Eating Disorders Flare-Up in Midlife
Recently some old foe of mine, binge eating disorder, returned without warning. I was baffled. How did this happen? I battled severe eating disorders when I was younger but I kept it pretty much under control for the past 10 years. I was hoping that things surrounding food and weight would get even easier as I cruised into midlife, but I was wrong, binge eating disorder came back with a vengeance.
Female Purgatory
Midlife and peri-menopause (aka female purgatory) sneaked up on me. I was not prepared for the ferocity of the infamous hot flashes let alone all the other fun symptoms: Sleep problems, night sweats, mood symptoms, concentration and memory problems, difficulty to exercise or keep weight under control, change in menstrual patterns, and a redistribution of body fat around the middle. To top this my friends, who have entered purgatory a little ahead of me, assured me that I still have a lot to look forward to such as decreased sexual interest, becoming best friends with lubricant, and muscle mass that disappear overnight. Oh man.
I Fell Down
As predicted, muscle deterioration came knocking at my door only a few weeks ago. I was squatting down in a store to admire something on a bottom shelf (as I have done a thousand times before), and when I tried to get up, I simply couldn’t. Instead, I toppled over into the aisle, to the horror of my kids. Luckily there is also something empowering and positive that happens to us during the middle years: An attitude of “I don’t care a hoot what people think anymore, whether I’m laying on the ground in Target or wearing sweatpants and no make-up to a party.” In fact, people should not mess with a woman in purgatory if they value their lives.
Denial Followed Close Behind
This all started up again about a year ago. I found myself consumed with thoughts of food, diets, and weight control, and worst of all, I could not stop binging. This, of course, meant I did not fit into my clothes and I felt like a total failure. For crying out loud, I wrote a book on this stuff, surely I could figure it out. So, I initially hid behind piles of denial and believed that I simply had to do better: Eat less (much, much less), exercise more (much, much more), make elaborate food and exercise plans, restrict food, and isolate myself until I look and feel better. It sounded exactly like a phrase from my journal years ago when I was in the midst of an eating disorder. What was going on? After more months than I care to admit, I couldn’t fool myself any longer, I knew I needed help. I stopped the diets, told my family and my doctor that I fell of the wagon, and started the process of getting the help I needed.
What Does The Research Say?
When I started researching the link between eating disorders and midlife I found that I was not alone. In her excellent book “Midlife Eating Disorders” Dr. Cynthia Bulik talks about the scores of clients she worked with that had an eating disorder flare up again (or for the first time) during midlife. According to her research binge eating disorder had been the most prevalent disorder, but she also reported cases of people who battled anorexia and bulimia. Interestingly, the most likely group to develop binge eating disorder was women in their mid-years. The average age in the US for peri-menopause is 50 and last approximately 4 years, however for some people it can last anywhere from one to ten years.
Don't Throw Away The Men
Dr. Cynthia also referred to men who battle with eating disorders in midlife. She calls this life stage “Manopause”, which is a time around 50 when men indeed go through some changes: Weight shifts to the midsection and love handles becomes a thing. Also, hair thins, or disappears, or migrate to parts of the body where it never used to grow. They also have to work harder to stay in shape, they also get injured, and their sex drive also decreases. The urge to recapture youth and become more muscular or leaner propel many men into eating disorders, with binge eating disorder in the lead.
Why Midlife?
Here are Some Key Reasons Why Eating Disorders Show Up in Midlife:
- Infidelity
When there had been infidelity in a relationship people may stop eating or turn to uncontrolled binges for distraction and relief. A binge can actually bring momentary relief, but it quickly becomes a nightmare. Dr. Don Baucom, an expert on couple interactions, said the following about infidelity: “Finding out that your partner was unfaithful creates a deeply visceral sense of shock, disgust, and disbelief. All that you believed about your partner and your relationship is destroyed. Your sense of control is gone, and there is nothing safe left to cling to.” No wonder so men and women turn to food or other substances to escape from the horror of infidelity and to feel better. - Divorce
Along the same lines, the deep devastation that usually accompanies divorce can also trigger either restrictive eating or binge eating. This could also happen a year or so after the divorce had been finalized and most of the drama is over. Other triggers such as loneliness or the fear of being back in the dating game may show up. This can also affect both men and women, depending on who had been the most harmed emotionally, financially, or mentally by the divorce. - Empty Nest
An empty nest can trigger eating disorders in both moms and dads. The primary caregiver many times experience a loss of identity after focusing on the kids for many years. This can trigger a low mood and disordered eating in some people. Some couples stop making healthy meals and eat out a lot, which does not help if there is already a tendency to binge eat. Others experience difficulty in their marriage relationship due to the huge shift in the home, and they can easily self-medicate with food or other substances if they do not get couples counseling to help them. - Troubled Nest
Many middle-aged people are shocked and disillusioned when they expect parenting to get easier and then encounter a whole new set of challenges such as adolescent or young adult children who face medical illnesses, psychiatric problems, legal issues, unemployment, or their own relationship or financial problems. These problems can cause stress, resentment, marriage problems, and no time for self-care. Many caregivers find themselves eating on the run and they have no time for exercise or relaxation. This stressful situation can easily cause moms and dads to turn to binge eating, purging, or self-starvation for stress relief, or an attempt to feel in control of something in their lives. - Bounce-Back Children
Currently, many midlife adults are facing an interesting cultural phenomenon that their parents did not have to face: Three generations living under one roof. Children leave the home later or return and aging parents live longer and need care. This situation can become super stressful as issues such as rent, grocery bills, laundry, cleaning assistance, sex, alcohol, and drugs are bound to arise. The anxiety and conflict need an outlet and food is an easy and affordable substance to turn to. - Retirement
People may fall into eating disorders due to unstructured days and nights associated with retirement. After the initial honeymoon period, all the free time can cause people to feel lost and directionless and turn to food to fill the empty hours. - Unemployment and Financial Concerns
Financial triggers such as unemployment or underemployment can erode financial portfolios and nest eggs that people worked on for years. Financial concerns can have far-reaching concerns that affect people’s lifestyle, their children’s education, and their retirement. People tend to look for ways to take off the edge and get through the shock and uncertainty, so they turn to food or starvation. - Illness or Surgery
An illness or a surgery, specifically bariatric surgery can trigger anorexia as some people restrict certain food. Dr. Maureen Dymek-Valentine, a clinical psychologist who has worked extensively with individuals undergoing bariatric surgery said, that many of her patients have long histories of dieting, which always ended in frustration and weight regain. They have dealt with low self-esteem and social stigma and suddenly they lose weight and feel great. However, many of them become fearful of eating even small amounts because they’re terrified of going back to the dreadful past and so they develop anorexia. Some patients, in fact, continue to struggle with binge eating disorder after the surgery and gain the weight back, because life’s stress and triggers do not go away after surgery. - Perimenopause and Manopause
This can be a very challenging time for men and women who struggled with eating disorders in the past. All the changes can be very triggering. Some people may turn to excessive exercise. Others who are not able to exercise due to injuries may instead restrict calories, purge, or use diet pills, or diuretics.
Some women actually have unpredictable food cravings or an urge to binge during peri-menopause because of hormone fluctuation.
Hormones fluctuation can also cause depression which in turn can trigger binging or restrictive eating. - Death of a Loved One
Bereavement can cause depression which can cause a loss of appetite or binge eating. Grief can lead to self-neglect, which in extreme cases can turn into a passive suicide through starvation. What may look like an eating disorder may, in fact, be bereavement and depression and such a person should get medication or psychotherapy. - Trauma and Abuse
Trauma and abuse from the past or present can unleash whatever underlying genetic predisposition to mental illness one may have, such as eating disorders. Memories of abuse can be ignited when the abuser ages, becomes sick or dies. Being in an abusive adult relationship can also trigger emotions from the past, which can trigger or reignite eating disorders.
What Can Be Done?
- Get physical and mental help: Midlife is a crucial time to take care of yourself so you can still be there for your family in the years to come. Start by making an appointment with your primary care provider, and also a mental health professional. It is very important that you get a team to help you deal with health issues as well as eating disorders. Also, if your peri-menopause or “manopause” symptoms are especially debilitating and you also have depression, anxiety, or another mental disorder you may need medication and a prescriber. Individual counseling can also help with trauma and abuse from your past, or the traumatic experience of going through infidelity or divorce.
- Join a group: There are excellent support and therapy groups that may help you. Divorce Care groups are very helpful to parents and children who came through the trauma of divorce. Bereavement groups can support you while going through grief after losing a loved one, especially a parent.
- Couples counseling may help with the many challenges couples face in midlife. If all the stress put a serious strain on your relationship, you will be wise to get help from a seasoned couples counselor ASAP.
- Family counseling can help with boundary setting and conflict resolutions within families. This can be especially helpful if there are three or more generations under one roof.
- Get help for children who have past trauma, mental disorders, behavioral problems, or other issues. School counselors can help you and you child get in touch with great resources. A therapist can help your child with mental and behavior problems, while a psychiatrist or psychiatric nurse practitioner can prescribe medicine if needed.
- Remember with bounce-back kids that it is still your house. Adult children should stick to terms just like any other adult who is renting a room from you would. Terms can include rent, a contribution to grocery bills, laundry and cleaning assistance, curfews, limits on noise after certain hours, negotiation for sharing the television or the car, and a frank discussion of any limits regarding sex, alcohol, and drugs in the home.
- Empty nesters or people in retirement may need to build a new structure into their routine and find a sense of meaning and purpose to not fall back into eating disorders. Counseling or career coaching can be very helpful in finding a new slant on life whether it is a hobby, a career, volunteering, traveling, renovating, gardening, learning to play an instrument, or going back to school.
Resources for You
We have Therapy Groups, including a group for people with eating disorders and food addiction, at Life Solutions Counseling in Beaverton OR. We also plan to do ONLINE groups in 2019, so let us know if you are interested. Our groups are real, inviting, and supportive and facilitated by a qualified mental health professional with years of group experience. Joining a group can be scary and awkward at first, but don’t let that keep you from the benefits of support, accountability, and friendship. Please call Heleen at (503) 914-2749 if you have any questions. Click here to learn more about our Therapy Groups
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Heleen Woest is a caring and skilled therapist who loves to help couples with relationship and parenting issues. She offers a safe space where couples can deepen trust, repair wounds, and communicate needs and wants to each other. **OFFER: 8 sessions of 90 minutes each for the low price of $80 per session (normally $160). Offer valid till December 31st, 2018. Call Heleen at (503) 914-2749 or CLICK HERE TO GET 50% DISCOUNT ON COUPLES COUNSELING
HOLIDAY SPECIAL TO HELP FAMILIES
Some families experience pain, chaos, and violence during the Holidays. Heleen knows about the many challenges and conflict that families face and she loves to help parents, children, and extended family members restore unity and peace.**8 sessions of 90 minutes each for the low price of $100 per session (normally $200).Offer valid till December 31st, 2018. Call Heleen at (503) 914-2749 or CLICK HERE TO GET 50% ON COUPLES COUNSELING
