It’s natural for older people to lose their appetites as they age to an extent. Health problems and less exercise can be physical causes for this, while many find preparing proper meals inconvenient if they are living alone. A lack of routine in retirement, not wanting to cook for themselves or having relied on a now deceased partner to do the cooking can all make maintaining a balanced, healthy diet tricky.
An eating disorder is a mental health condition that affects a person’s relationship with food.
Eating disorders are more common in teenage girls, not helped by the pressures of social media and filters that entice girls to strive for a perceived image of perfection. Eating disorders have been around for many years and can affect people of any age, gender or race.
Eating disorder charity Beat estimates that around 1.25 million people in the UK live with an eating disorder.
Many people follow diets or have preferences about food that some may find strange, but this dosen't mean they have an eating disorder. A change in eating habits could be a side effect of a physical illness or even another mental health problem, like depression.
Older people turn to food for comfort like we all do and it’s one of the main pleasures left in life. Whether that becomes an eating disorder is a fine line, that overlap between emotional eating and an eating disorder, but I do think sometimes it veers into binge eating. Also, the interaction between depression and how you can have a loss of appetite when you’re depressed versus eating disorder, it’s quite difficult to diagnose and tell the difference between the two.
Some symptoms of an eating disorder include:
Developing a deep interest in food that could be considered almost obsessive.
Becoming very sensitive about topics related to their eating.
Having reasons why they don’t eat the way they used to that you suspect aren’t true.
Developing strict rules and rituals around food, such as not eating before certain times, always eating from a certain plate or denying themselves food before they’ve “earned” it through exercise or other work.
Dramatic weight loss is certainly a sign but only 10-15% of people with eating disorders are classed as underweight. Dramatic weight gain can also be a sign.
An extremely negative view about the way they look, not just their weight.
Over-exercising or insisting on doing a daily exercise routine without fail.
Mood swings or becoming withdrawn.
Difficulty sleeping despite being very tired a lot of the time.
People who are not eating properly are often cold all the time.
Results from blood tests revealing issues like a low thyroid, low blood cell count or vitamin deficiencies.
Dental problems such as tooth decay or easily-chipped teeth.
Why Do Older People Get Eating Disorders?
For older people, eating disorders are less likely to be about the way they look, and more motivated by emotional factors.
Those who develop eating disorders in later life, bereavement seems to be a dominant aspect in that. Health professionals around them are often quite slow to pick up on that it’s an eating disorder and not grief.
We also seen that identity reasons can be a trigger. If you’ve been a mum and your children have grown up and left home, or you have retired from a career you enjoyed, that crisis of identity can absolutely impact. Any major transition in life can kick start an eating disorder.
Over the spectrum of life people use food as a means of communicating. Older people do use food as a means of communicating how they feel. It purveys more areas of life than people realise. Elderly people are losing control of lots of different things in their life, physical, capability, maybe feeling more isolated.
Older people can be more concerned about their health than younger people, with age and lifestyle-related diseases becoming a worry. This can sometimes be a trigger for orthorexia nervosa, an unhealthy obsession with healthy eating.
It isn’t easy to see a loved one struggle with an eating disorder. Much of the support available is aimed at parents of teenagers but having a parent or spouse with an eating disorder can be a very different experience. Not having parental authority over the person can make you feel helpless or even like your attempts to help are intrusive. Being in a caring role to a parent, losing that nurturing figure in your life as the roles reverse, is hard, especially when you know they lie to you all the time or regularly put their dietary restrictions before you in their priorities.
It’s very easy to be angry in situations like this, particularly if your loved one is in denial or refuses to get help. In the UK, unless someone is eligible for sectioning, they cannot be forced to seek professional help with mental health issues.
It can be more difficult for an older person with an eating disorder to seek help. Mental illness was a taboo subject in the past and older people can still be troubled by this stigma, despite it being a widely discussed and accepted topic today.
They may also lack motivation to get better. Ms Griffiths says: “What we use as motivators for change in younger people don’t always apply for older people. Quite often we’ll use those physical side effects to say well you might get your periods back, you might get your fertility impacted, and use those as motivators for change. But with older people, especially if they’ve been bereaved, you have to process that loss. Obviously the deceased loved one is not going to return, regardless of whether the person recovers from their eating disorder or not.”
Are eating disorders common in older people?
Eating disorders such as anorexia nervosa are typically assumed to be an illness that only affects teenage girls. However, eating disorders can affect people of any age or gender. Older people are increasingly being diagnosed with eating disorders as awareness and discussion around mental health improves.
What are the signs of an eating disorder in an older person?
Signs of an eating disorder are many and varied. The most common signs your loved one may have a problem with food include dramatic weight loss or weight gain, an unhealthy obsession with food, strict rules around what they will and won’t eat, and becoming secretive about their eating.
What can trigger eating disorders in older people?
For older people, eating disorders are usually an emotional response to trauma or a change in the lives. Bereavement is a common trigger. Often restricting their eating is a way of gaining control where they don’t have control over other parts of their life. Losing control of their eating and compulsively overeating can also become an eating disorder.
Can eating disorders be harder to treat in later life?
It is never too late to seek help for an eating disorder and anybody of any age can fully recover. What is more difficult is diagnosis, as older people often have other mental or physical health problems which may make spotting the eating disorder harder. Mental health was also not spoken about in the past, so they may not realise they have a problem or be afraid to seek treatment.
Is there any support for families of older people with eating disorders?
Having a parent or grandparent with an eating disorder is a very different relationship to having a teenage child with one. It can be extremely distressing to see somebody you care about struggling, especially if they refuse help. Eating disorder charity Beat recognises this and runs support services for friends and families. You can also get support via your GP, even if the person is not receiving treatment.