Eating Disorders In The Elderly
Every February, Eating Disorders Awareness Weeks are observed in Canada, UK and USA. So this month I'm writing about Eating Disorders (EDs) to acknowledge, recognize, and honour the struggles and successes in the journey of those with an ED.
"Eating disorders (EDs) are a challenging category of psychiatric disorders that often present a chronic evolution and are associated with significant functional impairment, with high rates of psychiatric and medical comorbidities and mortality. Although long-time described only in the young population, now eating disorders are increasingly diagnosed in elderly. The etiology of eating disorders is mostly unknown and, in elderly, appears to be multifactorial", say a group of researchers. Depression is the most common psychiatric comorbidity in elderly with EDs, says another group.
Many studies have identified poverty in old age as an important cause of weight loss. Living on a small budget makes shopping for healthy food difficult. Another study found that human networks played a significant role in the maintenance of healthy food intake and pointed social isolation and loneliness as one of the leading causes of weight loss and EDs in old age. Researchers Oakland & Speer found that institutionalization was also shown to contribute to the onset of EDs in elderly. When they enter a long-term facility, senior citizens do not get to decide about the foods they eat. Loss of control over food choices determines a lack of appetite in many elderly individuals. Also, the monotony of food choices in an institution leads to a decrease in food intake.
Limitations in daily activities such as needing help with shopping for food or assistance with cooking contribute to anorexia in older people, say Guralnik et al. Elderly abuse was shown to exist in 5% of the older population and contribute to anorexia through food deprivation from the caregiver or secondary to the experienced distress, says Anetzberger. Psychological abuse, such as being mocked for being dropping or spilling food at mealtime leads to feelings of shame and reduction in food consumption in elderly. A series of social factors like social pressure, weight-related teasing as well as race and ethnicity are sometimes mentioned in the literature as separate predictors of eating disorders in older women, says Menzel.
Inspite of the complex multifactorial causality leading to EDs in the elderly, researchers and multidisciplinary teams are working hard to help treat such disorders. The best outcomes have been observed for combined interventions such as integrated behavioral, pharmacology, and psychotherapy interventions. Family therapy and psychoanalytic interventions are applied in practice. Family therapy refers to teaching the family about EDs in elderly and how they can help the patient recover while they focus on unconscious factors that are linked to the EDs.
If you think you know someone dealing with an ED, reach out to NEDIC (National Eating Disorder Information Centre) for support. If you are looking for ways to participate in ED awareness and showing your support, find a list of events here: https://nedic.ca/events/
I can imagine how challenging it can be for someone to carry on with their life while dealing with eating disorders. At in4MED, we can make this stressful time easier by providing you with information about your condition, connecting you to local support systems and being there for you as your trusted health advocates. As always, feel free to connect with me or leave a comment.
Healthcare Consultant, in4MED
The author of this blog post is a Physician with over 10 years of experience working in the healthcare system as a clinician, researcher and educator. She is passionate about healthcare for older adults and strives to be a resourceful inspiration to caregivers. *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 healthcare professional.