There's no age limit on eating disorders

SHARON STEPHENSON
Last updated 05:00 19/05/2013
Eating
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Not perfect: Eating disorders can happen at any time, to anyone.

Eating
Auckland body image and eating-issue therapist Victoria Marsden.

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It was the lemon slice that did it. Biscuity layers of butter and condensed milk, swaddled in icing so sweet it could crack your teeth.

While the rest of us gobbled them down as though in the shadow of a famine, it was too much for Andrea, a former colleague. "Please stop bringing fattening food to work," she shouted, slicing through the calorific coma that made Monday mornings bearable.

"You should be ashamed of yourselves for eating such bad food." And so ended Baking Mondays.

What makes Andrea's behaviour unusual is that she isn't a 20-year-old desperate for thin thighs and a pert bottom, or an unfortunate 14-year-old trapped on the ferris wheelof anorexia. She is a 46-year-old, university educated, high-achieving, property-owning consultant.

Attractive and successful, she's the kind of woman whose good-luck thermostat has never been out of whack. Hardly the poster girl for eating disorders? You'd be surprised, says Auckland body image and eating-issue therapist Victoria Marsden.

"Most attention is given to adolescent eating issues, but they by no means discriminate by age. Eating disorders can happen to anyone at any stage of their lives," she says. Due to a lack of age-related research data on disordered eating in New Zealand, it's difficult to say if older women are the new face of eating disorders, but statistics from the United States indicate a 42 percent spike in the past five years of older women seeking treatment.

These include patients suffering from anorexia, where excessive or compulsive dieting, starvation and over-exercising can result in dramatic weight loss, as well as bulimia, which is characterised by excessive binge eating followed by purging with vomiting or laxatives.

Marsden, who has worked with patients from age nine to their late 60s, says older women suffering from eating disorders generally fall into three categories: those whose illness has gone untreated since adolescence; those whose disorder may have gone into remission, only to resurface later in life; and those who may have developed an eating disorder in their 30s, 40s, 50s, even 60s.

Blame life's major and often unexpected events - divorce, redundancy, illness, retirement and empty nest syndrome, among others - for propping open the door for middle-age eating disorders. "As women get older, they tend to be loaded with responsibilities - raising children, paying off a mortgage, caring for ageing parents - as well as having to navigate some of life's big career and relationship changes. Society assumes that by 40, a woman should have her life sorted, she should be so busy caring for family, working and running a home that she shouldn't have the time or energy to worry about how much she's eating or how slim she looks," says Marsden.

But while women may not be able to control what's going on around them, they can control what goes into their mouths. Wellington-based Andrea has spent more than 30 years doing this. "I've struggled with weight and food issues since I was 13. I believe that if I can control my eating, then I can control my life. The minute stress hits me, my first thought is, how can I restrict my food intake?"

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At her worst, Andrea survived on less than 500 calories a day. "Some days I would eat only 30 grapes. A blow-out day would be a cup of plain pasta or a Diet Coke." If she tried to eat more, Andrea's stomach would clench until she vomited. Her periods stopped and she couldn't brush her hair without losing clumps of it. At one stage Andrea's elderly labrador weighed almost as much as she did.

However, turning 40 proved somewhat of a lifeline: Andrea paid off her mortgage, landed her dream job and let go of some of what she calls her "craziness about kai". "For the first time in my life I was able to go to restaurants and eat, rather than just pushing the food around my plate. I felt normal."

But six months ago, the trifecta of a high-pressure career, unrelenting perfectionist tendencies and the death of her father pushed Andrea "back down the road of previous coping strategies".

"At a certain point, you cross that line and can't stop what you're doing. Sometimes it feels as though this illness owns me.'' 

One of the biggest culprits of disordered eating for women - and men - of all ages is society's obsession with body image. On any given day, around 60 percent of women are on a diet.The weight-worry gun is loaded early: in New Zealand, it's estimated as many as 10 percent of adolescent girls go through a mild phase of anorexia. And it would appear that there is no age at which we learn to love our bodies: an Austrian study of 475 women aged 60 to 70 years revealed that 60 percent were dissatisfied with their bodies, while four percent were diagnosed with an eating disorder.

Here in New Zealand, Weight Watchers reports 13,000 members over 40, with their oldest member being 79 years old. Marsden says that the necessity to maintain a certainweight is particularly critical if a woman's identity and self-esteem is wrapped up in her appearance.

"This may lead her to seek a thin, youthful body through unhealthy behaviours, such as food restriction, diet pills, extreme exercise, drugs, laxatives or purging." Throw in the weight gain caused by hormonal fluctuations in menopause and the stage is set for eating disorders.

Jenna was 38 when she first stuck a finger down her throat. "The feeling of wanting to be slim doesn't go away just because you get older," she says. When her husband of 10 years announced he was leaving her for a younger woman, his parting words included an insult about her weight.

"I associated the break up with being overweight, so I began dieting, bingeing and purging. It was like I had a pressure inside me that I had to release. As soon as I vomited, everything seemed better."

The Auckland lawyer says once she started losing weight, the compliments rolled in. "Society rewards women for keeping the weight off, but particularly older women who can conform to its ridiculous standards of beauty. We look at women like Madonna and marvel at her age-defying figure and sculptured arms and feel pressure to look the same way."

The more weight Jenna lost, the more praise she received. "By the time I was 40, I was vomiting up to six times a day. It got a bit tricky at work because I was always worried that someone would come into the ladies or notice the smell. But it gave me complete control over a time in my life when everything else - my marriage, housing situation, custody of our two children - was completely out of control."

Jenna's story has a happy ending: two years agoher mother took her to a doctor, and then a therapist, who helped her identify and deal with the issues that drove her to disordered eating. "Asking for help was one of the most difficult things I've ever done because, particularly in the legal world, being unable to cope is seen as a weakness. Thankfully, I'm much better now, but it's still hard to fight the behavioural patterns. The minute I get stressed, I think about bingeing and purging."

According to clinical experts, eating disorders can deliver a mind-body punch that kills more people than any other mental illness: patients of all ages can suffer from impaired brain function, infertility, kidney failure, cardiac arrest and dental decay. Older women are thought to be particularly at risk for damage to the heart, brain and bones.

"The longer a woman struggles with an eating disorder, the longer it can take to recover," says Marsden. "I would urge anyone suffering with this condition to seek treatment as quickly as possible."

For Andrea, who is currently back in therapy, every day remains a battle. "I still feel a strong urge to weigh less and the sight of food sometimes makes me feel queasy."

I ask her if she'll ever feel well enough to eat a piece of the lemon slice that signalled the end of Baking Mondays. "I am so sorry about that, I can only imagine what everyone thinks of me," she says, looking deeply embarrassed. "But I am getting better and you never know, one day I might be the one bringing in the sugary biscuits..."

- Sunday Magazine

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