Alarming rise of mid-life anorexia: Thought only teenagers had eating disorders The pressure to look slim is taking a worrying toll on women in their fifties and sixties
21:37 GMT, 1 August 2012
00:50 GMT, 2 August 2012
Addicted to dieting: Margaret Bradley
Until the age of 54, Margaret Bradley had never bothered with diets. A naturally trim size eight, the petite mother-of-two from Swindon, Wiltshire, maintained her 7st 5lb weight by eating healthily, jogging and making regular trips to the gym.
‘People were always telling me I looked ten years younger,’ she says. ‘But when I was 54 I suddenly became worried that as I got older, I would lose my figure. So just before Christmas I decided to shed a few pounds so that I wouldn’t have to worry about gaining any over the festive period.’
Margaret limited her calorie intake to 1,250 a day and the pounds started to drop off, but she decided they were shifting too slowly for her liking, so she restricted herself to just 1,000 calories a day — half the recommended intake for a woman.
Within a year, Margaret was a dress size six and despite pleas from husband Keith, 67, a retired plumber, that she was losing too much weight, she continued to diet.
‘I ate porridge for breakfast and then had salads for the rest of the day,’ says Margaret. ‘I stopped going out for lunch with friends and eventually I began skipping lunch altogether — that way I could eat in front of Keith in the evening and pretend everything was fine.
‘A part of me knew I was losing too much weight but another voice said I shouldn’t become complacent and I should continue.’
Margaret was in the terrifying grip of anorexia. While the eating disorder is usually linked to teenagers and young women, she is one of a rising number of women suffering from what have been dubbed ‘late-onset eating disorders’.
Eating disorders in older women have increased by 42 per cent in the past 11 years. Perhaps most startling of all, women over 50 — and with an average age of 69 — comprise 78 per cent of all deaths from anorexia.
The effects of the disease are even more severe for middle-aged sufferers than teenage girls — within months Margaret’s body was ravaged.
She says: ‘I had to give up my job as a carer because I was too frail and I even felt too weak to safely hold my grandchildren. Yet even when my family begged me to eat, I didn’t want to.’
But it was just before her 60th birthday five years ago when she visited her GP with backache that she got a shocking wake-up call. ‘My doctor asked me if I was eating OK and I said yes, but she was concerned enough to admit me to hospital for tests.
‘The more my weight dropped the less often I stood on the scales. With hindsight, I think I just didn’t want to know how little I weighed, as I would then have to accept I had a problem.
‘So when my GP told me I was only 4st 4lb it came as a shock. I was hospitalised for two weeks and fed by a tube and given bodybuilding drinks.’
She adds: ‘Worryingly, a few months later my backache was diagnosed as osteoporosis — caused by constant dieting and a lack of calcium, which was making my bones crumble.
‘I was horrified when the doctor said I had anorexia and if I didn’t eat more I could be dead within months. I thought anorexia was something only teenagers got. And although friends had asked if I was OK, no one had mentioned it could be an eating disorder.
‘I now know that as an anorexic you don’t acknowledge what you are doing to your body. And your mind is confused — I was in denial. I didn’t even buy smaller size clothes. Instead I wore baggy jumpers and fastened the belt tighter on my jeans.’
A recent study released in the International Journal of Eating Disorders found 70 per cent of women over 50 are trying to lose weight. ‘We are aware that increasing numbers of mature women are seeking help for their eating disorder,’ says Mary George, of Beat, the UK’s leading eating disorders charity.
‘Many are juggling a professional life with running a home and family and quite often, an eating disorder is triggered by an emotional trauma — which could be bereavement or divorce.’
Clinics such as the Priory, which regularly treats patients with eating disorders, are reporting an influx of women in their 40s and 50s suffering from anorexia.
‘We are in the middle of an epidemic of women who are not satisfied with their body shape,’ says Dr Alex Yellowlees, a consultant psychiatrist and director of the Glasgow Priory. ‘Women of middle age are emerging as increasingly vulnerable to developing an eating disorder.’
He believes women aged 40 and over are particularly prone because, like adolescents, who are going through the transition from child into adult, middle-aged women are also going through a transitional period.
‘Often it’s a time of great reflection on their lives,’ says Dr Yellowlees. ‘Their children are flying the nest and they are going through enormous change as their bodies approach the menopause.’
He cites celebrity culture — and its worship of age-defying stars such as Madonna, 53, Sharon Stone, 54, and Elle Macpherson, 49 — as one of the main causes of anorexia in mid-life.
‘All around them women see images, which are often airbrushed, of celebrities with perfect figures. Sometimes these are older women — and this, coupled with our preoccupation with looking younger, means for many women looking younger is equated with being slim.
‘On top of that, our expectations of life beyond 50 are higher than ever. Women still feel pressure to keep fit and youthful, to have a good sex life, a good career. It all takes its toll.’
Now 65, Margaret’s weight has stabilised at 5st, but she has a body mass index of just 15 — a healthy BMI is between 18.5 and 24.9 — and her health has been permanently affected. Tests revealed the osteoporosis was causing her spine to curve so much she is now just 4ft 8ins, having lost four inches of height since developing anorexia.
‘It’s been devastating,’ she says, ‘I am in such pain I can hardly walk up the stairs. Doctors can’t reverse the loss of bone strength — the damage has already been done.’
Margaret still struggles to eat and is currently receiving counselling. ‘Ironically, I thought dieting would keep me young but, instead, I feel prematurely aged. I just wish I’d never ever gone on a diet,’ she says.
Once anorexia takes hold it is notoriously difficult to cure. Psychotherapist Adrianna Irvine, from Clinical Partners, a private referral clinic, says one of the biggest problems with dieting is some people are unable to stop.
Ruth Hughes who also suffered from anorexia in middle-age
‘When someone starts such an extreme diet, chemical changes in the brain occur,’ she warns, ‘anorexia is an addiction to being slim and even if someone knows realistically they are ill, it can be difficult to change their mindset.’ Ruth Hughes, 49, is another woman who knows only too well how wanting to lose a few pounds can quickly develop into a dangerous obsession.
Two years ago, Ruth, who with husband Martin, 32, runs a smallholding in Redruth, Cornwall, decided to diet after seeing an unflattering photo of herself.
‘My main problem was I hated my tummy,’ says Ruth. ‘Sadly I’ve not been able to have children, but I always felt I looked six months pregnant.’ Ruth had always been a little overweight. ‘My mum Audrey was a fantastic cook, so by the age of 16 I was 9st 7lb, which was too heavy for my 5ft 2ins frame. By the time I met Martin, I weighed 12st.
‘Martin and I both loved nothing better than curling up on the sofa with a takeaway. When my weight crept up to 16st 7lb and I was a dress size 22, I decided to diet. After all, I didn’t want to be fat and 50.’
Ruth cut back on snacks and portion size and was delighted when within three months she’d lost 3st. A little over a year later, she’d reached her goal weight of 9st 3lb.
‘I felt so proud, and so pleased that I’d managed to lose the weight so slowly as I believed that was the healthiest way to do it.
‘But I still hated my tummy. Against my slimmer arms and legs it seemed to look incredibly bloated and so I decided to continue, cutting out meat and then dairy products.’
By September last year, Ruth was a size eight and weighed 6st 13lb, but was still unhappy with her stomach. ‘I even went to see my GP and asked for a tummy tuck, but the only way I could get one was by spending thousands privately,’ she says, ‘so I decided to keep dieting. Martin was pleading with me to eat but I didn’t listen.’
Instead, Ruth reduced her food intake still further, surviving on rice cakes, raw carrot and black coffee. Predictably, her health began to suffer. In the weeks that followed, her hair started to fall out, her periods stopped and she had no energy. By January this year, she weighed little over 6st and was too weak to get out of bed.
This time her husband Martin insisted that he accompany her to see their GP. ‘I weighed just 6st 4lb and was diagnosed with anorexia. The doctor told me that if I didn’t start eating I could be dead by Easter. I remember thinking, “Surely anorexia is for teenagers, not for someone sensible like me”
‘I had been keeping a weekly diary of weight loss so I had been able to see myself getting lighter but it felt like an achievement to get thinner. It might sound odd but it never occurred to me I was anorexic.’
Ruth now weighs 8st 6lb but confesses: ‘Bizarrely there are days when I look at myself and just see a fat tummy. Even now I have to battle against my urge to diet. The first thought is still to say no to food because you worry it will be fattening. I feel so guilty for putting Martin through such a nightmare and even though I am recovering I don’t know if I will ever be able to eat normally again.’
Despite recovering from anorexia that struck in her mid-30s, PA Rachel Evans, 42, also finds it hard to eat normally.
Rachel, a mum-of-one who lives in Grays, Essex, with partner Joseph, 41, an insurance broker, ensures her weight never goes above 8st — which at 5ft 7ins gives her a BMI of around 17.
She says: ‘As you get older it becomes more of a challenge to keep slim. Joseph is always telling me to eat more but any little bit of stress and I lose half a stone.
‘At the same time I feel guilty if I sit still — I go to the gym every day for at least half an hour. And in a bid to burn extra calories, I even do exercises such as squats and lunges when I watch TV.’
When Rachel was in her early 30s she gave birth to a stillborn baby. She coped with the tragedy by not eating — something that led to her anorexia.
Fortunately, seeing a photo of herself looking gaunt at a friend’s wedding when she was aged 35 and 7st shocked her into eating more.
‘It was the first time I realised how much my collarbones stuck out,’ says Rachel. ‘Suddenly I looked in the mirror and saw myself differently. I realised I was too thin. I have now managed to gain weight by going to the gym and putting on muscle, but I still don’t like the feeling of having a full stomach.’
Mary George is under no illusions that women like Rachel are becoming more common. ‘We are aware that increasing numbers of mature women are seeking help for their eating disorder,’ she says.
‘What’s more, older people may have an added burden of feeling they’re somehow to blame for the condition — “I’ve got a girl’s disease, and look at me, I’m 50,” — making it harder for them to seek or accept treatment, even though they were probably always disposed to developing an eating disorder.’
But she insists there is hope. ‘Whatever a person’s age,’ says Mary, ‘it’s important to know that with the right help, eating disorders can be beaten, and people can recover, no matter how long they’ve been ill.’