Midlife Eating Disorders

In most people's minds, "eating disorder" (ED) conjures images of a thin, white, upper-middle-class teenage girl. The ED landscape has changed. Countless men and women in midlife and beyond, from all ethnic backgrounds, also struggle with anorexia nervosa, bulimia nervosa, purging disorder, and binge eating disorder. Some people have suffered since youth; others relapsed in midlife, often after a stressor such as infidelity, divorce, death of a loved one, menopause, or unemployment. Still others experience eating disorder symptoms for the first time in midlife. Primary care physicians, ob-gyns, and other practitioners may overlook these disorders in adults or, even worse, demean them for not having outgrown these adolescent problems. Treatments for adults must acknowledge and address the unique challenges faced by those middle-aged or older. Midlife Eating Disorders-a landmark book-guides adults in understanding "Why me?" and "Why now?" It shows a connection between the rise in midlife ED and certain industries that foster discontent with the natural aging process. It also gives readers renewed hope by explaining how to overcome symptoms and access resources and support. Renowned eating disorder specialist Cynthia M. Bulik, Ph.D., helps partners and family members develop compassion for those who suffer with ED-and helps health professionals appreciate the nuances associated with detecting and treating midlife eating disorders.

"'Eating disorders.' Most of us instantly picture a teenaged or college aged girl when we see those words. After all, doesn't age immunize women from the body image, weight concerns and eating disorders that plague the younger years? Truth is that, over 15% women at midlife and beyond suffer from eating disorders, surpassing the number affected by breastt cancer! These are serious, life threatening and heartbreaking illnesses at any age. This story needs to be told and Betsy Brenner does just that. "The Longest Match: Rallying to Defeat an Eating Disorder in Midlife is a beautifully written and heartfelt memoir illustrating the trajectory from early childhood, through adolescence and early adulthood, to midlife when eating disorder thoughts and behaviors took over the author's life. Journal entries reveal occasional negative thoughts about her weight or food in younger years, but the stressors of midlife knocked this high functioning woman off her feet. "Like adolescence and young adulthood, midlife is full of tricky transitions. Unlike earlier in life, however, no one is there to catch you when you fall or to coach you back on your feet. Today women feel pressure to do it all and do it perfectly, constantly multitasking at home, and outside of home, taking care of their children and marriages, their extended families, ill and aging parents, all while trying to maintain an identity of their own. "Eating disorders can devour a woman at any age, but Betsy Brenner rallied, using every resource she had. Thank you, Betsy, for being painfully honest about your experiences and your pain, and for explaining the many factors that make a woman vulnerable to eating disorders during midlife. Thank you for finding the courage to access help, for trusting the treatment process and for inspiring other midlife women to believe in themselves. Thank you for telling your story so women struggling with an eating disorder at midlife will know they are not alone and will see a path to recovery. And, most of all, thank you for staying in the match-the 'longest match' ever-and winning." -Margo Maine, PhD, FAED, CEDS "I applaud Betsy Brenner for encouraging women of every age to reflect on their relationship with their parents. Through sharing her story, Betsy demonstrates how we can reframe our painful experiences with self-love and self-compassion. This book shows that, at every age, we can grow and find peace and fulfillment through bravely reaching out, connecting with like-minded others, and doing the hard work required to heal our childhood wounds. It's never too late to start. Thank you, Betsy, for showing us how to be free." -Dr. June Alexander, www.thediaryhealer.com "The Longest Match is an outstanding memoir. I have never seen a documented account of an individual who was first diagnosed with an eating disorder in mid-life. Brenner's description of the path that led to her illness and her route to recovery is remarkable. She eloquently describes her childhood, her family history, her personality traits, and her love of tennis, that all contributed to the development of her illness. She describes the process of her therapy with great clarity and allows us to see that full recovery is possible." -Beth Mayer, LICSW

February 2007, a landmark clinical study by researchers at Harvard University was published in Biological Psychiatry and was soon picked up widely by the media. A survey of 3,000 participants found that 2.8 percent of them suffered from binge eating disorder (BED); that women were twice as likely to report binge eating; and that BED occurs across the age span, from children to the elderly. By extrapolating the statistics to the general population, health professionals estimate 5,250,000 American women and 3,000,000 men suffer from binge eating. The same month the study was published Jane Brody revealed in the New York Times that when she was a 23 years old, her food binges were so extreme that "Many mornings I awakened to find partly chewed food still in my mouth...." Cynthia Bulik, director of the UNC Eating Disorders Progam, is a foremost authority on binge eating. BED can affect anyone, and can be caused by brain chemistry, genetic predisposition, psychology, and cultural pressures--but none of those triggers make giving in to food cravings inevitable. Crave helps readers understand why they crave specific foods, recognize their individual triggers, and modify their responses to those triggers. Binge eating disorder is highly treatable; 70% to 80% of patients at the UNC Eating Disorders Program triumph over their binge eating by using techniques to "curb the crave". Through the stories of some of these patients--men and women, young and old--and with the guidance of Bulik, readers will develop a variety of strategies to use in conquering their cravings and establishing healthy eating habits.

Over the past fifteen years, there has been a great increase in the knowledge of eating disorders in sport and effective means of treatment. In this book, the authors draw on their extensive clinical experience to discuss how to identify, manage, treat, and prevent eating disorders in sport participants. They begin by examining the clinical conditions related to eating problems, including descriptions of specific disorders and a review of the relevant literature. Special attention is given to the specific gender and sport-related factors that can negatively influence the eating habits of athletes. The second half of the book discusses identification of participants with disordered eating by reviewing symptoms and how they manifest in sport; management issues for sport personnel, coaches, athletic trainers, and healthcare professionals; treatment; and medical considerations, such as the use of psychotropic medications. A list of useful resources is included in an appendix, as well as a glossary of important terms.

"Clinical Handbook of Complex and Atypical Eating Disorders brings together into one comprehensive resource what is known about an array of complicating factors for patients with ED, serving as an accessible introduction to each of the comorbidities and symptom presentations highlighted in the volume"--Provided by publisher.

Patients with eating disorders frequently feel that they aren’t "sick enough" to merit treatment, despite medical problems that are both measurable and unmeasurable. They may struggle to accept rest, nutrition, and a team to help them move towards recovery. Sick Enough offers patients, their families, and clinicians a comprehensive, accessible review of the medical issues that arise from eating disorders by bringing relatable case presentations and a scientifically sound, engaging style to the topic. Using metaphor and patient-centered language, Dr. Gaudiani aims to improve medical diagnosis and treatment, motivate recovery, and validate the lived experiences of individuals of all body shapes and sizes, while firmly rejecting dieting culture.

Michelle Stewart always knew in her heart that her eating disorder would kill her. What she didn’t expect in its early stages was that she would continue to function - albeit far from optimally - for decades before succumbing to its deadly effects. A conscientious and ambitious woman driven by a desire to make a positive difference in the world, Michelle went on to build a successful career first in journalism and then in communications for the British Columbia Ministry of Health. Michelle devoted her working life to raising awareness of healthcare issues, all the while hiding her own anorexia and bulimia from friends and colleagues. By the time she was 48 years old, more than thirty years of self-imposed starvation, binging and purging had ravaged her organs. In May 2013 she was diagnosed with end-stage renal failure and given only a few months to live. Determined to come out of the shadows and share her story while she still had the chance, Michelle began writing a very personal and revealing blog in which she chronicled her lifelong struggle with her eating disorder and her experiences as a palliative patient within the very same healthcare system in which she had performed her life’s work. “I have had a 32 year dress rehearsal for the fate I now face,” she writes. This memoir is a collection of the most poignant pieces of writing from that blog, supplemented with previously unpublished pieces of original poetry from the author. Michelle Stewart’s book stands out against other eating disorder memoirs in several ways. As a middle aged longtime sufferer, she belies the notion that eating disorders only affect the young - or that victims tend to either recover or perish early. According to experts featured in the foreword, medical practictioners who treat patients with eating disorders are seeing rising numbers of long-term sufferers like Michelle. These tend to be high-functioning individuals who keep their disorder underground for years while their bodies slowly disintegrate. Michelle’s advanced years give her a valuable and rare perspective on a widespread mental health problem. Second, through her years spent in healthcare advocacy and communications, Michelle developed well informed insight into issues around medical services and the relationships between healthcare providers and their patients, including palliative patients. In her book, Michelle shares her personal views on disease-specific funding, patient care and the right-to-die movement, making a valuable contribution to the public conversation. Finally, the book is a deeply engaging and compelling tale of terminal illness progression that follows one woman from diagnosis to death. Anyone who has been touched by life-limiting illness in their own experience or in their family will be moved by this account of the palliative care journey told from the patient’s perspective.