6/3/2022 | By Megan Mullen

Seniors Guide looks at the realities of eating disorders in older adults, including anorexia and bulimia in seniors, and at impacts, symptoms, and action steps.

Eating disorders first became widespread public knowledge during the late 1970s and early 1980s, but they existed behind the scenes much earlier. In fact, eating disorders date back to ancient Greek and medieval times. Even that far back, though, mainly young people appear to have experienced the problem.

Eating disorders typically involve unhealthy eating habits, often based on mental health issues, which manifest in an obsession with food, body weight, or body shape. This commonly manifests in behaviors such as severe restriction of food, food binges, and purging behaviors like vomiting or overexercising.

Moving forward some 2,000 years, we’ve learned how to spot eating disorder symptoms more easily, and health practitioners, both behavioral and physical, are available to help, should the affected person accept it.

Still, it might come as a surprise that older adults suffer from eating disorders in growing numbers. The reality is that seniors and other older adults have many of the same underlying causes for eating disorders as teens and young adults. Unfortunately, the illness can cause more severe and lasting damage in older bodies, which often have comorbidities.

Older adults with eating disorders tend to belong to one of three categories:

  • Those with a chronic eating disorder, which they have been battling for many years
  • Those who were identified and treated but for whom the condition has returned
  • And those who develop the condition later in life

So, what’s behind this often-overlooked epidemic of eating disorders in older adults?

Causes and impacts of eating disorders in senior

older woman concerned with appearance. Photo by Ruslan Huzau Dreamstime. Seniors Guide looks at eating disorders in older adults, including anorexia and bulimia, and at impacts, symptoms, and action steps.

Factors leading to these illnesses can be physiological, interpersonal, psychological, and sociocultural. People can perceive food itself as a means of controlling and managing painful feelings and recollections that otherwise might overwhelm them. And in our beauty-obsessed society, even seniors can feel compelled to maintain a “perfect” body.

Eating disorders can take a formidable toll on physical health.

Anorexia nervosa is one of the most commonly recognized eating disorders. The National Eating Disorders Association explains, “People with anorexia generally restrict the number of calories and the types of food they eat. Some people with the disorder also exercise compulsively, purge via vomiting and laxatives, and/or binge eat.” This behavior can lead to anemia, kidney difficulties, bone loss, and cardiac concerns like arrhythmias and heart failure.

NEDA describes another recognized eating disorder, bulimia nervosa, as “characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.”

Related: Clean-eating obsession and the risks of a too-pure diet

Binge eating can cause obesity, which increases the risk of diabetes, hypertension, heart disease, and certain cancers.

Laurie Cooper, site director at the Renfrew Center in Nashville, points to Medical News Today out that eating disorders can be overlooked in older adults. “Many family members or helping professionals may attribute weight loss, malnutrition, or unexplained symptoms such as vomiting or diarrhea to a ‘normal’ aging process or some other medical condition, rather than a mental health disorder.”

Cynthia M. Bulik, professor at University of North Carolina School of Medicine, adds, “One of the main concerns is that eating disorders take a tremendous toll on just about every bodily system. In old age, these body systems are less resilient to begin with, just because of the aging process, so eating disorders can erode them more quickly and more seriously.”

Weight loss in seniors can lead to muscle atrophy, frailty, diminished immunocompetence, depression, and greater disease susceptibility. These concerns can, in turn, affect food and fluid intake, leading to a vicious circle.

Symptoms of eating disorders in older adults

According to a 2016 article, the primary eating disorders among seniors are anorexia nervosa and bulimia nervosa. A literature search reviewing published cases of eating disorders in people over 50 found that “The majority (81%) of cases had anorexia nervosa, and 10% had bulimia nervosa. Late-onset eating disorders were more common (69%) than early onset.”

The following early indicators point to senior individuals who might be struggling with eating disorders:

  • Significant weight loss or gain in a relatively brief time.
  • Excessive hair loss or increasingly feeling cold.
  • Medical problems including heart problems, gastrointestinal issues, and dental damage.
  • Food mysteriously disappearing or excessive amounts of food thrown away.
  • Using the restroom immediately after eating.
  • Using diuretics, laxatives, and diet drugs.
  • Behavioral changes, including a desire to eat alone or suddenly disappearing after eating.

We should note that not all elderly individuals will exhibit all these symptoms, while others may have several – and sometimes these symptoms can have other causes.

Treatment and action steps

Successful eating disorder management most often depends on a successful balance of pharmacological and behavioral interventions. These conditions are treatable, and older adults may have an advantage in recovering their health and wellness.

Related: Study finds that adults over 65 should have a few extra pounds

But what advantage could there be? Vivian Hanson Meehan is president and founder of the National Association of Anorexia Nervosa and Associated Disorders (ANAD). She explains that, in the case of older women, they will “dedicate themselves to the treatment and have many motivators that the younger women don’t have – i.e., children, a family, aging, etc. So, as a result, these women tend to do well in treatment.”

How to help seniors prevent or overcome eating disorders

If the COVID pandemic has taught us nothing else, it has demonstrated how socializing and camaraderie can buoy people’s motivation. Without the warm presence of other people, seniors especially can become lonely and depressed – whether living in a care facility or aging in place at home.

So, it’s of utmost importance that caring friends and relatives maintain contact. Even a simple daily phone call can make a tremendous difference! But even more beneficial would be taking them out for walks, to get their hair cut or styled, or do some light shopping.

Other significant benefits can derive from structured interactions with others their age to eat nutritious meals together, chat socially, and have health check-ups. For example, adult day programs can help ensure that people dine with others, become more socially active, and have opportunities to participate in physical rehabilitation, all of which can increase appetite – along with spirit and vigor.

To further help someone you care about who has an eating disorder, consider some of the following:

  • Make bland food more appealing by adding new flavors and fresh ingredients.
  • Invite old or new acquaintances to socialize with you and your elder.
  • Discuss with your elder’s doctor how to better treat comorbidity symptoms.

Unfortunately, virtually all medications conducive to weight gain also come with potentially dangerous long-term side effects and complications. So if you choose to combat the problem with medications, keep your eyes open for any new developments.

Megan Mullen

Megan Mullen is a freelance writer, librarian, and former college professor. Senior life is one of her niches (and a personal interest). Megan enjoys using her writing and research skills to create well-crafted web content and other publications.