Eating disorders may become habitual patterns of coping throughout life
Disordered eating habits started in childhood or adolescence may persist into adulthood. A study published in July’s issue of the Journal of the American Dietetic Association found that unhealthy eating patterns that start in childhood or teen years can spill over. They may even intensify with age.
Data from the 10-year study that followed 2,287 teens through early adulthood showed a sharp increase with age — 8.4 percent to 20.4 percent — in the number of young women resorting to extreme measures to control their weight.
The results are not a complete surprise to those working in the field of eating disorders. Individuals afflicted with an eating disorder tend to relapse during times of stress. Food restriction becomes a habit of coping - a soothing ritual that has become embedded in the way they manage anxiety.
Eating disorder therapists are seeing a resurgence of cases in middle-aged women. The Renfrew Center, a treatment facility for eating disorders with locations throughout the United States, has seen a 42 percent increase in the number of women over the age of 35 seeking help. That’s prompted the center to come up with a special program geared to their older patients.
In the minority of cases, an eating disorder seems to emerge in later adulthood, but experts believe that in those cases, patients may have always been lean and very careful about what they ate. “Then there is some major stressor that becomes a tipping point and this kind of sub-clinical disorder becomes full-blown,” says David Sarwer, an associate professor of psychology and director of clinical services at the Center for Weight and Eating Disorders at the University of Pennsylvania School of Medicine.
Many experts in the field believe that eating disorders, especially anorexia, are about controlling a chaotic or an overly restrictive environment – in a nutshell, an environment which leaves an individual without a sense of self-agency in the immediate circumstances of their lives. For years, many researchers and therapists, particularly of the psychodynamic persuasion, pointed out that anorexic young women typically came from homes in which high achievement was expected. Such patients would more typically have very scheduled lives and intensely involved parents. Other patients would be faced with disturbed family dynamics, such as divorce or parental animosity, and cope with the emotional burden by controlling the one thing they felt they could: food intake.
“Controlling what goes in your mouth is the last line of defense any of us have,” Sarwer said. “We can be told what to do and what to think. We can be pressured in all sorts of ways. But we decide what, if anything, crosses our lips.”
Eating disorders, and anorexia in particular, tend to be associated with perfectionism and obsessive-compulsive disorder. Although more men are being diagnosed with eating disorders, disorders of eating tend to be much more prevalent among women. While men more typically cope with stress or issues of control through externalizing behaviors (acting out) and substance abuse, women tend to turn inwards and perpetrate more damage on themselves. While anorexia and bulimia might be seen as a form of behavioral “acting out” they are a manifestation of a primarily internal cognitive process.