Disordered Eating and Older Adults
Updated on: February 2023
Written by: Kelly Koeppel
Although disordered eating is usually a health concern for younger people, it’s a major problem in every age group. A study published by Cambridge University Press found that 13% of women over age 50 had eating disorder symptoms. That is the same percentage as those under 20. The Cambridge research also found that 20% of women over 70 were dieting, and 62% over retirement age thought they had to lose weight.
The National Alliance on Mental Illness (NAMI) points out that diet-related issues are linked to poor self-image, peer pressure, emotional problems, and other social factors.
Eating disorder symptoms can be severe at any age, but they can have an especially dire impact on the health of elderly people. Malnourishment from these diseases can impact elderly patients who are already susceptible to low bone density, muscle wasting, and immune system issues. Anorexia and other related conditions can exacerbate these problems.
Here is a closer look at the causes and treatment options for eating disorders in older adults.
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Causes of Disordered Eating in Older Adults
NAMI emphasizes that eating disorders can develop because of different mental and emotional conditions, environmental factors, peer pressure, stress, and major life changes. Causes can differ significantly from person to person, but here is a look at the most common reasons elderly people develop disordered eating problems.
Physical Health Problems
Physical health problems can lead to some types of eating disorders in older people. For example, diabetes, certain types of cancers, dementia, heart disease, liver or kidney problems, digestive system infections, or thyroid issues can cause a loss of appetite.
In conjunction with these diseases, treatments for illnesses can lower the desire to eat and mute feelings of hunger. Chemotherapy can commonly cause malnutrition by taking away the patient’s desire to eat. Opioid-based pain medications, antibiotics, and heart medications like digoxin can also cause a chronic loss of hunger.
The medical term for this type of disinterest in eating is anorexia. The term simply means a loss of appetite, which is different from anorexia nervosa, which is a psychological disorder resulting in forced starvation and a distorted body image.
Mental Health Problems
Anorexia nervosa is a common eating disorder related to mental health and a distorted body image. Though it typically affects people in adolescence and early adulthood, studies, such as the one published by Cambridge University Press, suggest that many retirement-age women dieted to lose weight even though they were within the normal healthy weight range for their age and height.
Mental health problems like depression can also cause a loss of interest in self-care, including normal hygiene and eating. Somewhere between 1-5% of older adults suffer from depression, though instances are three times higher for those requiring home healthcare or hospitalization. Depression treatment methods such as medication, and any other types of mental health counseling can alleviate symptoms and, if they are the root cause of malnourishment, bring the patient’s appetite back.
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Stress can cause both a loss of appetite and overeating. Emotional overeating is an attempt to alleviate the symptoms of anxiety or depression by consuming excessive amounts of food. By dining continuously, emotional eaters can temporarily distract themselves from nervousness or unpleasant feelings.
In other instances, stress can cause people to lose interest in self-care, including maintaining a proper diet. This problem can lead to additional issues because stress raises the body’s metabolism, meaning you need a higher calorie intake to maintain normal function.
Social factors can play a role in the development of eating disorders. People of all ages might feel they have to lose weight to achieve a look that their peers find acceptable or attractive. This social pressure can lead to crash dieting, unhealthy exercise patterns, or the development of eating disorders like anorexia nervosa and bulimia.
These social pressures may create unreasonable or unrealistic expectations. One study published in the Clinical Psychology Review showed a strong link between clinical perfectionism and eating disorders. Psychologists found more cases of anorexia and bulimia in patients diagnosed with perfectionism, suggesting that those with clinical perfectionism and unreasonable expectations have a risk of developing unhealthy eating habits.
Meanwhile, overweight people may seek to lose weight quickly through extreme exercise or diet regimens. Others may develop anorexia nervosa or bulimia, which involves using forced vomiting, laxatives, or unhealthy amounts of exercise to burn off calories quickly.
Older adults may experience these problems when younger and experience a relapse after retirement due to stress from significant life changes or weight gain from a less active lifestyle. Often, their treatment was ineffective or incomplete in their younger years, and they never fully recovered.
Signs of Disordered Eating in Older Adults
In general, mental health issues are ignored or unidentified among older adults, as many may associate some of the symptoms of mental health struggles with the natural aging process. Also, those with lifelong issues may be adept at hiding signs, and others may feel ashamed to reach out due to the societal stigma about mental health concerns. As mentioned, continuing on this path is especially dangerous for adults, and all must become familiar with the symptoms.
Here are signs to look for when detecting eating disorders.
- Extreme weight fluctuations are a sign of anorexia, bulimia, or various binge eating problems. Those who avoid eating, engage in calorie purging, or exercise excessively may lose weight very rapidly, while those who binge eat may experience unnaturally fast gains.
- People with anorexia may disappear before mealtime to avoid eating, while those with bulimia may leave right after mealtime to force themselves to vomit the food they just ate.
- People with eating disorders often shy away from consuming food in public. They may prefer to eat alone, even when dining with family or friends.
- Common signs of malnutrition can also signal eating disorders. These may include hair loss, pale skin, bleeding gums, poor tooth condition, and chronic illnesses or infections due to poor immune system function.
- Gastrointestinal problems can also plague people with eating disorders because they have unnatural eating habits which disrupt their digestive cycles.
Treating Disordered Eating
Eating disorders require a balanced, holistic treatment plan involving mental health therapy, education about lifestyle changes, and new dietary habits. You may also need to treat any conditions developed as a result of the disorder.
Mental Health Care
Mental health care is an essential component for the treatment of conditions like anorexia nervosa and emotional overeating. It can also be helpful for general anorexia caused by depression or stress.
Cognitive behavioral therapy (CBT) is often effective in treating eating disorders with a mental health component. This approach seeks to retrain the way the patient thinks about their issues and provide thought-based coping mechanisms that can alleviate the compulsive need to eat or avoid food.
The advantage of this treatment is that it does not require medication, and it is effective either in person or through online therapy providers. In cases involving depression, anxiety, or excessive social pressures, doctors may prescribe antidepressants along with CBT therapy.
Nutritional Education and Diet
In many cases, education about proper nutrition can help fight eating disorders. With the correct information, seniors can develop practices to achieve and maintain a healthy weight. A healthy diet can improve energy and enhance immune functions, which can positively impact mental health and deal with chronic depression.
Studies have shown that disordered eating is still a problem among the elderly just as it is a problem among younger generations. However, with a combination of mental health therapy and education, it is possible to treat eating disorders, reverse or limit symptoms, and improve the patient’s quality of life.
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