Disappearing in front of our eyes

By Liz Montes

Trisha (not her real name) walked into the gym some time ago; on the phone she sounded vibrant and anxious. When I saw her I knew immediately that it wasn’t more exercise that she needed. Instead, I felt she was in dire need of a counselor to help with what was clearly an eating disorder.

It reminded me of an article in the New York Times several years ago about the 10 million Americans suffering from eating disorders. While we seem to think that eating disorders like anorexia and bulimia only affect the adolescents and young adults, we are wrong. According to the article in the quest to “get healthy” more people have obsessions with diet and sometimes exercise.

Eating disorders, experts say, are mostly diagnosed in young people; however, more and more women are showing up in midlife or even older with eating disorders. Women outnumber men with eating problems ten to one. Eating disorders programs throughout the country are reporting seeing a sharp rise in patients in midlife. Initially these programs were designed for the youth, but not any more.

Cynthia M. Bulik, director of the Eating Disorder Program at the University of North Carolina, Chapel Hill says, “We’re hearing from women, no matter how old they are, that they still have to achieve this societal idea of thinness and perfection.” Ms. Bulik goes on to state, “Even in their 50s and 60s and, believe it or not, beyond – women are engaging in extreme weight and shape control behaviors.”

It seems that younger or older; women tend to engage in destructive behaviors, restrictive diets, excessive exercise, laxative use, liquid diets, binge eating, etc. Most commonly it seems that a stressful event in that person’s life triggers the reaction. That then seems too difficult to break once the stressful event is over. Unfortunately, the problem is more difficult to detect in older women because they are adept at hiding the problem and the symptoms are often attributed to aging rather than an eating disorder.

For example, when a young girl stops menstruating, doctors will wonder about diets and exercise. But, in older women it is often attributed to menopause. Older women sometimes go on to develop anemia and osteoporosis; it doesn’t occur to many doctors that perhaps the real cause is malnourishment. On the contrary, one doctor in the New York Times story commented to a woman who was clearly anorexic, how great it was to see her commitment to her exercises. This particular woman had fallen twice, breaking an elbow and later her pelvis. Her exercise instructor helped her to discover that she had an eating problem. This woman, at 53 years of age, was 85 pounds and 5’3”.

One of the things many of these eating disorder clinics are providing is awareness. Many doctors do seem to be more aware of eating disorders happening across anyone’s life span, no matter the age. My mother is 80, and in her recent doctors visit her physician wanted to know why she had dropped three pounds. Now, my mother doesn’t have an eating disorder but the doctor was asking. That was good and made me realize the doctor was aware. The doctors should ask the questions just to be sure that they can distinguish between an eating disorder, menopause, and any other real health problem.

Back to Trisha, after a three- year absence she returned for a visit looking very well. Her comment: “I’m 25 to 30 pounds heavier and somehow I feel lighter.” But, one does wonder during that period of the dramatic weight loss, where were her husband, friends, and children? Didn’t they see what was going on with this woman? I guess not.


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