The Rise of Eating Disorders in Women in their Early 50’s
Posted by on July 11, 2012 - 10:31am

In a study recently published by the International Journal of Eating Disorders, women in their early 50’s (midlife) show more symptoms of disordered eating and concerns over their weight and shape than women in their late adulthood (mid 50’s and over).  The concerns are comparable to those expressed only in young women.

Hoping to better understand the weight and shape concerns of women over the age of 50, researchers gathered data from this population through an online survey.  Clinical studies have shown an occurrence of late-onset eating disorders and an increase in inpatient admissions for women over the age 35.  Reports show that there are three ways the disorders appear: a chronic presentation of an earlier-onset eating disorder that the patient never fully recovered from, a relapse of a disorder that the patient has previously experienced, or the late-onset of a disorder without having previously experienced it.

According to separate population-based studies, while the majority of women with eating disorders over 40 did not present with late-onset eating disorders, 69% of the cases studied in women over 50 concluded that the disorder was late-onset.  So at this age, many women are dealing with a new disorder that may negatively impact their lives.

Studies have found that body dissatisfaction remains somewhat stable throughout the lifetime, with surges among younger women and midlife women.  Higher incidence of reported body dissatisfaction occurs among midlife women with a higher BMI.  Physiologically, the BMI of a woman typically
increases during midlife, levels off and then decreases around the age of 60 (among other bodily changes).  Interestingly, areas of dissatisfaction in younger women seem to remain the same into adulthood even with a changing body and changing fat distribution.

The study (published by the International Journal of Eating Disorders) found that 71.2% of women were attempting to lose weight at the time of the survey with 35.6% spending at least half of their time dieting in the last five years.  Overall, 41.2% checked their body size/shape at least daily and 40% weighed themselves at least a couple of times per week.  Vomiting (1.2%), laxatives (2.2%), diuretics (2.5%), diet pills (7.5%) and excessive exercise (6.8%) were the behaviors women reportedly used to control their weight within the last five years.

61.8% said their concerns occasionally or often negatively affected their lives and 79.1% said their weight/shape had either a moderate or even the most important role in how they perceive themselves.  63.9% reported thoughts about their weight daily or more.  Most women had no history of eating disorders (59%); however, 13.3% of those sampled said they currently showed eating disorder symptoms while 27.7% had in the past.

The researchers concluded that younger midlife women showed more disordered eating/weight concerns. A possible explanation in the discrepancy of rates of disorders and concerns among younger midlife women relative to late adulthood is the cohort effect, in which these midlife women may have been exposed to different, and perhaps a greater amount of, socio-cultural pressures than those in later adulthood.  Another explanation may be that body health and function becomes more important than physical appearance in late adulthood.  Also, midlife women may be experiencing symptoms of menopause that prompts an increase in fat and how it is distributed, compounded by a decreased metabolism that may put them at risk for disorders.

Sources:

http://onlinelibrary.wiley.com/doi/10.1002/eat.22030/full

Menopause management complex but possible!
Posted by on October 7, 2011 - 6:10am

Recently, I attended the meeting of the North American Menopause Society (NAMS) in Washington DC along with 1500 other health professionals.    The bottom line:    Estrogen is not the devil, but it is not the panacea for all things female!

When the large Women's Health Initiative was halted in 2002 due to some unexpected findings in women on hormone treatment, the use of hormones significantly dropped.   However, many women found that their most bothersome symptoms returned and some went back on HT with a bit more concern.

The conference focused on new data, much of it refined to look at subsets of women.   It has become significantly clearer that all women are NOT alike when it comes to their health status at the time menopause begins, their age at onset, and the intensity of symptoms. Thus, generalizing outcomes to all women makes little sense.

Here are a few key points that were discussed at the meeting and are currently being studied by researchers:

  • Ill effects in the WHI  participants were more predominant in women who were 10 years post menopause when it came to heart disease.    The latest research suggests that estrogen can make atherosclerosis (one cause of heart disease) worse in women who already have it, but it may delay or prevent it in women who still have healthy arteries.
  • There is an increased risk of breast cancer in hormone users but the absolute numbers were small and were more prevalent among those who took HR that contained both estrogen and progesterone.   Women on estrogen alone had risks similar to placebo.   There is growing interest in the role certain types of progesterone  used in combination therapy play in breast cancer risk.
  • There is a major concern about osteoporosis and bone fractures among aging women whose estrogen levels are dropping.   As one researcher put it, "breaking a hip (in older women) can  kill you faster than breast cancer".   Approximately 50% of women over age 50 will have at least one fracture and we know that hormone therapy significantly reduces that risk. Understanding personal risk profiles for these two conditions should be part of the decision process.
  • While there are more drugs on the market to help maintain bone health, there is more long term data available  on their use that is indicating some alarming side effects with prolonged use. Some of these side effects may be worse than those related to hormone therapy.
  • Researchers are finding that the stages of the menopause transition are quite complex and there may be several levels of the transition that may need different interventions.
  • Vaginal atrophy in women including breast cancer survivors  can be devastating and reasonable treatment options are sorely needed.
  • Since the WHI, there are new treatment options available today for menopause symptoms using different drug formulas and different means of applications (pills, patches, creams, gels and sprays) that may have reduced risk profiles.

That's just a sampling of the many topics discussed at this conference.    Our Institute has been awarded a grant from the Evergreen Initiative at Northwestern Memorial Hospital Foundation to create a decision making tool for women who are menopausal and having bothersome symptoms.    As a result, we will be focusing on all aspects of menopause this year through our educational and fact finding events and I encourage you to follow our blog for our latest findings.