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Bulimia in the Elderly

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Eating disorders are typically associated with younger—even adolescent—people. But data on the subject shows that a large number of elderly people are struggling with eating disorders, including bulimia nervosa (BN).

Bulimia in the Elderly

Examining Rates of Bulimia in the Elderly

According to the National Eating Disorders Association, as many as 20% of women aged 70 and older are “trying to change the size of their bodies” through a range of means, and 13 percent of women aged 50 and over struggle with some type of eating disorder. (1)

These statistics most likely account for a number of less obvious factors, including individuals who have had untreated or undiagnosed eating disorders for years and those who previously had eating disorders which have since resurfaced.

In fact, one study found a majority of its elderly eating disorder cases were reported by women who previously struggled with bulimia and other forms of disordered eating, with 86 percent of respondents saying their disorder originally started before they turned 20. And only 50 percent of respondents who reported previously struggling with an eating disorder said they had recovered at any point. (2)

It’s also possible to develop bulimia or any type of eating disorder at any age. There are a number of challenges particular to elderly people that may have a hand in bringing about, resurfacing, or complicating these conditions.

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Elderly Bulimia Patient Risk Factors

No matter what age someone develops an eating disorder, stress is often a key factor in bringing about the disorder. 

For younger people—especially teenagers—that stress is often linked to the big transitions underway in their life and the impact of those events on their self-esteem. Older people also face many big and stressful transitions, though the changes they see are typically more centered around grief and loss.

In the later stages of life, people may be dealing with careers winding down, children moving out, family and friends passing away, or leaving their long-time homes. As time goes on, they may face additional changes, like losing their ability to drive. 

Aside from stress, these situations represent, for many people, a loss of control. Turning to eating disorders, such as bulimia, can be a way for people to feel like they’re taking some of the control back over their life. (3) 

Older people may also experience a number of physical changes that make it easier for them to gain and carry weight—and, subsequently, worry more about losing weight. And, unfortunately, the societal pressure to “look good” doesn’t cease at any age, leaving elderly people vulnerable to the same demanding expectations to be a certain size and shape.

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Recognizing Bulimia Nervosa in Elderly Patients

It may be difficult to identify bulimia and other eating disorders in older patients, thanks to another set of unique factors.

Elderly people are more likely to live alone or not have regular contact with close friends or family, which can allow them to develop and struggle with eating disorders for some time without anyone noticing.

Additionally, many signs and symptoms of bulimia and other eating disorders can present similarly to symptoms frequently encountered by older people for other reasons. Vomiting, weight loss, hair loss, malnutrition and moodiness—all key signs of bulimia—can all be attributed to a number of other illnesses or even the effects of some medications.

While it’s impossible to track how many people struggle with an eating disorder but never report their condition, this may be the case for an outsized number of elderly people struggling with bulimia. One report sadly conjectured that fewer older people acknowledge having an eating disorder, since they have “fewer motivations or goals for the future,” or may not want to burden their families at this stage in their life. (3)

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Treatment for Elderly Patients With Bulimia 

When an elderly person does develop an eating disorder, the consequences can be disproportionately devastating when combined with the physical effects of aging, which makes it even more important for these individuals to find proper treatment for their conditions. (3)

Unfortunately, there can be a number of barriers to care for elderly people struggling with bulimia and other eating disorders. Availability of programs in their area is one; and, as many elderly people live alone and no longer drive, accessibility to those programs may be another.

Insurance—or, the lack thereof—is another factor that may particularly impact an older person’s search for treatment, especially for people who are retired or otherwise no longer working. 

But even for people who can’t find or afford more traditional treatment options, there is still hope. Bulimia, in particular, has shown promise to be effectively treated with a method called self-help therapy. Composed of a number of workbooks and other take-home materials, the treatment helps people work themselves through the problem, and is often more cost-effective and easier to find than other types of treatment. (4)

Regardless, anyone struggling with bulimia or another eating disorder shouldn’t give up hope. Recovery from these conditions is always possible—and it’s never too late to seek help. Call our team at Within Health to learn about our virtual care programs for bulimia nervosa.

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Frequently asked questions

Resources

  1. Gagne, D. A., Von Holle, A., Brownley, K. A., Runfola, C. D., Hofmeier, S., Branch, K. E., & Bulik, C. M. (2012). Eating disorder symptoms and weight and shape concerns in a large web-based convenience sample of women ages 50 and above: Results of the gender and Body Image (gabi) study. The International Journal of Eating disorders. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459309/
  2. Schaeffer, J. Elder eating disorders: Surprising new challenge. Today’s Geriatric Medicine. https://www.todaysgeriatricmedicine.com/news/exclusive_0409_03.shtml 
  3. McIntosh, J. (2015). Older people and eating disorders: Not 'just a teenager's problem'. Medical News Today. Retrieved March 18, 2022, from https://www.medicalnewstoday.com/articles/290023 
  4. Yim, S. H., & Schmidt, U. (2019). Self-help treatment of eating disorders. Psychiatric Clinics of North America, 42(2), 231–241. https://doi.org/10.1016/j.psc.2019.01.006
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