anorexia is the only ‘real’ eating disorder (there is no hierarchy of eating disorders; all are serious, all can be fatal, all deserve treatment). Perhaps we felt excluded (too old / ‘wrong’ skin colour / gender / ethnic group / socioeconomic group); after all, most of the narrative seems to be aimed at the younger, white, female generation. We don’t necessarily relate to what we see in the media about eating disorders and we, wrongly, assume it doesn’t apply to us.
The target audience for so many of the discussions around eating disorders is significantly younger than we are, thus contributing to our isolation and difficulty in reaching out for help. Will we be listened to and understood? Will we be cast aside because we’ve struggled for ‘too long’. This response simply serves to magnify the guilt and shame we may already be feeling. We must expand the conversations around eating disorder to include older age groups. Until we do, the sole focus of attention will remain on children, adolescents and young adults. Again, this wouldn’t happen with non-psychiatric conditions.
Another reason we can feel trapped in an eating disorder, or disordered eating, is that we see celebrities of all ages embarking on various so called “lifestyle” changes (that’s diets to you and me) and deep in our subconscious minds we think if only we could emulate them in that, then we too could look like them. Or at least, a little bit less like us. We must remember that how we look is so much more than purely the result of what we eat and how much we move. If one hundred people all ate and exercised the same, they would all still look different. In our simplistic views, we’ve left genes, sleep, stress, work and age out of the equation. All of which are influencing factors.
Food has been dichotomised and demonised which leave us feeling wretched, ‘sinful’, guilty and bad whenever we eat a so called ‘forbidden’ food. The way society has normalised disordered eating, by eliminating entire food groups or fasting for example, is deeply concerning and we are seeing the negative results all around us. Eating disorder referrals have increased by an alarming 79% across adults in the past 5 years.
It is heart-breaking to think of people in their fifties, sixties and beyond, still so burdened by concerns about how they look, depriving themselves of the enjoyment of food through fasting, cutting out food groups and exercising for the wrong reasons. All of which are forms of deprivation; one way or another. Deprivation of food or enjoyment. Or both.
Our later years are often ones when we can be more sociable as the demands of work and raising families reduce but if we are battling with food, weight and shape, there is a serious risk that instead, we become increasingly isolated because so much of life revolves around food. Meeting up with friends and loved ones? You’d be hard pressed to find something that doesn’t include food in some way.
We know, however, that eating disorders are about so much more than weight and shape. They are coping mechanisms for difficult emotions and life events. They are our way of responding when we don’t know how else to process or express what we’re experiencing. It’s never too late to seek help and there is still too much life to be lived to not seek it.