In recently published findings from a longitudinal study subset of more than 5,000 women, 15.3 percent had met criteria for a lifetime eating disorder by midlife, while the 12-month prevalence was 3.6 percent.1 The study concluded that active eating disorders are common in midlife, both due to new onset and chronic disorders.
“Women in their forties through sixties with eating disorders are a very underserved population,” says Allison Lansky, Ed.S., LMFT, CEDS, NCC, Lead Senior Therapist at the Center for Eating Disorders Care at University Medical Center of Princeton. “In our culture, eating disorders are sometimes still perceived as a vanity illness among adolescents or young adults. The pressure that women are expected to be ‘over it’ adds to feelings of shame and the desire to hide the problem, and can hinder the capacity to seek treatment.”
While some eating disorder cases first present in midlife, it is more common for a woman to be silently struggling throughout life or for an eating disorder to reappear later in life, according to Lansky. Women face new stressors as they age, including physical changes like menopause and emotional issues ranging from empty nest syndrome to divorce, relationship problems, or the death of a parent—all things that can trigger a relapse.
Establishing a Connection
Women in midlife who may be struggling with an eating disorder—along with the stressors common at this life stage—may feel lonely or disconnected, so it’s especially important to establish a connection during treatment. Lansky suggests that therapists:
- Connect with patients based on their own style
- Use a compassionate, nonjudgmental approach to help patients feel empowered by the therapeutic relationship
- Include loved ones in a frank dialogue, since women in this age group often have responsibilities caring for family—both children and parents
- Demonstrate that positive change is possible, as women with longstanding suffering often have given up hope
"Therapists can help women in midlife recognize and reinforce positive accomplishments in their lives and provide tools like cognitive behavioral therapy to change thinking,” says Lansky. “When more intensive care is needed, the Center for Eating Disorders Care at University Medical Center of Princeton offers both inpatient and partial hospital treatment that focuses on each patient’s individual journey to recovery.”
1. Micali N, Martini MG, Thomas JJ, et al. Lifetime and 12-month prevalence of eating disorders amongst women in mid-life: A population-based study of diagnoses and risk factors. BMC Medicine 2017. 15:12.