Eating Disorders in Midlife: An Overlooked Issue
About 28.8 million people in the U.S. are expected to be diagnosed with an eating disorder during their lives, with women being the most affected. While disordered eating—like anorexia, bulimia, and binge eating—is often linked to young women, it’s clear that women in midlife can also develop or relapse into these disorders. In fact, nearly half of those treated for eating disorders relapse, according to a 2019 study from the University of California, San Francisco.
Some have even coined the term “menorexia” to describe the onset of eating disorders in menopausal or perimenopausal women, mixing the words menopause and anorexia. This shift seems to be a growing concern, though research and treatment for this demographic remain scant. According to Samantha DeCaro, a psychologist and director at the Renfrew Center, we’re missing crucial insight into this issue because adults developing these disorders are often underrepresented in studies and treatment facilities.
“Midlife adults meet the same diagnostic criteria as younger patients,” DeCaro explains, mentioning that they struggle with bingeing, purging, and restricting food. But clearly, they face different challenges: menopause, divorce, empty nest syndrome, chronic illness, changes in physical appearance, and the pressures of aging in a society that emphasizes youth.
Many individuals can trace their issues with food back years. Some report having struggled with body image since their teenage years, only to cross into disordered eating as adults. For others, who might have felt comfortable with their bodies until middle age, the fixation may come as a stark and disconcerting surprise.
“I think many midlife eating disorders go undetected because they don’t look like what we typically think an eating disorder ‘should’ look like,” shares Erin Parks, co-founder and chief clinical officer at a virtual treatment platform. Currently, a quarter of their adult patients fall within the midlife category (ages 40-65).
Earlier this year, Parks’ organization surveyed over 1,000 adults over 40 to understand the issue better. They discovered that 35% of women reported developing disordered eating behaviors for the first time during midlife. “I think many midlife eating disorders go undetected because they don’t conform to our classic ideas of what eating disorders entail,” Parks states.
Beliefs grounded in diet culture—where thinness equates to health—can often mask unhealthy behaviors as “wellness,” like skipping meals, excessive exercise, or strict dieting. While women are notably affected, men also experience their own struggles. Parks pointed out that 39% of men reported feeling worse about their bodies with age, yet their symptoms are frequently overlooked or misattributed to other issues.
Hormonal changes during menopause and andropause significantly contribute to these disorders later in life. For women, estrogen levels can plummet by about 60% during menopause, leading to alterations in body and mood. This, Parks notes, creates a tangible sense of losing control over one’s body.
Men, too, face challenges; as testosterone declines about 1% annually after age 25, this can result in increased belly fat and decreased energy. Moreover, eating issues might sometimes be driven by medical professionals suggesting weight loss as a remedy for conditions like high blood pressure or elevated cholesterol levels. Lauren Muhlheim, a psychologist, pointed out that many of her midlife clients are trying to manage health conditions but could potentially trigger an eating disorder through dieting and exercise.
DeCaro emphasizes that eating disorders are not born from a single factor but can develop from a “perfect storm” of stressors during sensitive life stages, including menopause, grief, chronic illness, and ageism.
Advice for Those Concerned About Eating Disorders in Midlife
DeCaro explains that eating disorders extend beyond just food and weight—they’re also deeply emotional. Recovery often involves rediscovering one’s own needs and desires.
Recognize that Body Changes Are Normal
If you find yourself fixating on your body changes, it might be helpful to think about all the things your body has allowed you to do over the years. It’s perfectly normal for bodies to change, especially during hormonal shifts, and it’s unhealthy to become overly obsessed with weight or diet. Such focus can detract from enjoying life.
Seek Specialized Care
Eating disorders are serious issues that may require specialized treatment. If you’re facing struggles, getting a professional assessment can help determine the appropriate level of care to meet both medical and emotional needs. Virtual care can be particularly beneficial for midlife individuals balancing work and family commitments.
Connect with Others
Eating disorders flourish in isolation. Finding connection with others who understand can be powerful in recovery—whether it’s through support groups or shared stories in podcasts and memoirs.
Be Wary of Diet Culture
Be cautious of messaging that promises to reverse aging or return you to your prior self. Such narratives are common and can be particularly triggering during midlife transitions. There’s a strong need to shift the conversation from managing aging bodies through fad diets to supporting them with compassion.
In short, eating disorders at this stage of life warrant attention and understanding—not just from the individuals affected, but from society as a whole.
