Eating Disorders in Older Adults

When we think of eating disorders (ED) such as anorexia nervosa and bulimia we commonly associate them with adolescents and teens, however researchers are now finding these diseases may linger into older age. Using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a 2006 study found that out of the 1000 women aged 60-70 that were randomly selected in a non-clinical sample, 18 women met criteria for EDs and another 21 women reported single symptoms of an ED (2).

Amongst those exhibiting signs and symptoms of ED in their later years, few were new or late-onset diagnosis but often life-long cases (3). Perhaps in their youth, these older adults may have not been properly diagnosed, under-treated or may not have fully recovered. Depression was identified as a common co-morbidity exhibited in these cases (3).

This provides strong indication that eating disorders and body dissatisfaction transcend beyond the years, and more research is needed to help the medical staff identify, better diagnose and treat eating disorders in older adults.

What can dietitians and family do to address eating disorders in suspecting older adults (1)?

1) “Confront or Carefront?” Voice your concerns directly to the patient in a sensitive way.

2) Admit the problem. Help the patient acknowledge the elephant in the room.

3) Ask questions about usual weight, weight and menstrual fluctuations, and dieting history.

4) Educate and convey the importance of adequate nutritional intake and balance.

5) Never overemphasize weight as an indicator of general health.

6) Respect the patient’s feelings and privacy.

By Canh-Lien Nguyen, RD, LD

References:

(1) Maine, M. Addressing Eating Disorders as a Physicians: A “Twelve Step Program.” NEDA 2012. Retrieved July 10, 2012 from http://www.nationaleatingdisorders.org

(2) Mangweth-Matzek, B., Rupp, C. I., Hausmann, A., Assmayr, K., Mariacher, E., Kemmler, G., Whitworth, A. B. and Biebl, W. (2006), Never too old for eating disorders or body dissatisfaction: A community study of elderly women. Int. J. Eat. Disord., 39: 583–586. doi: 10.1002/eat.20327

(3) Scholtz S et al. Eating disorders in older women: does late onset anorexia nervosa exist? Int J Eat Disord. 2010 Jul; 43(5):393-7; doi: 10.1002/eat.20704]. Faculty of 1000, 22 Jun 2010. F1000.com/3660963#eval3383064

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