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Eating Disorders Beyond Young Adulthood

A common misconception throughout the non-clinical world is that eating disorders are a youthful diagnosis. There is a misbelief that eating disorders only effect naïve and impressionable teens and emerging adults who are easily persuaded by peer pressure and social media, intensified by unformed self-esteem and overwhelming feelings, emotions, and hormones. For those of us working in, supporting loved ones, or navigating the complexities of the eating disorder treatment community, we know this is just not the case. Based off of DSM-5 criteria, 3.5% of women 40 and older have a diagnosable eating disorder. While we tend to identify individuals struggling with eating disorders in school and university settings, it is just as common for them to show up in PTA meetings, book clubs, staff conferences, church gatherings, on bleachers of sporting events, and “in the empty nest”.

While it is true that the onset of an eating disorder does typically occur in one’s late teens or early 20s, when those diagnoses go unnoticed or untreated, an eating disorder can often last decades. Rollercoaster dieting ranging 10, 20, 30, 40+ years is often riddled with countless efforts to change a genetically predisposed body and countless missed memories due to preoccupation with calories, inches, and pounds. In some instances, adulthood brings new challenges and stressors, which can manifest themselves into disordered eating and oftentimes a debilitating eating disorder. Other times, life changes can trigger a relapse of a previous eating disorder from one’s youth.

For those of us well outside our 20s, we have lived through an endless number of diets and promises of a new you. People have tried and failed at so many of these conflicting food rules and instructions, thinking that it was a lack of willpower, motivation, or effort. None of the advertisements for the latest “healthy lifestyle” come with a warning sign that says “90% failure rate” or “95% guarantee to result in regaining your lost weight in the next 1-5 years”. With opposing messages promoting the love and or hate of low fat, high protein, high fat, sugar free, and low carb, no wonder so many chronic dieters are confused. It is easy to listen to the abundant messages telling us when and want to eat, rather than trusting our own personal hunger and fullness cues. For many, allowing time to intuitively listen to our body’s needs, instead of looking for external guidance, feels unnatural.

Thankfully the body positivity and body acceptance movements started gaining popularity in 2012. Many of us still have a lot of “unlearning” to do, which unfortunately takes time. Some mindset shifts may include: challenging food beliefs and misconceptions, ditching decade long food rules and fear foods, not assigning moral labels on things we consume, appreciating your body for what it does instead of how it looks, and identifying habits and actions as disordered eating. Sometimes while reflecting on our relationship with food, it becomes evident that years of dieting is more accurately, years of eating disorder behaviors.

Let’s also acknowledge that adulting is hard. Adults in their “middle ages” seek out coping skills just as often as any other group. People in their 30s, 40s, 50s, and 60s shocking still feel the pressures of societal norms, high levels of body dissatisfaction, and the need to “keep up with the Joneses”. They fall prey to diet culture and the world’s unrealistic and unobtainable standards of beauty, along with fleeting or ever-present messages of fat phobia. Pair any of these with fluctuating demands of everyday life, births, deaths, marriages, divorces, medical issues, relationship conflicts, shifting priorities, job and role expectations, and disconnection to biological changes in our bodies, it is easy to seek comfort and support in maladaptive coping mechanisms such as restricting, over-exercising, or other compensatory behaviors.

Regardless of the duration of behaviors or age of onset, the negative side effects of eating disorders do not discriminate. They are dangerous to our physical and mental health regardless of age, as they can negatively affect someone’s cardiovascular, neurological, gastrointestinal, and endocrine systems. These systems are also forever changing and adapting with age, therefore as we get older our organs, cells, and skeletal structures become more fragile and sensitive to the impact of eating disorder behaviors. Mentally, the ripple effects of body dissatisfaction and food preoccupation, as well as all-consuming feelings of guilt and shame, takes a toll on our mood, relationships, and self-worth.

Reaching out and seeking support for what many consider a “teenage disorder” might feel scary, but you are not alone. According to research posted by The National Eating Disorder Association, from 1999 to 2009 hospitalizations involving eating disorders increased 88% for patients between the ages of 45-65 years old. In 2009 alone, people over the age of 45 made up 25% of eating disorder related hospitalizations. Over the past 5 years 2,289 adults over the age of 25 contacted McCallum Place Eating Disorder Centers asking for eating disorder support. From 2009 to 2021, patients between the ages of 25 and 65 have made up 41.5% of McCallum Place’s admissions into Residential, Partial, and Intensive levels of care.

We proudly help “mature adults” navigate eating disorder recovery but know that more individuals struggle in silence due to the continued stigma around mental health. Find your support in friends, outpatient therapists, NON-diet dietitians, or peers in recovery. You can reach out to our intake counselors to determine what level of care is most appropriate for your specific nutritional, physical, and emotional needs. Community connection is also a great tool in recovery. Support groups now have no geographical boundaries, making it easy to connect with others from literally anywhere. Join clinician or peer lead support groups specific to “mature” adults and seek solace in knowing that recovery is possible.

About Kelly Kelley, LCSW, Director of Business Development

Kelly earned her Bachelor of Social Work degree from Southeast Missouri State University and a Masters of Social Worker from the University of Missouri-Kansas City. She is a Licensed Clinical Social Worker and has worked in a wide range of clinical fields including acute psych, outpatient mental health, school counseling, medical social work, and residential treatment. Prior to moving into business development, Kelly’s clinical focus was the treatment of adolescents with depression, anxiety, and trauma.

View all posts by Kelly Kelley, LCSW