Eating Disorders in Older Women : Deadly, Misunderstood and Underestimated : Part Two

The Stigma of Mental Illness

Striving to look younger and thinner is seen as a worthwhile goal in our society. Women who try to achieve that goal through unhealthy means continue to hide the problem from themselves and from others. One of the reasons may be that eating disorders are classified as a mental illness and there is a stigma associated with having this disease.

In a study undertaken in the UK by Crisp (2005) he found that over 30% of the respondents thought people with eating disorders could pull themselves together, have only themselves to blame, are different to the general population and are hard to talk to. In contrast to schizophrenia and severe depression patients, eating disorder sufferers are viewed by some members of the population as responsible for creating their own disease.

The NEDC says “Eating Disorders are often poorly understood and underestimated in contemporary society. There are mistaken beliefs that Eating Disorders are about vanity, a dieting attempt gone wrong, an illness of choice, a cry for attention or a person ‘going through a phase’. Eating Disorders are also frequently believed to affect only adolescent girls.”

Sports and Eating Disorders

One of the most fertile breeding grounds for eating disorders is the field of sports. “Establishing the true prevalence of eating disorders is very difficult due to the secretive nature of the illness. Using strict criteria for anorexia and bulimia, prevalence rates among athletes are about 3% and 20% respectively. When the definition of eating disorders is expanded to include all disordered eating behaviours, the prevalence rates increase to 15 – 60% depending on the study and the sport,” explains Sports Dieticians Australia.

The highest incidence of eating disorders is in sports that celebrate leanness – gymnastics, figure skating, ballet dancing, distance running and bodybuilding.

After Simone suffered an injury from running six days a week she decided to try bodybuilding as way to control her weight and achieve the physical perfection she always dreamed about. But instead of being a healthy sporting pursuit, it fed her obsession. She says, “Preparing for and competing in a body building competition brought all of its own challenges making my eating disorder worse than ever. In my opinion the industry is certainly harsh and punishing and I fear the longer term consequences of the body building diets that are advocated (no fruit, no dairy, very little whole grains etc.)”

The body building industry, with its emphasis on low body fat, is a rife with disordered eating. Researchers in Canada interviewed a group of female bodybuilders and asked them their thoughts about themselves and their behaviours around food and exercise. They found that 90% of competitive bodybuilders thought that they were fat and were involved in a vigorous exercise regime. 15% met the criteria for bulimia and a percentage had binged, abused laxatives and diuretics, and engaged in vomiting behaviours.

A New Zealand study found that bodybuilding increases the risk of developing eating disorders. “Body-building has the capacity to play into, even amplify [women’s] sensitivities surrounding appearance and body image, their preoccupation with diet and weight control, and a propensity towards eating disorders.” One participant in the study said, “Women who already have a negative relationship with food, bodybuilding can completely screw them mentally forever.”

The Causes of Eating Disorders in Older Women

What causes any person to develop an eating disorder is complex and researchers continue to try to understand the importance of gender, genetics, biological factors, culture, personality traits, trauma and dieting. What causes the onset to occur later in life in older women is even less evident. Gilbert and Thompson, in a review of research literature, take a feminist perspective that may resonate with more mature women. They identify the commons themes as – the culture of thinness, weight as power and control, anxieties about female achievement, and eating disorders as self-definition.

When I asked my friend Gail about eating disorders she made a comment that highlighted nearly all of these themes. She said, “I can see why women could develop an eating disorder later in life. I am very close to turning 50 and my body is starting to show all these changes that I don’t have much control over such as developing love handles for the first time in my life, and a pouch in my lower tummy. Talking to other ladies who are of the same age has shown me that they are going through the same thing. They all hate it and all of them feel they have lost control of their body. It is quite a scary and confusing time of your life. A lot of women feel they are no longer needed as their children have left home etc. It really can be bewildering, so I guess eating is one thing they feel they can control.”

Recovery

For women like Simone there is hope. She has now confronted her problem and is getting better. She says, “I’m slowly travelling the road to recovery. I’ve had help from a psychiatrist who helped me understand why and gave me some simple ideas to help me to stop the binges and to work on my thoughts around food and eating. She also instilled a very basic moral – “whether you believe you can do it (stop bingeing) or you believe you can’t, you’re right.” I still have a way to go before I can say confidently that I have it under control or that it’s no longer a problem but I feel like I’m getting there instead of being stuck in my old diet/binge rut that was getting me nowhere.”

Recovery for a bulimic person is a three-step process. The first step is for the sufferer to recognise that their eating disorder behaviour is an unwanted coping mechanism that they are committed to changing.

The second step is a willingness to tolerate uncomfortable emotional and physical sensations and to replace the bulimic behaviours with alternative more positive behaviours.

The third step is ongoing and characterised by the person learning to care for herself and developing coping mechanisms that improve her self-esteem.

Whether alone or with a therapist, women find the path to healing includes increasing their self-confidence, developing a more positive body image, improving their relationships with others, adopting different coping mechanisms for the stressors of life and being happy being with themselves rather than conforming to the expectations of others.

Support and Advocacy

In order for older women to recover from the effects of dieting, purging and other disordered eating behaviours they need to feel that they are not alone and that there is no shame in asking for help. There are many Australian organisations that provide support for eating disorder sufferers and provide education and awareness within the community.

The Butterfly Foundation is non-profit organisation dedicated to bringing about change to the culture, policy and practice in the prevention, treatment and support of those affected by eating disorders and negative body image. They provide information, run support groups, have an education program and fund research.
→ www.thebutterflyfoundation.com

The National Eating Disorder Collaboration is an Australian Government initiative committed to funding research, setting up a national patient register, prevention programs, improving treatment, and educating the community.
→ www.nedc.com.au

Other organisations are working on changing the way women see themselves in society. The Dove Campaign for Real Beauty is an example of a corporation supporting cultural change. Their philosophy is “to make beauty aspirational, but also attainable for women,” and is committed to “broadening narrow beauty stereotypes.”
→ www.campaignforrealbeauty.com.au

When dieting and exercise get out of control it can have serious consequences. What starts off as an innocent weight loss strategy can turn into a disorder that destroys lives. With education, acceptance and support, woman in our community can seek the help they need to break this cycle of self-harm.