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Friday, April 15, 2011

Over 30 or 40 and Struggling? You're Not Alone!



You carpool, cook and shop. You work at home without pay—childrearing, cleaning, managing the household—and perhaps at your job professionally. Universally bright, you are seemingly well-functioning to those who know you, at least superficially. Yet you’re ignorant about your own needs on so many levels. You’ve successfully gotten pregnant, and produced healthy children. Then proceed to ensure that everyone’s needs get met. That is, except your own. Most of you are in your 30’s, 40’s and 50’s. But some are still struggling into their 70’s. Yes, seventies.

You are my closest friends, from college and beyond, and my local acquaintances. You are my patients recently seeking care, and those struggling for a lifetime. And you are my blog followers from Australia to New Zealand.

And you have all managed to slip through the cracks for way too long, failing to get the help you so badly need, to acknowledge your eating struggle. You’ve successfully deceived family, denied concerns from friends, as well as the medical community, when they’ve had the occasional sense to ask.

In some ways, you are the riskiest ones. You see adult practitioners who are largely uneducated about eating disorders. And so they don’t know to ask the questions. And you certainly won’t volunteer the information. Instead, you get praised for your runner’s pulse and your low blood pressure, and for avoiding the middle age spread.
Usual signs of an eating disorder fall short in flagging you as at risk. Perimenopause or excessive exercise easily ”justify” a lack of menstruation. Low energy? Who wouldn’t be, with changes in sleep patterns associated with age. And besides, you function so well given the juggling that you do!

But let’s be real. We know each other too well. Please don’t minimize your disorder, attributing your eating issues simply to anxiety; selecting diet sodas and choosing a fat-free salad without the bread is a giveaway. And no, eating a breakfast or missing your exercise does not justify meal skipping.

Please don’t tell me it’s because you have a small frame, when you have never before maintained a size zero. And when XS-sized clothes slip off of you. No, there is nothing normal about being a zero.

Please don’t tell me “but I do eat!” when you know as well as I that it takes more than simply eating. Yes, it requires eating enough to support a healthy weight and a healthy body.

I’ve heard you say I’m just not hungry. And I know that’s honest and true. But you fill the voids with coffees and diet beverages. And with food restriction the hunger cues get lost. And so you really don’t feel hungry. And your anxiety, disordered thoughts and body image don’t make it any easier.

Please don’t suggest that you need your exercise to stay healthy and fit. You are only deceiving yourself. Physical activity supports health, but only when you fuel your body with adequate nourishment. Otherwise, you will slow your metabolic rate and suffer the many symptoms I’ve referred to above. And the very muscle you hope to build will be burned as fuel. It takes adequate calories from carbohydrate, protein and fat to fuel your body and maintain health.

Regardless of your absolute weight—even if it is in the normal range—if your thoughts and behaviors are disordered, there’s work to be done! You can be in the normal weight range or overweight while restricting and binging. That is no way to live.

And what impact is your eating having on those you care about, in particular, your children? Do you unintentionally, through your minimal food intake, convey what normal is? Do you role model denial using diet products or guzzling water when you are hungry, versus honoring your body’s cry for fuel? Do you send the message that food is the enemy? Do you set unrealistic goals for yourself as well as your children, suggesting avoidance of pleasurable foods, with lists of good versus bad foods to eat? Perhaps, simply passing on to another generation the very distorted messages you were raised on?


Loved ones read here

If you are a loved one wondering what the big fuss is, consider this. Restrictive eating consumes our thoughts and distorts our reality. It makes us irritable and contributes to depression and anxiety. It leads to social isolation, and contributes to losing one’s voice, so to speak. It’s numbing and protective, but impacts your loved one’s quality of life, and zaps her potential. It can lead to nutritional deficiencies, dehydration, muscle wasting, cardiac and renal issues. And ultimately, it can lead to death. And it impacts not only your loved one, but your children.

What do I do now?
It's not too late to change. I've seen it. It will be challenging, but it can be done. But don't put it off.

First, own it. Acknowledge that you are struggling with nourishing yourself.

Use your resources. Educate your spouse or significant other. Check out websites such as http://www.nationaleatingdisorders.org, www.somethingfishy.org and www.medainc.org, as well as the many other online resources.

Enlighten your MD. She relies on you to share to appropriately guide you.

Seek out a therapist to help you understand why this pattern of eating and thinking is helping you meet some needs. Then learn alternative ways of coping to slowly let the eating disorder go.

See a Registered Dietitian experienced with eating disorders to help you reality check abut your needs compared to your perceptions. Get correct information to allay your fears of change, and the consequences of failing to do so. A good RD will let you work on baby steps, while ensuring you stay safe.


And if you are not yet in the age range I describe, consider the writing on the wall. Where do you want to be in five years? In ten? Please take this post as a wake up call for change.

Share this post with your supports. And pass it on to anyone you know who might benefit from this wake up call. Spread it on Twitter, Reddit, Facebook, Stumble upon or simply via email.

I do care what you have to say, so please leave a comment!

12 comments:

  1. One of the biggest motivators for my recovery has been the older women I have been in treatment with. The first time I went to an eating disorder support group and heard these middle-aged women describing their struggles, I thought, "I don't want that to be me." My heart breaks for those women, but their struggle also pushes me forward. I have already been struggling with this eating disorder for 12 years - no need to make it 20 or 30.

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  2. Up until about 6 months ago I did not know that someone my age could have an eating disorder - I thought I was too old. It was not until my early-childhood nurse (who has known me for 8yrs) insisted I go to my gp did I find this out. I don't know how long I would have remained in the dark if not for her.

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  3. Excellent post! None of my close friends (in late 30's to mid 40's) have an eating disorder -that i know of - but more than a few struggle with disordered eating and serious body image issues. I remember so well my close friend during dietetic internship back in 1993-1994 -everyday at lunch a green salad -no dressing, water and a yogurt. the same lunch every day that whole year!!!! We did not keep in touch, she went on to do her masters and has a very prestigious job as an RD -i often wonder about her, now approaching 40's too, I never had the courage to confront or discuss it with her back then....but i knew . This post immediately brought her to my mind. In fact, there were only 8 of us in internship, i believed another girl had an eating disorder then too. Eating disorders are not only affecting women of this age group, ED's are lurking in the shadows of our profession.

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  4. Hopefully this post has raised awareness--both of those around us who might need support, and of what life could be like if we don't initiate change from our unhealthy ways.

    AnonymousRD- eating issues I'm sure are more prevalent among dietitians, just as depression and anxiety are more prevalent among mental health professionals. One would hope that before embarking on their professional life they would have resolved their issues.Yet, regrettably, some patients are healthier than their treaters!

    Thanks for your comments!

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  5. Miss Metabolic MayhemApril 19, 2011 at 7:42 AM

    Oh my....is it possible that years of an eating disorder (anorexia in my case) can limit one's physical capacity to increase one's metabolic rate? I was recently told (after BMR testing)that my metabolic rate was 400-500 calories under what a typical woman of my age and height normally have...I want to attempt to raise it through jogging again...but will the metabolism simply refuse this and perhaps lower itself even further? After seven years of no menses..they have returned for the past four months... I am stymied as to why my metabolism seems to "refuse" to kick in...I am eating mindfully and trying to eat according to my hunger cues (only recently returned)...Do we actually become "broken" after a time in regards to metabolism? I would find it sad to realize that I would always have to strictly survey caloric intake..due to my past, long-term nutritional mistakes. Does age and length of illness factor in? Any thoughts you may have would be immensely appreciated..

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  6. @ MissMM
    Without knowing all the details, my first question is Is your caloric intake adequate to support a healthy weight? if not, then it needs to increase, and in doing so, will increase metabolic rate. If your heart rate and body temp run abnormally low, if you miss your periods, likely intake remains inadequate.
    If you maintaining in the range, but calculated calorie need appears low, could be that you've lost some muscle mass over the years of restricting. To build muscle, besides doing weight training, it requires both adequate protein AND adequate calories!
    Hope that helps.

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  7. Wonderful article. You are helping women to know that eating disorders affect people at any age. Adults suffer not only from the eating disorder but from the tremendous effort they use to function while keeping their disorder a secret.

    The next step, after awareness, is what to do about it. Help for adult women is not the same as help for teens.

    That's why I wrote Healing Your Hungry Heart. I was an adult with an eating disorder. Now I specialize in working with adult women with a past or active eating disorder.

    Tools and exercises exist to support adult recovery. When women know that eating disorders are prevalent among adults I believe they will take a more active and effective role in finding their recovery and freedom.

    P.S. and FYI I work with women from 21 - 73.

    Thank you for helping to bring awareness to the mature woman with an eating disorder.

    Joanna Poppink, MFT
    Los Angeles psychotherapist
    author: Healing Your Hungry Heart
    08/11 Conari Press http://amzn.to/grcDfG
    www.facebook.com/HealingYourHungryHeart

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  8. Late to the party but this post just resonated with my experience.

    I'm 32, alternating between binge eating and pretty much anorexic behaviour. I was anorexic some time ago (although I doubt I would match the diagnostic criteria, I'm just big and massive and I looked like a hungry teenage boy even with some 68 kilos) and then it somehow evolved to said binge eating alternating periods of living on steamed vegetables.
    I'm doing my best to cope, to learn to eat normally, which is sometimes pretty tough, starting from borked TMJs and my lessened ability to chew, to gluten intolerance (not coeliac, thank gods, the stuff just makes me miserable but it doesn't eat my guts away).
    The worst drawback is that apparently, in this country, eating disorders are only allowed to to teenage girls, most docs only laugh at me because, after all, I'm on antidepressants so I'm just being neurotic and if I tried harder, I'd simply lose that excess weight. And sometimes I get a brochure on eating healthy. At least my shrink takes me seriously but he's not an ED specialist. Still, I'm glad that he at least believes me.

    Now, I should lose weight. I'm pretty fat (BMI says pretty obese but I'm taking it with a huge grain of salt) and I don't like the decorative fat rings around my waist and the whole thing. I tend to lie to people, that I'm just fine but that's my old knee injury that could improve with weight loss. Because... there isn't a single day when my parents or some random acquaintance wouldn't nag that I should do something about weight / how can I eat ice cream when I'm that fat / whatever. I'm able to defend myself on the verbal level pretty well but it does hurt somewhere inside. And then I get my daily dose of chocolate or something greasy and retire to some hiding place to eat my noms in peace.

    It's one big tangle of things and since I'm confined to the internet when seeking for advices, ideas or some positive reinforcement, it's always heart-warming to hear that things can be dealt with.

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  9. Hi, Liisa. And, you're never too late to the party (or too old to change your relationship with food). Can you find an ED team where you live? I hope you'll find support from the various posts on this (and other) sights.There REALLY is hope. If you can't find an RD there with this focus, do get back in touch. But stay in touch and comment often anyway. You are not alone in your struggle.

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  10. Hi Lori, thanks for the kind reply.

    I feel somewhat grumpy today and don't want to start my whinefest here. I poured part of the crap out on my blog (accessible via my profile) should you, or anyone, for that matter, be interested. Also, I had some mind-boggling experiences with RDs and docs. A real ED team lives some 350km away from here but as I reckon, they work moreless with people who are in imminent risk of death or long-term physical damage, from what I read and heard.

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  11. 43 this year.
    in recovery for AN, 5 years down this time.
    every day is hard.
    we aren't actually as invisible as everyone sees, they just think we should know more so mum and blind fit the bill.

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  12. This post was right on. I am an adult woman with anorexia and even hearing myself say it I can hardly believe that this has been my life for 20+ years. I feel so much shame in being a 'grown-up' with an eating disorder. I feel alone and that no one understands. My dad recently said, "she's so smart, I don't understand how she let this happen'. It makes me sad to hear those words and sometimes I think them, too. I've had healthy times, and I've had relapses. They suck and make me feel like a bigger failure each go around.
    Your post makes it clear that you understand how my brain tricks me, how Ed says all is fine. I am fine despite that my weight has plummeted, not the biggest issue, not that my hair falls out in the shower each morning. I forget stuff daily, can't complete a sentence and lose thoughts multiple times a day. How can I say this and still believe its not eds fault? I have no idea, but boy is he convincing. I hope you are right - that this 'old dog' can learn new tricks bc I really don't want to be writing these same words again in 20years. And I'd like to be able to believe some part of me

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