Eating disorders and the elderly
One reason why many people may not associate eating disorders like bulimia nervosa (BN), anorexia nervosa (AN), and binge eating disorder (BED) with middle aged, older, or elderly patients is that a majority of research on the subject is conducted on younger people. But what studies have been done on older populations have found that late-onset cases (presenting in people age 35 and older) are increasing.1
Various studies compiled by the National Eating Disorders Association and other groups studying eating disorders found:1,5
- 3.8% of 475 Austrian women between ages 60 and 70 met diagnostic criteria for eating disorders, including BN and AN
- 11% of women between ages 42 and 55 in one study reported binge eating at least two times per month
- 60% of adult women have engaged in pathogenic (capable of leading to disease) weight control measures
- 20% of women age 70 and older were dieting, despite potential health complications connected to losing weight at that age
- 70% of Swiss women between ages 30-74 had body weight and shape concerns, despite presenting at a normal weight
Overall, one analysis of nearly 50 case studies surmised that 69% of patients over 50 had late-onset eating disorders, representing a combination of previous eating disorders that had reappeared later in life and first-time cases.
Risk factors for bulimia in older adults
While it's possible to develop BN at any age, there are a number of challenges particular to elderly people that may have a hand in bringing about, resurfacing, or complicating this condition and other disordered eating behaviors.
Challenges of recognizing bulimia in the elderly
It may be difficult to identify bulimia nervosa and other eating disorders in older patients, thanks to a number of unique factors that exist for this group of people.
Elderly people are more likely to live alone or not have regular contact with close friends or family, which can allow them to develop and struggle with eating disorders for some time without anyone noticing.
Additionally, many eating disorder symptoms can present similarly to symptoms frequently encountered by older people for other reasons. Vomiting, unexplained weight loss or weight gain, hair loss, malnutrition and moodiness—all key signs of bulimia nervosa—can also be attributed to a number of other illnesses or even the effects of some medications frequently used by older adults.
Many older people may also be less forthcoming about their condition, even if they're aware their behavior has become problematic. One report sadly conjectured that fewer older people acknowledge having an eating disorder, since they have “fewer future goal-related motives for recovery,” or may not want to burden their families at this stage in their life.3
Treatment of eating disorders for older adults with bulimia
When an elderly person does develop an eating disorder, the consequences can be disproportionately devastating when combined with the physical effects of aging, which makes it even more important for these individuals to find proper treatment for their conditions.3
Unfortunately, there can be a number of barriers to care for elderly people struggling with BN and other eating disorders. Availability of programs in their area may be limited; and, as many elderly people live alone and no longer drive, accessibility to those programs may be an additional challenge.
Insurance—or, the lack thereof—is another factor that may particularly impact an older person’s search for treatment, especially for people who are retired or otherwise no longer working.
But even for people who can’t find or afford more traditional treatment options, there is still hope.
A method of treatment called self-help therapy has shown particularly effective for helping people with bulimia nervosa. The treatment helps people work themselves through the problem, by having them follow a series of exercises in workbooks, apps, or online programs, and is often more cost-effective and easier to find than other types of treatment.4
Regardless, anyone struggling with bulimia nervosa or another eating disorder shouldn’t give up hope. Recovery from these conditions is always possible—and it’s never too late to seek help. Call our team of eating disorder professionals at Within Health to learn about our virtual care programs for bulimia nervosa.