Have you seen later-in-life anorexia? (trigger: disordered eating)
March 9, 2018 1:59 AM   Subscribe

Do you know any men or women who BEGAN their disordered eating later in life, such as past the age of 25? 30? (I picked arbitrary numbers and would be interested to hear about anorexia onset at any age above, say, 19.) Can you tell me more about their situation? More details below.

*Was there a trigger for these new food-related symptoms? Divorce? School? Family?
*Was it a diet taken too far that pushed individual into the clinical definition of anorexia?
*Has he or she always been 'funny' about food, just not to a clinically significant degree?
*Did s/he seem to have more insight into their symptoms than do teenagers? ("I know it's unhealthy because I've seen the effects in others, but via food restriction I really need to exert control over this aspect of my out-of-control life.")

Literature cites that most people who develop anorexia develop it when they're about 16-17 years old. And people under 25 account for 90%+ of the eating disordered population. This is a question in which I make sense of an epidemiological phenomenon--that last 10%--about which I have little personal evidence. It certainly does happen, but I've literally never seen older-onset anorexia for myself--I hope to get a little glimpse of what symptoms, trigger points, course of treatment might look like, if different.

(The idea is that often teens are more susceptible to media images, are subject to family dynamics over which they have no control, are new to mood disorders like depression, OCD, etc.)

Full disclosure: This is mostly curiosity because of something I'm reading in a paper. I struggled with weight as a young woman. But despite my longing for the euphoria that comes with starvation, my adult brain knows that it's dangerous to quit eating. My brain still "goes there" because of old inclinations, namely addiction to a feeling. Do adults who fall into disordered eating patterns set aside their adult knowledge of EDs--their prevalence, risk factors?
posted by flyingfork to Health & Fitness (19 answers total) 2 users marked this as a favorite
 
Best answer: I've seen this, and in the two cases in my life it has been people who didn't set aside their knowledge, but rather gathered new "knowledge" which they used to justify their actions. Their eating disorders didn't come in the form of them stopping eating as a decision, but more in the form of "cutting out" various things that they felt were doing them harm, until there was basically nothing left.
posted by greenish at 3:49 AM on March 9, 2018 [7 favorites]


Best answer: Like greenish above, I've seen many cases of later in life orthorexia, rather than anorexia. I feel like the current health food culture and the obsession with eating "clean" is fueling this to some extent and we're going to continue to see a lot of it.
posted by ElectricGoat at 4:48 AM on March 9, 2018 [24 favorites]


Best answer: I have a friend who is in fact a specialist in geriatric eating disorders. They are increasingly common, she says, but generally have different causes than body image. One does lose ones appetite as one gets older and tissues shrink and metabolism decreases. There's not that much hunger. Then there are a whole bunch of mental disorders that can magnify the lack of interest in eating -- depression, anxiety, etc., all the way up to dementia. And then there is simply forgetfulness. You're not hungry -- you're losing touch with life a little bit -- you just don't remember to eat.

So they came up with stuff like Ensure drinks and so on to make it easier to get at least some nutrition.

And, so I don't think it's a matter of triggers and body image -- more a confluence of the natural side effects of aging. Not to say that a lifelong anorexic might not continue those patterns of thinking, but, harsh as it is, they often don't live that long, because older people do need a little more fat for insulation and cushioning of the organs.

Hope this is helpful.
posted by jfwlucy at 5:02 AM on March 9, 2018 [5 favorites]


Best answer: One of the reasons a lot of eating disorders go undiagnosed at any age is that even though someone is suffering, and is doing the behaviors to a harmful degree, if they aren't visibly underweight as a result, then people are reluctant to call it diagnosable. Most people find it harder to lose weight as they age, and the youthful thin body is the societal ideal. An older person with an undiagnosed ED might be doing the same behaviors to the same degree as a younger person with a diagnosed ED, but if they live independently they are less likely to have someone close enough to monitor their overall habits ("I already ate" is more likely to fly), and they're less likely to reach the extremely low weight that signals something diagnosable.
posted by Former Congressional Representative Lenny Lemming at 5:16 AM on March 9, 2018 [4 favorites]


Best answer: IANAD or therapist, I just read a lot about trauma. That said: disordered eating is sometimes a symptom of PTSD or CPTSD, which can arise in adulthood as the result of an abusive relationship or any other scenario where you’re frightened, abused, and trapped. Pre-existing C/PTSD that was previously manageable can also be triggered into greater severity by events later in life — sometimes having kids brings back child abuse, or sometimes life is just a jerk and you go through a break up, a death, and a job loss or something in a very short period, and your nervous system goes batshit crazy. In these situations it’s better seen as a coping mechanism for an underlying disorder. Anecdotally, I’ll second what others said above — there are PLENTY of “new paradigm based off this new bullshit research” diets out there. One is literally just called calorie restriction, IIRC? Plus there’s intermittent fasting, veganism, raw food diets, etc etc — basically an infinite amount of rationalizations for whatever degree of control you need to exert over your eating to feel better.
posted by schadenfrau at 5:39 AM on March 9, 2018 [4 favorites]


Best answer: Yes, this happened to me. It was triggered by an abusive partner who called me fat and grotesque a lot and forced a diet of mostly bran flakes (with eight chocolate chips!) on me, until I weighed 88 pounds. I was 26-30. I now continue to struggle with food (at 35) and will probably never have a healthy relationship with it anymore.

So yeah, my anecdote jibes with the "trauma" cause described above.
posted by sockermom at 6:16 AM on March 9, 2018 [5 favorites]


Best answer: The concept that eating disorders are triggered by wanting to exert control is very outdated. It can be triggered by C/PTSD, by OCD, by good old fashioned anxiety. You’d be surprised but a lot of people with eating issues aren’t directly anxious about their appearance, but instead trying to manage physical symptoms of anxiety in a disordered way.
posted by annathea at 6:29 AM on March 9, 2018 [7 favorites]


Best answer: I know a woman who while in her late 30s who was left by her husband of 20 years. She always presented with varying levels of orthorexia, but this was an entirely different thing. She just...stopped eating...to the point that she was put on an involuntary hold. She had a lot of trauma in her childhood, and trauma from the marriage and the ending of the marriage, and it was like something just broke for a while. She relapsed a couple times but I think she finally realized the things that happen after a relapse & re-dedication to health are so not worth it and so now she's back to just good ole orthorexia.
posted by I'm Not Even Supposed To Be Here Today! at 6:54 AM on March 9, 2018 [1 favorite]


Best answer: I'd say I always had the tendency but kept it largely in check as a teenager. I had bad depression and anxiety problems but I think I was working them out in other (unhealthy) ways, including some self-injury. The actual disordered eating kicked in in my early 20s--I'd had an abusive relationship where near the end I'd largely stopped eating just because the anxiety made me so nauseous, and then there was a combination after that of family members getting on me for regaining weight I'd lost during that time, and anxiety over starting college, not even what I'd call PTSD. My mother and grandmother were really grossly pleased with how slim I got and have approved of virtually nothing else I've ever done; I don't think body image was the main issue but that definitely contributed.

It's always been largely correlated to stress and anxiety--it also got bad when I was in law school, but I didn't wind up losing as much weight that time because I'd intersperse fasting periods with binge-eating periods. At this point what I consider to be bad spots tend to be periods that last maybe a week, not months, but it still really makes trying to work out diet and exercise stuff really complicated even now that I've hit a point in my life where I genuinely need to lose weight (but not that much and not that fast).
posted by Sequence at 7:00 AM on March 9, 2018 [1 favorite]


Best answer: Chiming in to say trauma and being triggered. When Trump's pussy-grab tape came out, I stopped eating for about a month. I wish I was exaggerating. I drank coffee with milk, tried to eat crackers or blueberries or rice but never managed more than a bite without nausea kicking in, and that was it. Appetite never went fully back to normal even though the anxiety is almost gone. I still eat way less than I used to. I just can't anymore. My habits shifted.
posted by MiraK at 7:50 AM on March 9, 2018


Best answer: Also it might be useful to make a distinction between various expressions of disordered eating. OP seemed to be asking specifically about disordered eating that is accompanied by distorted beliefs about one’s body or health, but IME that’s just one variety.

For me, it has been a result of trauma and triggers, but it felt more physiological than anything — literally nauseous — but was accompanied by the belief that oh shit this is really bad (and from previous experience I know can result in health complications), which added to the stress.
posted by schadenfrau at 8:17 AM on March 9, 2018 [1 favorite]


Best answer: My paternal grandmother had OCD and was also anorexic, to the point that it degraded her quality of life and resulted in her death. In her case I think it was related a lot to both her living situation which I would qualify as 'trapped' with an abuser. She was 5'4" and weighed 90 lbs or less for the last 15 years of her life, and when she moved the family discovered two closets full of empty laxative containers. Her eating habits had been obvious but that was a twist.

She died in her 70s, the mid-1990s. Her official diagnosis was Huntington's Disease, although her doctor acknowledged that the lack of weight made it difficult to really pinpoint what was caused by what. That diagnosis would have meant she probably did not appear in any statistics around anorexia. But from her behaviour I have no hesitation saying she suffered from anorexia.
posted by warriorqueen at 8:22 AM on March 9, 2018 [3 favorites]


Best answer: I've known men who were into bicycle racing and became anorexic as adults, probably for the first time. Everyone lost weight during the season, to the point where their eating looked disordered, but a with couple of them it took on a life of its own. I come from a family of female anorexics and addicts and the behavior of these guys was really similar with the distorted body image and reasoning. I've read about this kind of thing with wrestlers and jockeys too. It's probably hard to tell from the outside who is just maintaining a low weight aritifially and who has picked up a disorder.
posted by BibiRose at 9:17 AM on March 9, 2018 [3 favorites]


Best answer: My former partner’s mother is bulemic in her late 50s. As an occasional guest in her home, her eating habits were noticeably disordered (that, and my partner confided in me.) I can only guess there is considerable trauma in her past, judging from the overall family dynamic.
posted by Grandysaur at 9:19 AM on March 9, 2018


Best answer: Ive seen late-onset anorexia in connection with alcohol abuse, as the person quite literally stopped eating in favor of drinking and sleeping until they could drink again. Other factors like depression and PTSD were present, so it's hard to point to one root cause, but a desire to lose weight was absolutely not a factor.

That is absolutely not to say that EDs in younger people are always caused by concerns about body image. That would be far from the truth.

I'm having a hard time finding this now, but there were studies done with adult male prisoners, and the results pointed to a fairly extreme psychological aversion to healthy eating after a period of restricted diets. (The book Brave Girl Eating touches on this, but only you can know whether reading such a book would be healthy for you.)

The treatment* (for anyone dangerously underweight is the same, as far as I know, and it's not fun for the individual or for anyone trying to help.

In any case, alcoholic anorexia is a very real thing that likely contributes to that "missing" 10%.

*Of course the therapy aspect is different, but the reintroduction of calories looks very similar.
posted by whoiam at 9:39 AM on March 9, 2018 [1 favorite]


Best answer: I know someone who saw me almost die of an eating disorder (I had a BMI of 14.9) but has fallen into the exercise addiction and restrictive "clean" eating rabbit hole (their BMI just barely scrapes to 19.) I don't think it really matters how much they know about eating disorders.. they don't have one, of course.

It's surreal to watch them measure their wrists an ankles surreptitiously using their own fingers after they finish a 5 mile run. I used to do the exact. same. shit.
posted by xyzzy at 10:53 AM on March 9, 2018 [3 favorites]


Best answer: I dated a guy (cis, straight) who had always been tall and skinny, his whole life, to the point where he had a hard time finding clothes that fit him as a child and teenager.

In his late 30s he hit a patch of realizing that his life was going nowhere -- he was unemployed, wasn't really trained to do anything that would lead to steady employment, didn't really have any close friends, and was realizing that some of his romantic issues were not specific to his ex girlfriends, but rather were cropping up in every relationship he had.

He started talking about "clean" eating. He started saying he'd "been bad" when he ate popcorn at a movie. He started referring to days he ate ice cream (which were rare) as "cheat" days. His BMI fluctuated between 16 and 19. He looked for the skinniest jeans he could find, the tightest t-shirts. He made it clear that he wanted me to be thinner.

To me it seemed clear (and I told him this) that he was caught in a loop of exerting control (and feeling proud of himself) in the one area of his life he felt able to, and also tying that into value judgments about thinness, and the aesthetics of thinness.
posted by mrmurbles at 12:39 PM on March 9, 2018


Best answer: My mother developed an eating disorder in her 70's and it killed her. She had maintained a really, really low body weight for about 10-12 years and it wiped out her immune system, she developed oral cancer. I think all of us were sort of in denial about it, but one time I confronted her and she told me if I ever mentioned it again she would stop speaking to me forever. This was my mother, and it was so baffling.

I have often wondered about geriatric eating disorders and how common it is. I think in my mother's case that she could have survived if she had a normal body weight, or at least had a chance, but who knows. One time I sent her a box of chocolate cakes from Zingerman's, and she was mad at me.
posted by chocolatetiara at 4:45 AM on March 10, 2018 [1 favorite]


Best answer: I know some older-in-life athletes as described above. It's pretty prevalent in the biking and running communities when type- A high achievers take up sports. They grieve that they didn't do it sooner in life, then they try to be Lance Armstrong anyway which involves starving themselves and/or getting sketchy doctors to prescribe things like thyroid medication, adderall (sp?) modofinil etc You'd be surprised how super easy that is if you're a middle aged, affluent "active" type person. Losing weight for endurance sports or having a fighting weight is normal and fine but most athletes do it to compete and don't love it. When it's all you can talk about and you want your B cup boobs removed because "real athletes don't need to wear a bra" and you're 45 years old and only competing in local 5K races- you've lost the thread. There are a LOT of people caught up in this, there's normal orthorexia and then there's this which has a real undertone of self hatred and recrimination. I run into a lot of these folks in my social circle and it's very uncomfortable.

I also know someone who developed an eating disorder in her 40s after a really terrible trauma. She's been quite heavy before, to the point of having had the reversible weight loss surgery, so when she initially lost a lot of weight (because of grief and doctor prescribed tranquilizers) she got a lot of positive feedback for it. She decided it was the one positive thing to come out of tragedy and has starved herself down past size 0 since. It's not good.
posted by fshgrl at 12:16 PM on March 10, 2018


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