This article was posted on myspace's bulletin board by 'I refuse to be defined by disease', it made me sit up and think.
Eating disorders affect more middle-aged women
By EILEEN ZAFFIRO
Lori Jacobs watched in horror as her friend's lifeless body was thrust into a cremation furnace and reduced to ash.
Jacobs and the deceased woman had become inseparable when they were patients at an intense treatment center for eating disorders. The friend was just 30 years old, a bulimic whose heart gave out after years of relentless purging.
"You'd think it would make me want to stop," said Jacobs, a 43-year-old mother of three boys.
"I just spiraled down farther," she said.
The Palm Coast woman's weight didn't rise above double digits for years. She lost half of her teeth, developed osteoporosis, went through menopause 13 years ago, and was in the emergency room and hospital so many times her youngest son used to get nervous when she left the room.
Jacobs is living the chapter of the eating disorder story that's rarely told. It's the part about women in their 30s, 40s and 50s who started a diet when they were in junior high and woke up decades later with broken bodies and broken spirits.
Local psychologists and doctors at eating disorder clinics around the country say they're seeing more and more women over 30 walking through their doors. Most have been battling their destructive compulsions since childhood, but there's a new breed of women who are developing eating disorders for the first time in middle age, they say.
Dr. Edward Cumella, a psychologist at an Arizona eating disorders clinic, said over the past 15 years he's seen a 400 percent increase in women age 40 and older seeking treatment.
Five years ago, a Minnesota eating disorders clinic reported helping 43 patients who were age 38 and older. In the first six months of 2007, the Minneapolis-area clinic checked in nearly 500 patients who were 38 and older, The Associated Press reported.
Local psychologists also say they've seen a jump in the number of older patients whose lives are being destroyed by self-imposed starvation, daily vomiting and massive binges that rule their existence.
"Women aren't supposed to age anymore," said Dr. Karen Samuels, a Daytona Beach psychologist who has worked with eating disorders patients for 25 years.
"Women are uncomfortable in their skin now, and they're dieting even if they're in a normal weight range. The culture is much kinder to males. They're allowed to gray and bulk up."
MORE MIDDLE-AGE STRUGGLES
Statistics that break down eating disorders by age are hard to come by, so the precise gravity of the problem among those older than 30 is unclear.
"We don't know yet how big the spike is with older women, but we're all seeing it," said Dr. Pauline Powers, a Tampa psychiatrist who has worked with eating disorders patients for 30 years. "I've been noticing it for 10 years."
Cumella, who's with the Remuda Ranch clinic near Phoenix, said he started seeing an increase seven years ago.
"Other facilities said they saw the same thing," Cumella said. "We've seen no letup. It seems to be increasing."
There's no one reason for the jump, experts say.
Movies, television programs and commercials during the past 10 years get a lot of the blame. The moms on "Happy Days" and "Family Ties" definitely had more curves than the pencil-thin stars of "Desperate Housewives."
A strong wind could topple today's supermodels.
"It's this idea that we all need to be anorexic with breast implants that drives eating disorders," said Dr. Anita Sanz, a DeLand psychologist and Stetson University psychology professor who has been treating eating disorders for 15 years.
There's also the baby boomer factor, the youthful obsession that runs rampant in the generation that has no intention of aging gracefully.
And there are women feeling out of control in the midst of traumatic life events -- divorce, children moving out, spousal abuse, parents dying -- who begin obsessing over control of their food and weight just like girls have for decades before them.
CONTROL RUN AMOK
"They start out saying, 'I'm going to hit the gym, get control and make over things,' " Sanz said. " 'If I look better, I'll feel better.'
"The desire comes from a good place, but you're very vulnerable anytime you feel out of control. It depends on your coping skills. It can catch you off-guard."
Industries that profit from a fixation on forever looking like Paris Hilton add fuel to the fire, psychologists say. And family dynamics, control issues, perfectionism, childhood weight and genetics also contribute.
"Sixty percent of the risk for anorexia and bulimia is hereditary," Powers said. "We're seeing more mothers and daughters."
Although psychologists agree the causes are complex, most heap a large portion of the blame on current culture.
"There's such an emphasis now to be thin that it's spreading to different ages and to men," said Powers, who's also a professor of psychiatry at the University of South Florida in Tampa. "It's common now to see 12-year-olds with anorexia. I've even seen 8- and 9-year-olds."
Powers recently tried to admit a 62-year-old woman suffering from an eating disorder to an inpatient facility. Sanz said she has a patient in her 70s who's fighting both alcoholism and anorexia.
She's helped dozens of women older than 30 tackle eating disorders.
"I've watched women say, 'I'll deal with this when I'm in college, or married, or pregnant,' and all they've done is postpone and postpone," Sanz said. "Once they're over 30 or 40, they get physical signs their body won't support eating disorders forever. They get digestive issues, stress fractures, and realize their body won't hold up."
TREATMENT CAN HELP
Many people still can't grasp why a grandmother would eat nothing more than an apple and popcorn every day, or down a dozen doughnuts along with an entire package of cookies and then purge.
In the past, even family doctors didn't recognize anorexia and bulimia, and scores of women went undiagnosed, psychologists say. Those thought to be naturally thin actually had a top-secret battle going on.
Dr. Donald McAlpine, a psychiatrist at the Mayo Clinic in Rochester, Minn., said some middle-age women who reached out for help in decades past were treated in what he calls the Wild West days, when some patients didn't get psychotherapy to help correct their distorted thinking and faulty self-perceptions.
"There wasn't a lot of good research in the past, so the treatment was different," he said.
Beyond all the bad news, psychologists say there's plenty of hope for those who get proper treatment -- the earlier the better.
About 50 percent of those with eating disorders recover, 30 percent achieve partial recovery and 20 percent never improve, Sanz said.
"I have seen people get past it," said Sandra Brooks, an Ormond Beach nurse who has worked with eating disorders patients for 20 years. "But the longer someone has struggled with it, the longer it takes, and the harder it is to recover."
Recovery often includes relapses that, with hard work, eventually become less severe and less frequent, psychologists say.
"We're not perfect people, and we don't have to recover perfectly," Sanz said. "The truth is this doesn't get under control quickly."
NO EASY WAY OUT
Unlike addicts who can just swear off alcohol and drugs, those with eating disorders can't stop eating. They have to develop a healthy relationship with food.
"They'll probably fight it in their minds their whole life if they're older," Powers said.
Sanz agreed long-term eating disorders can penetrate a person's psyche.
"You'll always have to keep an eye open," Sanz said. "When you come out of one month of inpatient, people think you're cured, but it's really a beginning. We can't cure it in a month. You have to learn new coping skills."
But older women who have fought themselves for decades can make dramatic progress once they become so frustrated with their decades-long nightmare that they pour that anger into getting better, Sanz said.
The breakthrough comes for most people in an existential moment when they decide they're truly willing to do what it takes to get better.
Although doctors are better at diagnosing eating disorders and understand the causes better than they did 10-20 years ago, progress hasn't come fast enough for thousands of women. Nothing can add back the lost years. Nothing can undo the permanent damage to their bodies.
BATTLING FOR A BETTER FUTURE
Jacobs, the Palm Coast woman who's determined to dodge the fate of her bulimic friend who died a few years ago, still has to beat back her past every day.
She said her mother put her on the first of many forced diets when she was in second grade, and she hasn't had too many happy moments in front of the mirror since.
"I look in the mirror now, and I'm like an old lady," she said. "I don't like the way I look. I still feel fat."
Most of her life has been a blur of dieting, bingeing, anorexia, bulimia and laxative abuse. She said she "practically lived in the emergency room," was hospitalized four times, went through inpatient treatment four times and, at one point, wound up with a feeding tube at home.
One of her son's friends thought she was a cancer patient.
"In my mind, from a very young age, it's been fat is failure," said Jacobs, who noted her mother was constantly on diets herself. "Thin is happy and successful."
Believing that has cost her dearly.
"It destroys your family, friendships, looks, everything," Jacobs said. "I was afraid I was going to die. You're not happy thin. It's not that euphoria you think it'll be. I feel sad for all the teenagers who have no idea.
"It hurt to sit. I was cold all the time. I'm so glad to be away from that. I won't go down that path again -- ever."