Women and Malnutrition

We all want to look our best so paying attention to the number on the scale and temporarily restricting calories after a weekend of over eating-or dieting periodically— can be a healthy way to control our weight. But for some women, counting calories and/or exercising excessively is a dangerous obsession that puts their health at risk.

If your efforts to control what you eat have gone to an extreme, it could be a sign of an eating disorder, says psychologist Margo Maine, PhD, FAED, CEDS, author of The Body Myth.

Eating Disorders Don't Discriminate by Age

Maine says that younger girls are particularly vulnerable to experience eating disorders when their bodies began to mature and change. But today the medical community is increasingly recognizing that women in their forties and fifties can also be at risk for similar problems. And while eating disorders usually aren't as obvious in adult women as they are in girls, their impact can be just as harmful.

Are You at Risk for Developing an Eating Disorder?

Some women who get eating disorders in middle age experienced the problem when they were younger and unfortunately it never fully resolved. Others might have been on the fringe of an eating disorder as a teenager but it never developed into a full-blown case. In either scenario, one major trigger can be the transition through menopause, which causes the metabolism to slow, hormones to shift, and other visible signs of aging to increase.

Feeling overwhelmed by the multiple demands of daily life in mid-age can also set off an eating disorder. "A middle-age women isn't able to focus on herself the way a younger woman can. She's usually juggling a job, a relationship, maybe kids and an extended family, all of whom expect a lot from her," Maine says. All of these stresses can cause her to feel out of control. One response may to exert control in areas she can—what she eats and how much she exercises.

Why Eating Disorders Are Easy to Miss in Adult Women

Maine says that in most women, an eating disorder usually doesn't progress to the extreme but instead hovers on the threshold (sometimes referred to as either "atypical ED" or "near anorexia"), with the woman monitoring her food intake intensively and using excessive exercise and/or other forms of purging to keep her weight at the lowest end of the acceptable range. Although the situation doesn't become as extreme as it might in a teenager, the behavior will still have a clinical impact on the patient, putting her at risk for serious health issues.

Since adult women with eating disorders don't typically become as significantly underweight as a younger person might, her family and friends often overlook the condition. In a culture immersed in unrealistic ideals of healthy and beauty, Maine says that many primary care doctors today even miss the signs of eating disorders in their middle-age patients. This means that many women are left without access to beneficial treatment.

Signs of an Eating Disorder

So how do you know if you, or someone you care about, could be experiencing any sort of eating disorder? Maine shares some of the common signs that could indicate a problem:

  • Planning the whole day around food.
  • Eating in a ritualistic way.
  • Refusing to eat out in restaurants.
  • Exercising compulsively to burn off calories.
  • Refusing to miss a workout even due to injury or illness.
  • Eating different foods than she feeds her family.
  • Being very judgmental about other people's weight.


How to Help

Maine says that the best way to approach someone else with a possible eating disorder is in a very gentle, caring way—without being confrontational. "Women with eating disorders tend to be perfectionists and have poor self-esteem. So if you hit them too hard with your concern, it may sound to them like a sense of failure in themselves instead of caring coming from you," she explains.

The good news, though, is that with the right support from a counselor and family, many women with eating disorders do recover. For more information about eating disorders or to seek help for you or someone you know, visit the National Eating Disorders Association's website or call their helpline at Helpline at 1-800-931-2237 for advice.

Margo Maine, PhD, FAED, CEDS, reviewed this article.



Margo Maine, PhD, FAED, CEDS, Maine & Weinstein Specialty Group, LLC interview 6 Sept 2013

The Body Myth: Adult Women and the Pressure to be Perfect (2005)
Accessed online 12 Sept 2013

National Eating Disorders Association
"Learn," accessed 12 Sept 2013