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How Eating Disorders Affect the Elderly

During the last several years, the public has become more aware of the many types of eating disorders and how they affect different individuals. Eating disorders, however, have primarily been associated with teens and young women. Conditions such as binge eating, bulimia nervosa and anorexia nervosa can affect elderly individuals as well. There are several ways eating disorders affect the elderly and different approaches may be needed when finding the best eating disorder treatment.

Statistics Regarding Eating Disorders and the Elderly

The National Eating Disorders Association (NEDA) states that approximately 10 million men and 20 million women in the United States will experience an eating disorder at some point in their lives. It may be surprising to learn that many older individuals are part of those statistics. NEDA also reports that 20 percent of women at the age of 70 and older are trying to change the size of their bodies. According to ANAD, 13 percent of women over the age of 50 are engaged in some sort of eating disorder. These statistics support the fact that eating disorders are prominent among the elderly. Eating disorders among older people generally fall into three categories.

  • An individual who has had an eating disorder for many years that has gone untreated
  • An individual who went through previous treatment and the condition has resurfaced
  • An individual who developed an eating disorder later in life

The first two categories are more common. It is possible, but more unlikely for a person to develop an eating disorder in their later years. In the second case, when the condition occurs again later in life, it is often triggered by some sort of stress or negative event in a person’s life. Those in the third category may not have a condition that would have risen to the level of being considered an eating disorder, but they often had issues or a preoccupation with eating throughout their life.

ANAD found in a study that 86 percent of the participants stated their eating disorder had occurred before the age of 20. According to this particular study, only 50 percent reported they had previously achieved recovery. This makes it likely a large number of elderly with eating disorders had experienced at least some problem with managing their eating during their younger years. It is important to note that eating disorders occur as a result of genetics, personality traits and environmental factors. Some people may have a disorder because of a combination of two or more of these factors. These factors play an important role no matter what age the person may be.

How Eating Disorders Specifically Affect Elderly Individuals

When older individuals experience an eating disorder there are several symptoms, side-effects and physical complications associated with this particular age group. It is important to understand the different types of eating disorders the elderly may have and how these conditions can specifically affect them.

Types of Eating Disorders

Binge Eating is a disorder in which a person eats an excessive amount of food. The person usually has a strong compulsion to eat large amounts of food very quickly. An elderly individual may horde food in their home or hide extra food containers from family and loved ones. An older adult with this condition will likely need eating disorder treatment.

Bulimia Nervosa is characterized by an individual eating large amounts of food. This is followed by purging the food in an extreme manner. The purging may be done through vomiting or using laxatives. Sometimes a person will engage in excessive amounts of exercise to burn the extra calories. Health complications may be more severe in the elderly with this eating disorder because of advancing age and a general increase in adverse medical conditions due to aging. A few medical issues associated with this condition include electrolyte imbalances, colon problems and heart and kidney damage. Eating disorder treatment may also prove effective for those with this condition.

Anorexia Nervosa is a condition in which a person has a distorted body image. People with this condition view themselves as fat or overweight when in reality they are not. They will indulge in extreme behaviors to lose weight or keep from gaining weight.

Anorexia of Aging is similar to anorexia nervosa is many ways. While the results of anorexia nervosa and anorexia of aging are primarily the same, the causes can be quite different. The first is related to a distorted body image and a desire to be thin. According to the National Institutes of Health, anorexia of aging is normally caused by a variety of issues specifically related to aging. These can include a decrease in smell and taste, which leads to diminished food intake, as well as hormonal issues, gastrointestinal abnormalities and low-grade inflammation.

Triggers for older individuals may be different than those that affect adolescents with eating disorders. Stressors in life will often change as an individual gets older. Older individuals are more often dealing with loss and grief while younger adults and teens are working through transitions and self-esteem issues. Older people may also be dealing with issues such as the loss of a parent or a spouse, retirement, an empty nest and facing their own mortality.

Risk Factors for Elderly Individuals

There are several risk factors that are more prevalent among older individuals that can lead to a variety of eating disorders. ANRED discusses several factors that may play a role in eating disorders among the elderly.

  • An older individual may exercise less often and less strenuously due to general aging or increased physical limitations. This may cause concern about a change in appearance.
  • As careers advance many middle-aged and older people may have greater access to rich food or spend time eating in restaurants. This may also cause a change in appearance.
  • Marriage difficulties or the death of a spouse or significant individual may cause stress that leads to various eating disorders.
  • An empty nest may be a risk factor for developing an eating disorder. This may be especially true for women who see themselves primarily as mothers or caregivers.

Symptoms and Signs of Eating Disorders

Signs of eating disorders can be more difficult to diagnose in the elderly and may be different than those for adolescents with eating disorders. They often live alone and may be more adept at concealing their habits. The following are several signs that a person may have an eating disorder.

  • Significant weight loss or weight gain in a relatively short amount of time
  • Excessive hair loss or increasingly feeling cold
  • Medical problems, such as heart problems, gastrointestinal issues and dental damage
  • Disappearing food, an increase in food bills or an excessive amount of food that has been thrown away
  • Behavioral changes can include the desire to eat alone or suddenly disappearing after eating

It is important to note that not all elderly individuals will have all these symptoms while others may have many of them.

Reasons for Eating Disorders

An older adult may develop an eating disorder for many of the same reasons younger individuals do. There may also, however, be reasons that are specific to aging. Two of the more prominent reasons include medical conditions that can lead to an eating disorder and increasing cultural expectations for older individuals to look youthful and attractive well into old age.

  • An elderly individual may develop an eating disorder because of other underlying medical problems or even as a protest from being put into a nursing facility. Sometimes the fear of a medical condition, such as having a heart attack or a stroke, may initiate an eating disorder. Older people may develop anorexia nervosa or even bulimia nervosa when trying to avoid these types of medical issues. Some older individuals may not be eating because of damaged teeth or dentures that don’t fit correctly. Different types of medications may also hinder or stimulate the appetite.
  • Culture may also explain why eating disorders are a problem with older adults, especially women. Our culture often tells men as they age they are distinguished, seasoned and sophisticated. Modern society does not, however, always have the same attitude toward women. There is increasing pressure on older women to stay thin and youthful even into the latter part of their lives.

Treatment Options for Older Adults

Treating older adults for eating disorders will usually require a different approach than what is needed for younger adults or adolescents. There may be underlying medical conditions and concerns to take into consideration when treating an older individual. This means eating disorder treatment for an older person may require more than one type of treatment or therapy at the same time.

Types of Treatment: Eating disorder treatment may include Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT) or family-based therapy. Nutritional counseling can also be very important for mature adults. The best treatment for older individuals will be personalized to meet their specific needs. Elderly patients may require several types of medication and therapy simultaneously to provide the most effective treatment. Being part of a support group is often a crucial component of treatment for older individuals. Many may have reached a point in their lives where previous family and friends have either passed away or have moved.

Choosing Residential or Outpatient: Residential treatment involves being treated in a live-in facility with 24-hour care. Outpatient treatment would allow the individual to live at home while meeting with a therapist and other health professionals several times each week. How many days each week and how many hours treatment takes place would be determined by the patient’s own individual needs. The elderly may often need a residential program to successfully treat several co-occurring conditions. If they are experiencing medical issues along with an eating disorder, 24-hour care and supervision is often the best type of program to ensure success. If there are reasons that make residential treatment impractical, it may be possible to choose an outpatient program that provides intensive treatment several days each week.

Individual Factors to Consider: According to Harvard Medical School, receiving a complete medical examination is an important step when evaluating exactly what type of treatment will work best for an elderly individual. Along with therapy, it is crucial that nutritional and medical needs be taken into consideration for treatment to be successful. While residential treatment is ideal for individuals with underlying medical conditions that need to be treated, many older individuals may find it difficult to commit to residential treatment. Older individuals may still be working full-time jobs or have a spouse they are caring for. As people age, they often try to remain independent for as long as possible.

The elderly need a combination of therapeutic, nutritional and medical assistance to meet their personal needs and fully recover. When looking for eating disorder treatment near you, Monte Nido provides a holistic approach when helping individuals recover from an eating disorder. They provide individualized programs under the guidance of experienced health professionals in beautiful, tranquil settings. Carolyn Costin, the founder of Monte Nido, states the facilities “promote tranquility and connection to nature, providing an environment conducive to healing.” This is the type of facility that can best meet the needs of many older individuals. If you are looking for eating disorder treatment nearby, contact Monte Nido for more information on how finding healing and becoming fully recovered is possible.




Eating Disorder Statistics


Eating disorders and older people


Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.