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Bulimia in the elderly

Most people associate eating disorders with younger adults or even adolescents. But the reality is that these debilitating mental health conditions impact everyone, regardless of age, race, sexual identity, or any other personal factors.

And data on the subject shows that a large number of middle-aged and older adults struggle with eating disorders, including bulimia nervosa.

 minute read
Last updated on 
September 12, 2023
September 12, 2023
In this article

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.

One study found that 69% of patients over 50 had late-onset eating disorders.

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.

Previous eating disorder diagnosis

Having previously struggled with an eating disorder is a big risk factor for experiencing BN in older age.

One study found a majority of its elderly eating disorder cases were reported by women who previously struggled with bulimia nervosa and other forms of disordered eating. As many as 86% of respondents said their disorder originally started before they turned 20, and only 50% said they had recovered at any point.2


No matter what age someone develops an eating disorder, stress is often a key factor in bringing about the disorder.

In the later stages of life, people may be dealing with careers winding down, children moving out, family and friends passing away, or leaving their long-time homes. They may lose their ability to drive or, in more advanced stages of certain geriatric conditions, start experiencing difficulties with everyday activities.

Aside from stress, these situations represent, for many people, a loss of control. Falling back on—or developing—disordered eating habits may present as a maladaptive coping mechanism, helping elderly people feel like they’re taking some of the control back over their life.3

Physical changes

Older people may also experience a number of physical changes that make it easier for them to gain and carry weight. In fact, at a certain point in life, remaining at a higher weight may pose less of a risk to one's life than actively losing weight.5

Still, body image concerns don't go away with age. Reports have found women in middle and older age reporting similar levels of body dissatisfaction as younger women, and large numbers of older women utilizing weight control methods.1,5

Co-occurring mental health conditions

Eating disorders very rarely occur alone. In many cases, they develop alongside other mental health conditions—most prominently, depressive and anxiety disorders.8 And these same afflictions often impact the elderly community.

For older women in particular, there may be a sense of becoming "invisible" as society increasingly turns its view to young women. (5) But whatever the case, older people do struggle with depression and anxiety disorders at significant rates, which could potentially leave them more vulnerable for developing an eating disorder later in life.6,7

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.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.


  1. Gagne, D. A., Von Holle, A., Brownley, K. A., Runfola, C. D., Hofmeier, S., Branch, K. E., & Bulik, C. M. (2012). Eating disorder symptoms and weight and shape concerns in a large web-based convenience sample of women ages 50 and above: Results of the gender and Body Image (gabi) study. The International Journal of Eating Disorders, 45(7), 832–844.
  2. Schaeffer, J. (n.d.). Elder eating disorders: Surprising new challenge. Today’s Geriatric Medicine. Accessed September 2023.
  3. McIntosh, J. (2015). Older people and eating disorders: Not 'just a teenager's problem' Medical News Today. Retrieved March 18, 2022.
  4.  Yim, S. H., & Schmidt, U. (2019). Self-help treatment of eating disorders. Psychiatric Clinics of North America, 42(2), 231–241.
  5. Maine, M. (2012). Body Image Despair and Eating Disorders: What’s Age got to do with it?  National Eating Disorders Association. Accessed September 2023.
  6. Zenebe, Y., Akele, B., W/Selassie, M., & Necho, M. (2021). Prevalence and determinants of depression among old age: a systematic review and meta-analysis. Annals of General Psychiatry, 20(1), 55.
  7. Liu, Y., Xu, Y., Yang, X., Miao, G., Wu, Y., Yang, S. (2023). The prevalence of anxiety and its key influencing factors among the elderly in China. Frontiers in Psychiatry, 14.  
  8. Blinder, B., Cumella, E., Sanathara, V. (2006). Psychiatric Comorbidities of Female Inpatients With Eating Disorders. Psychosomatic Medicine, 68(3), 454-462.


Further reading

Anorexia among the elderly

Anorexia nervosa (AN) is one of the most well-known and widely recognized eating disorders, but there are...

Eating disorder treatment programs for elderly

Eating disorders occur among all ages, genders, ethnicities, and demographics. How...

Bulimia in the elderly

Most people associate eating disorders with younger adults or even adolescents. But the reality is that...

How eating disorders affect the elderly

It’s a common misconception that only thin, young, white girls and women experience eating disorders...

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