April 26 — FRIDAY, April 25 (HealthDay News) Nearly two-thirds (65 percent) of young American women report disordered eating behaviors, and 10 percent report symptoms of eating disorders such as anorexia and bulimia nervosa or binge eating disorder, a new survey finds.

The findings — from an online poll of more than 4,000 women between the ages of 25 and 45 — found that 75 percent eat, think and behave abnormally around food. The survey was conducted by SELF magazine in partnership with the University of North Carolina at Chapel Hill.

“Our survey found that these behaviors cut across racial and ethnic lines and are not limited to any one group. Women who identified their ethnic backgrounds as Hispanic or Latina, white, black or African American and Asian were all represented among the women who reported unhealthy eating behaviors,” Cynthia R. Bulik, a professor of eating disorders and director of the UNC Eating Disorders Program, said in a prepared statement.

“What we found most surprising was the unexpectedly high number of women who engage in unhealthy purging activities. More than 31 percent of women in the survey reported that in an attempt to lose weight, they had induced vomiting or had taken laxatives, diuretics or diet pills at some point in their lives. Among these women, more than 50 percent engaged in purging activities at least a few times a week, and many did so every day,” Bulik said.

Eating habits that some women think are normal — such as skipping meals, avoiding carbohydrates and, in some cases, extreme dieting — may actually be signs of disordered eating, which is often linked with emotional and physical distress.

While there’s a widespread belief that eating disorders affect mostly young women, the survey found that women in the 30s and 40s had about the same rates of disordered eating as younger women.

Among the other findings:

  • 67 percent of the women (excluding those with actual eating disorders) are trying to lose weight.
  • 53 percent of dieters are already at a healthy weight and are still trying to lose weight.
  • 39 percent of the women said concerns about what they eat or weigh interfere with their happiness.
  • 37 percent of respondents said they regularly skip meals to try to lose weight.
  • 27 percent said they’d be “extremely upset” if they gained just five pounds.
  • 26 percent have eliminated entire food groups from their diet.
  • 16 percent have dieted on 1,000 or fewer calories a day.
  • 13 percent smoke to lose weight.
  • 12 percent often eat when they’re not hungry, and 49 percent sometimes do.
  • The survey was expected to be published in the May issue of SELF and to be presented May 17 at the Academy for Eating Disorders’ International Conference on Eating Disorders, in Seattle.

    More information

    The U.S. National Institute of Mental Health has more about eating disorders.

    SOURCE: University of North Carolina at Chapel Hill, news release, April 22, 2008

    ED After Age 30

    Article Contributed by Kathleen L. Someah, B.A., PhD Candidate, Palo Alto University, Nutrition Assistant, New Dawn Treatment Centers

    Eating disorders have received significant attention as a disorder that occurs most readily in young women. A recent study found that nearly 95% of individuals struggling from disordered eating range between 12 years of age and 25 years of age (ANAD, 2013). However, eating disorders do not discriminate among age and additional evidence indicates a growing prevalence of eating disorders in women aged 30 and above.

    After surveying 1,849 women above the age of 50, researchers noted a somewhat surprisingly elevated rate of eating disorder behaviors in middle-aged women. According to this study, which was later published in the International Journal of Eating Disorders, nearly 80% of respondents reported purging during the previous five years, and an additional 7% of participants said that their preoccupation with weight control led to regularly engaging in excessive exercise routines. In addition, researchers noted that a significant number of such respondents also reported feeling dissatisfied with their bodies. Resulting data revealed that more than 70% of the surveyed women were actively trying to lose weight, and 62% of such individuals described eating as exerting a negative impact on their life either occasionally or often. Of those women 41% mentioned that they regularly scrutinize their body at least once per day.

    Further studies also support such findings. Using a random sample of 475 women between the ages of 60 and 70 years old, 90% of those surveyed described feeling dissatisfaction with their bodies. Eighteen of the women in the study also met the diagnostic criteria for an eating disorder and an additional 21 women reported using laxatives, diuretics, or engaging in other behaviors common in eating disorders. Furthermore, research indicates that body dissatisfaction does not diminish but rather increases for middle-aged women when assessed in comparison to their younger and senior cohorts. However, reasons for this remain uncertain.

    In a study aimed at discerning the various reasons why eating disorder symptomology is increasingly prevalent among middle-aged women, researchers examined factors often associated with disordered eating in women aged 30 years and above (Mclean, Paxton, Wertheim, 2010). Using a community sample of 200 women between the ages of 35 and 65 years old, researchers conducted a series of assessments in the effort to better understand this occurrence. The Eating Disorder Examination-Questionnaire (EDE-Q) was used to measure concerns related to weight, physical shape, eating, and restraint. Concluding data showed a positive correlation between the importance of appearance and the various EDE-Q subscales. Data also indicated a strong association between the importance of appearance and body dissatisfaction and disordered eating. The higher the importance placed on appearance, the higher the level of body dissatisfaction. Of the participants who were identified as probable eating disorder cases, many had a significantly elevated Body Mass Index (BMI) score. Those individuals also reported greater concern with appearance and demonstrated significantly lower cognitive reappraisal and self-care scores than participants who were not identified as probable eating disorder cases.

    Women in today’s society are inundated with messages concerning body dissatisfaction and ways to alter one’s physical appearance. With the increasing onslaught of such advertisements it is of little surprise that so many young women find it difficult to accept their body as is. These messages do not stop either and much of this scrutiny over physical attributes perpetuates into adulthood. Studies show that nearly 62% of women between the ages of 13 and 19 years old report some level of body dissatisfaction and further studies reveal that this value rises 67% in women over the age of 30 years old. Therefore, while young women are initiated to think poorly of their body, such messages continue to persist into adulthood, thus affecting their self-image during middle age.

    Eating disorders continue to be difficult to treat regardless of the age at which they initially present. However, addressing the thoughts and proceeding behaviors early on remains imperative, regardless of the age of onset.

    Garner, DM. Psychology Today, February, 1997.

    Montepare JM. Actual and subjective age-related differences in womens attitudes toward their bodies across the life span. J Adult Dev 1996;3:171–182.

    Zerbe, K., & Domnitei, D. (2004). Eating Disorders at Middle Age, Part 1. Eating Disorders Review, 15(2), 1-3.

    Published Date: March 11, 2013

    Last Reviewed By: Jacquelyn Ekern, MS, LPC on March 11, 2013
    Page last updated: March 11, 2013

    Published on EatingDisorderHope.com, A Resource for Eating Disorder Help

    Disordered eating in midlife and beyond

    Selected resources

    Academy for Eating Disorders

    The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment , by Kathryn J. Zerbe, M.D. (Grze Books, 1993).

    Gaining: The Truth About Life After Eating Disorders , by Aimee Liu (Wellness Central, 2008).

    Treating eating disorders

    The goal of treatment is to achieve a healthy weight, exercise level, and eating pattern; to eliminate binge eating and purging; and to address any contributing emotional problems or distorted thinking. This usually requires the help of one or more physicians, a mental health professional, and a nutrition professional. “From the standpoint of psychiatric symptoms, the best person for treatment is a psychologist, psychiatrist, or other therapist. Because of the many medical complications, it’s also very important to work closely with an internist and, if there is bone loss, with an endocrinologist as well,” says Pouneh Fazeli, instructor in medicine at Harvard Medical School.

    Treatment approaches include the following:

    Psychotherapy. This is the cornerstone of treatment for eating disorders. Cognitive behavioral therapy (CBT) challenges unrealistic thoughts about food and appearance and helps you develop more productive thought patterns. Other types of psychotherapy, such as interpersonal and psychodynamic therapy, can help you gain insight into issues such as role transitions, loss, and unresolved relationships that may underlie disordered eating and an excessive focus on body image.

    CBT is the best-studied approach and seems to be the most effective treatment for bulimia. For anorexia nervosa and binge eating, other approaches may also be effective. According to Dr. Zerbe, “CBT can be very helpful, but women in midlife often benefit from therapy that gets under the surface and also looks at the spiritual-existential dimensions of life. You look back to make sense of why you did what you did up until now, and you prepare for the next phase of your life.”

    Nutritional rehabilitation. A dietitian or nutritional counselor can help a woman recovering from an eating disorder to learn (or relearn) the components of a healthy diet and motivate her to make the needed changes. A nutrition professional will help her plan how to eat in a way that keeps the digestive system working well during recovery while avoiding the dangerous electrolyte and fluid imbalances that can arise when normal eating begins again after a period of semi-starvation.

    Medication. Fluoxetine (Prozac) is the only medication approved for the treatment of an eating disorder. When taken at certain doses and combined with psychotherapy, it can reduce bingeing and vomiting up to 70% in the first eight weeks; without psychotherapy, results are much poorer. Other antidepressants and the seizure medication topiramate (Topamax) are sometimes prescribed for bulimia or binge-eating disorder, but their effectiveness hasn’t been proved in controlled trials.

    No medications are approved specifically for treating anorexia nervosa. Although antidepressants, seizure medications, and certain antipsychotic medications are sometimes prescribed, no drug works well until some weight is restored. The primary “medication” is simply food. Drugs may be helpful for associated depression or anxiety.

    Hospitalization. Hospitalization may be recommended if a woman is dangerously underweight, unable to eat or stop vomiting, or seriously depressed or suicidal. It may also be necessary if she is medically unstable or has other medical complications that require inpatient treatment.

    As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

    You hear the word anorexia, you think weight loss. If only the consequence of this illness was that limited, it can have Long Term Effects of Anorexia.

    Although anorexia is a psychological disease, it behaves more like a physical disease, namely cancer.

    A cancer cell may begin its life in the breast, brain or bone; but given enough time, it will metastasize throughout the body with a singular goal of destroying all healthy tissue it encounters.

    Similarly, anorexia may start with a simple diet and associated weight loss. But, once this disease gets a firm grip on its subject, it too metastasizes – and it doesn’t stop at merely ravaging a woman’s body.

    Instead, it strives to destroy her mind, spirit, relationships, future, and ultimately, her life. Sadly, it is often successful on every front.

    The Long Term Effects of Anorexia

    Anorexia kills people. In fact, this disease enjoys the highest fatality rate of any psychiatric disorder. In the case of a celebrity death, the media provides coverage. Perhaps the first recognized case was that of Karen Carpenter in the early 8Os. An anorexic who relied on ipecac for vomiting, she died of heart failure.

    Years later, she was followed by Christina Renee Henrich, a world-class gymnast who died in 1994. Ana Carolina Reston Macan, a famous Brazilian model, died in 2006, and Isabelle Caro, a French actress, and model succumbed to the disease in 2010. Interestingly and ironically, this second model had displayed her shockingly skinny body in an advertising campaign designed to raise awareness of anorexia. One has to wonder if she had sought expert treatment for anorexia – would she have lived and thrived?

    So, when a celebrity dies, it makes headlines. But what about the thousands of women and girls and men who will die this year from the same disease? Their stories, though equally important, will probably go unreported.

    Certainly, the majority of those who have anorexia will not die. But make no mistake, the long-term consequences of this disease can be severe.

    Medical Implications of Anorexia Nervosa

    The health consequences related to anorexia are noticeable: emaciated appearance, dry skin, and hair, bluish fingertips, etc. Unfortunately, the long-term and far more severe medical issues cannot be seen on the surface.

    The brain actually shrinks due to lack of nutrition with a commensurate lowering of IQ. The skeletal system is damaged, especially if the anorexia occurs in adolescents before the bones are fully developed. Nearly 90% of women with anorexia experience osteopenia (loss of bone calcium) and 40% have osteoporosis (more advanced loss of bone density). This bone loss is usually permanent.(1)

    Because the entire hormonal system is compromised by starvation, infertility often results and can be permanent. Perhaps the most endangered organ in the body is the heart. In fact, the most common cause of death in anorexics is heart disease. Much of this is related to muscle deterioration. As the body strives to maintain life, it starts consuming its own muscle; in effect, it starts eating itself. The heart is not immune.

    The Impact of Anorexia on Relationships

    Anorexia is in the destruction business. This is not confined to the individual with the disease. No matter what the connection is — parents with an ill daughter; a husband with an anorexic wife — the relationship will be profoundly impacted, if not destroyed altogether. This is because such a disease is unfathomable to anyone who does not have it.

    Whereas a woman may have some understanding as to why she embraces certain behaviors, those in a relationship with her simply see self-destruction. With each additional pound lost, she inevitably changes. She becomes more obsessed with food and weight, frequently loses interest in normal life and activities, and often isolates.

    Basically, she transforms into a completely different person. How can this not negatively impact relationships with friends and family? Friendships, even marriages, often end due to frustration or fear. Although parents may remain connected and involved, even that relationship is dramatically affected as they watch their daughter slip away into the disease.

    Spirituality & Recovery in Anorexia

    Anorexia is not a disease of any one group or belief system. Especially, it is not relegated to those who believe in God, or not. In fact, profoundly committed Christian women sometimes begin walking the anorexic path as an extension of perfectionism. They possess a strong desire to appear perfect to the church community – and according to our culture … that means thin.

    They forget that the Lord made every one of His children to be distinctive and unique. God doesn’t make cookie-cutter children. Additionally, He has a plan for every one of our lives; these plans undoubtedly do not include premature destruction.

    Regardless of original intention behind weight loss, once a woman is in the grip of full-fledged anorexia, her relationship with God will likely be damaged. He will not leave her, but she might drift from Him.

    Perhaps she will disconnect from Him due to guilt or shame regarding her actions, or simply because she is too exhausted to focus on prayer or worship. Anorexia is a demanding, selfish disorder. It wants a woman’s full attention. Often, there is no room for a continuing relationship with a loving and nurturing God.

    Change Is Possible

    When a woman gets cancer, she immediately seeks treatment, knowing the sooner the medical intervention, the greater the possibility for a full recovery. Anorexia should be no different. Excellent, life-changing treatment is available. If you, or someone you know, struggles with anorexia, please get eating disorder treatment immediately.

    Last Reviewed & Updated By: Jacquelyn Ekern, MS, LPC on February 14, 2018
    Published on EatingDisorderHope.com, Eating Disorder Resource

    Eating disorders leave their scars – both physical and emotional (Picture: Ella Byworth for Metro.co.uk)

    Anorexia is sometimes seen as a ‘slimmer’s disease’, glamourised as a lifestyle choice, with self-absorbed girls striving for size zero and obsessed with vanity.

    But when stories like Pippa McManus’s (a teenager who committed suicide days after leaving a psychiatric unit where she was being treated for anorexia) makes the headlines, the fact that anorexia is a deadly disease becomes a reality.

    Mental Health Awareness Week 2017: How I went from surviving a mental illness to thriving in the big wide world

    Anorexia has the highest mortality rate of any psychiatric disorder. Up to 20% will die prematurely from their disorder and suicide rates are high too.

    I started struggling with an eating disorder, depression and self harm in my teens. This continued through to my 30s. I also suffered extreme suicidal behaviour.

    Although I needed hospital treatment many times, I’m one of the lucky ones, I’m here to tell my story but my body suffered a great deal.

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    I have a number of physical issues now, and while I’ll never know for certain, there’s a high chance that they are related the chronic malnourishment and destructive behaviours I put my body through.

    My eating disorder left me with a lot to deal with (Picture: Deirdre Spain for Metro.co.uk)

    I have been diagnosed with fibromyalgia, commonly triggered by psychological stress. This means I am in constant pain and feel unrelenting fatigue. Although there is no cure I work hard to manage the illness.

    My anorexia made me hate the feeling of any food in my body and I preferred feeling empty.

    This led to me abusing laxatives (overdosing chronically). My colon no longer functions normally – this causes pain and inconvenience.

    At the worst stages of my illness I would immediately purge the small amounts of food that I ate, this has led to me developing a hiatus hernia which causes me constant indigestion and other uncomfortable symptoms.

    One suicide attempt led to a fractured vertebra and I have three vertebrae pinned together. This has put pressure on the rest of my spine to compensate, which causes inflammation and pain.

    Anorexia often leads to low bone density, a related condition is the development of osteophytes (bone spurs), which I have in my cervical spine, they cause impingement on nerves and soft tissue which leads to pain and stiffness in my neck, shoulders and arms.

    (Picture: Mmuffin for Metro.co.uk)

    Other bones I’ve broken are also haunting me with pain and I’m having an operation to remove osteophytes from my ankle and treat damaged cartilage.

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    A consequence of low body weight is that the female reproductive system shuts down. Since I started restricting my food intake at puberty, I have never had regularly periods.

    Unfortunately, as a consequence of chronic malnourishment (having suffered to varying degrees for over 15 years) I may be infertile.

    I’ve been left with physical and mental scars that impact my self-esteem on a daily basis. It’s been really difficult to write about the conditions I’m suffering.

    I have some feelings of anger and self pity. But mostly I feel guilty, wondering if I could have done anything to prevent such long term conditions. Part of me thinks I deserve to continue suffering.

    I feel guilty that I’m taking up more NHS time as I need numerous treatments to manage the chronic conditions and that my life is sometimes restricted and this impacts my friends and family.

    Other long term problems can include skin and hair conditions, muscle wasting, problems with immunity and even brain damage. I’ve been fortunate that problems I had with my kidneys and heart have been resolved, but this does not happen for everyone.

    It may sound like recovery isn’t worth it but living with anorexia is so much more painful than living with its consequences.


    Anorexia is not glamorous, people die from it and live with the condition chronically and those that do recover have to live with the consequences.

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    If you like reading about mental health stuff, you’ll probably also like listening to it.

    So rejoice. We’ve launched a snazzy new podcast discussing all things mental health without getting too serious, science-y, or stuffy.

    It’s called Mentally Yours, it’s great, and you can subscribe here. Let us know what you think by commenting, tweeting us @MentallyYrs, or leaving a review. We are very keen for any and all feedback.*

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    MORE: I’ve recovered from anorexia, and this is what I’d like to tell my younger self

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    The Physical Effects of Anorexia

    Anorexia (anorexia nervosa) has very serious physical effects and complications, as well as a devastating impact upon psychological well being.

    The effects of anorexia are both short and long-term. There are the immediate physical effects as the body struggles to function without the nutrients and fuel that it needs. The sufferer is also at risk of developing long-term and potentially life-threatening health problems, particularly if the condition is untreated for many years.

    Immediate physical signs of anorexia

    Food deprivation has a range of physical effects as the body struggles to cope with insufficient nutrients and calories.

    Anorexia sufferers can suffer some or all of the following:

    • constipation
    • dizzy spells and faintness
    • abdominal pains
    • muscle weakness
    • poor circulation resulting in feeling constantly cold
    • dry, yellow coloured skin
    • early morning waking
    • bloating
    • people with anorexia often develop long, fine downy hair on face and body
    • disrupted menstrual cycles or no periods at all

    Anorexia and osteoporosis

    Osteoporosis, or ‘soft bones’ is a disease which results in the density of the bones reducing. This leaves sufferers prone to painful fractures, particularly in the spine and hip, persistent and disabling pain and loss of height.

    People with eating disorders are at risk of developing osteoporosis because their bodies are deprived of the vital nutrients bones need in order to grow and remain strong. Calcium is the most important nutrient for the bones.

    The risk of osteoporosis is particularly serious for people with eating disorders because dangerous eating patterns commonly develop from the age of 13 and throughout the teens, when the bones are still growing and reaching peak strength.

    Anorexia and fertility

    Infertility is a serious and common complication of anorexia. If a woman’s body fat falls dramatically, she will no longer produce the hormone, oestrogen, which is necessary to stimulate ovulation.

    Nine out of ten women with anorexia will stop having periods. If the menstrual cycles and ovulation are suppressed for a very long time, this can affect fertility. A recent study found one in five women at an IVF clinic were experiencing problems due to an eating disorder.

    The stopping of periods can be permanent, if a sufferer has had untreated anorexia for a long time. But for most women, menstruation will start again once they begin to gain weight. Approximately 80 per cent of women who recover from anorexia will regain their ability to conceive.

    If a woman with anorexia does conceive, she faces a high risk of miscarriage and having a low birth weight baby. Any woman who is struggling with an eating disorder should delay pregnancy until she has recovered.

    Anorexia and heart problems

    Anorexia has the highest mortality rate of all forms of mental illness, with rates of between 10 and 15 per cent. A significant proportion of these deaths are due to heart failure as a result of long term, severe anorexia.

    When anorexia has become this severe, the heart is often damaged. There not enough body fat to protect the heart, anaemia, which weakens the blood, can develop and there is commonly poor circulation. This means that the heart is not able to pump and circulate blood effectively.

    Severe anorexia results in the loss of muscle mass, including heart muscle. Consequently, the muscles of the heart can physically weaken, there can be an overall drop in blood pressure and pulse can contribute to slower breathing rates.

    Studies have shown that the majority of people with anorexia who are admitted to hospital have low heart rates. Common heart problems include arrhythmias (fast, slow or irregular heart beat), bradycardia (slow heart beat) and hypotension (low blood pressure).

    Anorexia and neurological (brain) problems

    People with severe anorexia may suffer nerve damage that affects the brain and other parts of the body. This can lead to nerve affected conditions including the development of seizures, confused thinking and extreme irritability and numbness or odd nerve sensations in the hands or feet (peripheral neuropathy).

    Brain scans show that parts of the brain can undergo structural changes and abnormal activity during anorexic states. Some of these changes return to normal after weight gain, but there is evidence that some damage may be permanent.

    Anorexia and anaemia (or blood problems)

    Anaemia is a common result of anorexia and starvation. In one study, 38 per cent of anorexic participants had anemia. A particularly serious blood problem is pernicious anaemia, which can be caused by severely low levels of vitamin B12. If anorexia becomes extreme, the bone marrow dramatically reduces its production of blood cells, a life-threatening condition called pancytopenia.

    Eating disorder side effects

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