How Eating Disorders Impact Older Women: ‘The Changing Body Is a Trigger’

By Gena Hymowech

Joan Rivers struggled with bulimia and anorexia, according to the new biography Last Girl Before Freeway: The Life, Loves, Losses, and Liberation of Joan Rivers by Leslie Bennetts. Precisely when she developed anorexia is unclear, but Rivers wrote about the bulimia, which started after her husband Edgar Rosenberg’s death, in her book Bouncing Back: I’ve Survived Everything… and I Mean Everything …and You Can Too!, released in 1997. She was 54 when her husband killed himself.

The number of older women with eating disorders has risen for about the last 15 years, says Dr. Margo Maine, a clinical psychologist with a specialty in eating disorders. Life transitions, Maine says, such as the loss of a husband, are a major trigger for eating disorders.

Maine and Dr. Alexis Conason, a psychologist who focuses on overeating disorders and body image, point out that aging can lead to weight gain. Conason says she believes “The changing body is a big trigger. … But despite it being a healthy adaptation, there’s so much fear and difficulty in accepting this change, because we live in a culture that really idolizes thinness and youth, and we see weight gain as we age as being a sign of becoming invisible in society, as a sign of desexualization.”

Eating disorders can occur out of nowhere in middle age or perpetuatef an earlier problem. A woman who has had an eating disorder longer has unique issues because she has “more decades of giving herself negative messages about her body, and about her self-esteem and all of that, so she has to counter decades of those negative messages and decades of bad habits in regard to her self-care,” says Maine, co-author of the recent book Pursuing Perfection: Eating Disorders, Body Myths, and Women at Midlife and Beyond.

Public speaker and author Denise Folcik, 55, has been in “strong” recovery for the past five years.

Her cycle of eating disorders started with bulimia at 28, when she was motivated, she says, by the desire “to get back to my pre-baby weight.” She became anorexic around 40, began treatment at 43, and developed binge-eating disorder, she says, “probably within a couple of years of going into treatment.” Her mother’s death was a trigger. Menopause also proved a difficult moment in her recovery. “It was mainly the weight-gain issue, but also body-shape issues, [and] even the fact that I was losing my youthful appearance.”

That Folcik was diagnosed at all might have been a lucky break. “I think that the myth that eating disorders are exclusively disorders of young, white, thin girls — adolescent and young women — means that these other groups are underdiagnosed. The other groups include — but are not limited to — older women, men of any age, and people of color. … People at higher weights are also underdiagnosed,” says Conason. “A lot of women over 40, they may be demonstrating eating disordered behaviors, but they don’t recognize them as such, because there’s not awareness brought to eating disorders in this population.” Furthermore, “a middle-aged woman might go see her physician and be reporting the symptoms of disordered eating, but it’s not readily recognized as that.”

A woman’s shame that she is eating too much can pose a problem as well, as far as being treated is concerned, says Maine, as can the fact that a woman may not want or be able to abandon her role as caretaker to get help.

And when an older woman does enter treatment, age may be a stumbling block. Folcik was among the older patients, so sharing was difficult. Conason says that “it’s hard to find a program that’s uniquely for women of this age group, so it can feel alienating and isolating to be a woman who’s maybe 20 or 30 years older than all of the other patients in a program.”

“I have gained a lot of weight since I’ve been out of treatment,” says Folcik. “I mean, I’ve gained a substantial amount. And you know what? I always tell everybody that I feel lighter than I’ve ever felt because I let go of so much baggage that was weighing me down.”

For help or information about eating disorders, contact the National Eating Disorders Association at 1-800-931-2237 or email info@NationalEatingDisorders.org. The Renfrew Center, which specializes in treating older women with eating disorders, can be reached at 1-800-RENFREW.

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