The Scary Rise in Adult Eating Disorders

By Jenny Deam

Eating disorders leaped into the national conscience in the 1970s and ’80s, when the number of diagnosed cases exploded. The patients were adolescent girls, many of whom became anorexic or bulimic as a means of controlling their bodies—and, by extension, their lives—as they made their way through puberty. So many girls fell victim that eating disorders were branded a teenage disease. (And experts continue to see a troubling number of cases among teen girls, says Ovidio Bermudez, M.D., board member of the National Eating Disorders Association.)

Yet lately doctors have noticed a disturbing spike among a different group: women in their late twenties, thirties, and forties. At the Renfrew Center’s 11 treatment locations, the number of patients over age 35 has skyrocketed 42 percent in the past decade.

Likewise, a couple of years ago at the Eating Recovery Center in Denver, an estimated 10 percent of patients were over age 25; today, a whopping 46 percent are over 30. And when it opened in 2003, the University of North Carolina’s Eating Disorders Program was designed for adolescents—now half of its patients are over 30 years old.

Just like their younger counterparts, adult eating disorders deliver a mind-body punch that kills more people than any other mental illness. Patients of all ages can suffer impaired brain function, infertility, dental decay, or even kidney failure or cardiac arrest.

But while the teen and adult diseases share physical symptoms, and both can be tied to deep psychological roots, their catalysts are quite different, says psychotherapist Jessica LeRoy, of the Center for the Psychology of Women in Los Angeles.

“As women get older and their lives evolve, so do their stressors and triggers,” she says. These can nudge the door open for an eating disorder. But research on the adult-onset versions is lacking—and without sufficient tools and awareness, women are being misdiagnosed.

For decades, the eating disorder lexicon had two main entries: anorexia and bulimia. But modern research reveals that these fall woefully short of encompassing the many facets of disordered eating. In the early ’90s, the American Psychiatric Association introduced a new diagnostic category: eating disorders not otherwise specified (EDNOS).

A catch-all label that includes dozens of subdiagnoses, EDNOS applies to patients who don’t meet the exact criteria for anorexia or bulimia but still have very troubled relationships with food or distorted body images. Today, EDNOS diagnoses significantly outnumber anorexia and bulimia cases.