How Prevalent Is Binge Eating Disorder in Older People?

Binge eating disorder, as well as other eating disorders, is widely associated with teenagers and young adults. Although binge eating disorder is known to emerge in pre-teens and teenagers, it’s becoming clear that it can strike at any age. Just as adults over 40 are not immune to suffering from anorexia nervosa or bulimia nervosa, they are also susceptible to developing binge eating disorder. In fact, more older adults are seeking help from binge eating disorder treatment centers today than at any other time. They also experience the onset of this disorder after age 40 much more often than with other eating disorders.

A recent study reported 13 percent of women over 50 years old had symptoms of an eating disorder during the past five years of their lives. The same study found that over 60 percent of these women were dissatisfied with their body appearance and thought it negatively impacted them. In addition, 70 percent of them said they were currently trying to lose weight.

This is important as concerns binge eating disorder because it is so closely linked to body image, attempts to lose weight, and dieting. How so? Well, first it’s important to understand what binge eating disorder is comprised of. Here are the diagnostic criteria for binge eating disorder, per the DSM-V (which is the American Psychiatric Association’s official diagnostic manual, and to which binge eating disorder was added in 2013):

• Recurrent episodes of binge eating. An episode of binge eating is characterized by both the following:
  • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances
  • The sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
• Binge-eating episodes are associated with three (or more) of the following:
  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone because of being embarrassed by how much one is eating
  • Feeling disgusted with oneself, depressed, or very guilty after overeating
• Marked distress regarding binge eating is present.
• Binge eating occurs, on average,
  • at least 2 days a week for 6 months (DSM-IV frequency and duration criteria)
  • at least 1 day a week for 3 months (DSM-5 frequency and duration criteria)
• The binge eating is not associated with the regular use of inappropriate compensatory behavior (e.g., purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa.

Why Do Older People Develop Eating Disorders?

The above is a lot to unpack. It lists the symptoms psychiatrist use to diagnose binge eating disorder but doesn’t necessarily explain why the disorder develops, especially in older people. As mentioned, it’s tied in many cases to shifting body image and attempts to control weight. Binge-eating episodes are often a response to extreme hunger. Anyone who’s ever gone on a diet has experienced the feeling of being unsatiated by the limited food they’re eating. “Cheat days” act as a safety valve, for this but it can become easy to make excuses for why “cheating” on a diet is justified. However, binge eating as a release can become compulsive, and this is exacerbated by the hunger pangs that dieting brings on.

At Olive-Pyatt Centers, we promote intuitive eating, so diets are of course not part of our culture. But many of our clients have been dieting for years, and almost all are dissatisfied with their weight or body. This is true of both young adults and older ones. It is natural for people in their thirties and later to begin to gain weight as their body slows down. Attempts to counteract their newfound body dissatisfaction by dieting can lead to disordered eating behaviors, even in a person who never displayed them before.

Similar to the tumultuous physical and psychological changes experienced by teenagers and young adults, older adults also experience upheavals in their lives, such as relocating, and family and career changes. They may be forced to take on caretaking responsibilities for an aging parent who can still live at home with assistance. Combine these difficult situations with physiological changes (menopause for women; andropause for men) and weight gain, older adults may develop an eating disorder attempting to regain a feeling of control over their body and the unexpected events happening to them.

Signs of Binge Eating Disorder in Older Adults

It is more complicated to diagnose eating disorders in people over 40 than it is to diagnose eating disorders in teenagers. This is because some symptoms resemble age-related conditions common to virtually every patient in middle age and older. In addition, few gerontologists have the in-depth awareness and training needed to consider binge eating disorder a possible cause of symptoms like heart problems, diabetes type 2, weight gain, and high blood pressure. Alternately, binge eating disorder treatment centers most often employ specialists in psychiatry who are trained to recognize symptoms of eating disorders, examining both behavioral symptoms and physical ones.

Behavioral signs of binge eating disorder in adults are, for the most, part, the same as those found in younger people. They include:

• Food hoarding (hiding large amounts of food under the bed, in closets, and other places in preparation for the next binge eating episode)
• Eating rapidly during an episode, barely chewing food
• Eating to the point they feel extremely uncomfortable
• Inability to control the compulsion to eat enormous amounts of food in a short time
• Rarely eating out with others/always turning down dinner invitations

During a binge eating episode, people are frequently compelled to eat far more than usual, and sometimes eat to the point of experiencing physical pain from it. Since binge eating disorder symptoms do not include purging (forced vomiting), older adults with the disorder tend to gain weight. This exacerbates their dissatisfaction with their appearance and reduces their sense of self-control. Consequently, depression, anxiety, and obsessive-compulsive behaviors may increase unless they get help from binge eating disorder treatment centers.

Securing Binge Eating Disorder Treatment as an Older Person

Because of the potentially dangerous health consequences of untreated binge eating disorder, securing help is essential for an older adult’s long-term health. Many people with the disorder will dismiss it as simple overeating and convince themselves that this weight gain is just a natural occurrence. Friends and family might be able to help convince someone with a binge eating disorder to seek out a therapist or psychiatrist who can help diagnose it and develop a treatment strategy.

When the time comes to seek help, adults should consider the treatment center’s target clientele. Since many eating disorders present themselves during adolescence, some centers are geared toward teenagers. Older adults will be better served by finding a center that caters to adults, especially if a residential treatment program is required. You can reach out here to learn more about the residential program at OPC.