Middle-aged anorexics on the increase

Surrounded by images of stick-thin and toned women such as Madonna, Teri Hatcher and Jane Fonda (who has admitted to suffering an eating disorder herself), women are exposed to increasingly unrealistic images of how they should look as they age and are working harder than ever to counter the effects of getting old.

"Ten years ago, there were very few women in their 30s, 40s, 50s and older who were diagnosed with anorexia. That has changed significantly, especially in the past five years," says Susan Ringwood, chief executive of Beat, the national eating disorders charity.

In the US, says Trisha Gura, author of Lying In Weight: The Hidden Epidemic Of Eating Disorders In Adult Women: "Some treatment centres are reporting that 50% of patients are now 40-plus."

Dr Peter Rowan, a consultant who specialises in eating disorders at Cygnet Healthcare, Britain’s leading independent providers of psychiatric care, maintains, however, that in the majority of cases, anorexia has its roots in a girl’s formative years.

He says: “Almost all women who have an eating disorder later in life have been suffering with it for many years, usually since they were in their teens or early twenties. It doesn’t arise at all commonly later in life so that unrealistic images of women in later life have much less effect on potential anorexics than in the teens and twenties. In the main, women are likely to grow out of an eating disorder if it is fairly mild but the increasing focus of women on their appearance as they get older may influence this trend adversely.”

Rowan says the fact that there are now more women who are diagnosed with an eating disorder later in life is probably a reflection of two things. One is that the illness became much more common from the 1960’s onwards and these sufferers are now older.

An effect of the increasing incidence of the illness appears to be that there are more women who have milder degrees of illness in their teens or twenties, who may never have sought help and so present later. The other is probably that during the past two decades or so the illness has become more acceptable and women are more likely to acknowledge it.

“Most of the women who present with an eating disorder are in my experience still young,” says Dr Rowan.

“I think there is some reason to think that more older women present now than in the past but not 50% at over 40. Maybe this trend in the US will occur here in due course but I think that most older women are still reluctant to seek help and usually prefer to keep the illness secret. They are often not motivated to get better and don’t believe it is possible.

Dr Rowan says: “Most women who present with a chronic form of anorexia later in life have been ill for many years. They are often not really wanting full recovery but help to live with their eating disorder in a more healthy way. Treatment needs to be individually tailored to their needs but is usually on an outpatient basis. It often consists of some dietary advice and help using some of the techniques of cognitive behaviour therapy. It may involve therapy given usually on an individual basis.

“They may need help with some complication of the illness, especially when that has been their reason for seeking help. Severely underweight patients may need a short admission to increase weight but they seldom join an anorexic program or wish to return to a normal body weight.”

For more information about the programmes available at Cygnet Health Care, log onto Cygnethealth.co.uk.