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Eating disorders in older women are far more common than most people realize. By age 40, one in five women has dealt with an eating disorder, twice the proportion identified in women at age 21. Contrary to popular belief, these serious mental health conditions don't exclusively target teenagers and young adults.
Despite being underrecognized, the incidence of eating disorders in older adults has increased significantly in recent decades. Studies have shown that up to 7.7% of middle-aged women meet the diagnostic criteria for an eating disorder, with 13% having at least one symptom. While anorexia becomes less common after age 26, eating disorders in the elderly manifest differently—binge eating disorder, the most common type among all adults, can continue to affect women well into their 70s. Understanding how eating disorders start and evolve throughout a woman's life is essential for proper identification and treatment.
Contrary to widespread assumptions, eating disorders don't discriminate by age. The mean age of older adults with eating disorders is 68.6 years, with 88% of these patients being women.
Older women with eating disorders typically fall into three distinct categories. First, those who develop an eating disorder later in life—representing approximately 69% of cases. Second, individuals who received treatment early in life but experienced a recurrence. Third, those who have lived with an undiagnosed eating disorder for many years. Notably, the duration of eating disorders is far longer in elderly patients compared to younger populations.
The onset patterns of different eating disorders vary considerably across the lifespan. Based on retrospective data, anorexia nervosa typically plateaus near age 26, bulimia nervosa continues to develop until around age 47, and binge eating disorder can emerge even after age 70. In fact, research shows that rates of binge-eating disorder don't reach their highest level until the 70s. Several life circumstances can trigger eating disorders in older women. These include:
Body image concerns remain surprisingly prevalent among older women. One study found that 62% of women over 65 reported a desire to lose weight, while 31% reported dieting. Moreover, 73% of midlife women experience dissatisfaction with their weight, a significant risk factor for eating disorder development. Another study revealed that women aged 65-80 were just as likely as young adult women to feel concerned about their body shape. Physiological changes associated with aging also contribute to the development of eating disorders. As the body ages, perception of smell and taste diminishes as taste buds begin to atrophy, potentially causing decreased interest in food. Additionally, saliva production decreases, making it harder for foods to dissolve and interact with remaining taste buds. Hormone regulation fluctuates during aging, affecting key hunger-related hormones like ghrelin, leptin, and insulin.All these things can be contributors to negative body images in older adults.
Eating disorders in older women often go undetected because healthcare providers rarely screen for these conditions in this population. A study found that between 1.8% and 3.8% of independently-living women over 60 have an eating disorder. Another study revealed approximately 6% of women aged 65-90 met clinical cut-offs for a likely eating disorder. Even more concerning, nearly 12% of participants in this age group reported objective binge episodes in the past month.
The consequences of eating disorders in older adults are particularly severe. The mortality rate reaches 21% due to the eating disorder and its complications. Treatment outcomes are also less favorable, with only 42% of older patients treated successfully. Physical vulnerabilities associated with aging make recovery more challenging—even modest weight loss of 3% in one week or 5% in one month represents a significant concern for older individuals.
Older women with eating disorders face unique psychological challenges as well. Many feel embarrassed by having what they perceive as a "teenager's problem". After living with an eating disorder for many years, some women come to view their disorder as part of their identity, resulting in more rigid or entrenched behaviors. The natural aging process can also intensify anxiety about appearance and health.
Understanding how eating disorders start and manifest in older women requires recognizing that these conditions often coincide with other mental health disorders. About 60% of elderly individuals with eating disorders have co-occurring conditions, with major depression being the most common. Perfectionism has also been identified as significantly correlated with eating disorder attitudes and behaviors in older women.
