“As a teenager, I did not obsess about bingeing. I just did it on occasion. No big deal, I thought. As I got older, however – from my 20’s straight through my 50’s – it became more frequent as I strived for the ‘perfect’ figure. I tried every diet — I would lose weight only to gain it back. With every failed attempt I turned to food to cope. Before long, every thought of mine was about my next binge. It was consuming my life.”
These are the words of Nancy* from Pennsylvania, who unknowingly struggled with binge eating most of her life. At the age of 62, Nancy was diagnosed with binge eating disorder and sought treatment.
Some might say Nancy is not your ‘typical’ eating disorder patient – teenage/college age, single women. However, according to clinicians at The Renfrew Center, a nationally renowned eating disorder treatment facility, they have been treating women similar to Nancy in age, and even older, for the past 31 years. In fact, The Center has seen a 42 percent increase in patients in that age range who have been in the residential level of care.
Why Midlife Eating Disorders?
Women in midlife face many of the same eating disorder struggles as adolescents and younger women (i.e., body dissatisfaction, body image distortions, fear of food) — however, these issues are often exacerbated by the added lifespan concerns that accompany the aging process. Often, women in midlife find themselves faced with new stressors, such as marital discord, divorce, ‘empty-nest syndrome,’ menopause, chronic illness, career changes, and rumination over “what have I accomplished in my life?” Our society’s emphasis on youth and thinness is an overriding factor that is difficult for this age group to disregard. Loss is also a serious issue for women at midlife – whether it is the loss of youth, the loss of children heading off to school or living independent lives, or the loss of elderly loved ones.
The majority of midlife women with eating disorders have usually experienced some degree of disordered eating in their past. Many have struggled with episodes of anorexia, bulimia or binge eating disorder in their teens and twenties; others had untreated disorders which re-emerged in midlife. For some at midlife, however, a crisis or trauma can be the trigger for an eating disorder when there is no reported history leading up to the event.
Unbeknownst to Nancy, her eating disorder began at age 13 with those occasional binges. As she grew older, food became her coping mechanism when life threw curve balls, whether it was a failed diet or dealing with family stressors. The more she relied on food, the more food she consumed. She was always thinking about where she would get her next round of food, where she would eat it, how would she get rid of the ‘evidence,’ etc. It was controlling her life.
As she entered retirement at the age of 60, Nancy was determined to get healthy. To accomplish this she thought she had to get skinny with yet another diet. She met with her primary care physician to discuss a new diet pill. As the conversation progressed, Nancy was shocked when her doctor said it wasn’t a diet pill that would make her healthy; she needed to seek treatment for her binge eating disorder. Binge eating disorder is characterized by episodes of uncontrolled eating or bingeing followed by periods of guilt and depression. It was with that diagnosis and referral to The Renfrew Center of Southern New Jersey that started Nancy on her recovery journey.
She attended Renfrew’s Intensive Outpatient Program three evenings a week for two months. With a multidisciplinary team of therapists, dieticians and a psychiatrist, Nancy began addressing issues that were driving her eating disorder. She found that understanding the different parts of her emotions and learning to tolerate them without engaging in her eating disorder symptoms were extremely helpful in the healing process and in everyday life situations. Furthermore, she discovered support and strength from the community of women with whom she attended the program. No matter their age, diagnosis or where they were in their recovery journey, she related to each of them on some level.
Approach to Treatment or Eating Disorders
Midlife women often report they are slow to seek treatment because they experience feelings of guilt for leaving behind their family members or work obligations. They are accustomed to putting everyone else’s needs above their own.
The good news is that treatment tends to be successful for this demographic, because the women often are motivated and devoted to their recovery. So much of the treatment process is recognizing they are worthy of recovery and deserve to be happy.
In response to the increasing number of midlife women seeking treatment, The Renfrew Center has designed specialized programming to help meet this population’s unique needs. The Thirty-Something and Beyond program allows women 30 and above to address their own special issues within a community of their peers – women struggling with similar issues around nutrition, wellness, relationships, exercise and self-nurturing.
For Nancy, her healing is an ongoing process; she attends a weekly Eating Disorder Outpatient Group to keep herself on track. “I am still working towards full recovery, but binging thoughts don’t consume me anymore.”
*Name has been changed to protect patient’s privacy.
Holly Grishkat, PhD, is the Regional Assistant Vice President and Director of Quality Management. She received her Bachelor’s degree in Psychology from Allegheny College, her Doctoral degree in Experimental Psychology from Bryn Mawr College and she re-specialized in Clinical Psychology at Widener University. Dr. Grishkat has been with The Renfrew Center for 15 years in both clinical and administrative roles, providing direct patient care and leadership to frontline staff. She has led start-up operations for The Renfrew Centers of Baltimore, MD; Mount Laurel, NJ; Pittsburgh, PA and Radnor, PA. Most recently, Dr. Grishkat has taken on direction of quality management at The Renfrew Center. Dr. Grishkat is a member of the Pennsylvania Psychological Association.