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Eating disorders in women more common during midlife than expected

Eating disorders do not just affect adolescents and young adults, study finds

Ingrid Torjesen

Thursday, 19 January 2017

Eating disorders affect more women in midlife than expected, with 3.6% of women in their 40s and 50s reporting having experienced an eating disorder in the past 12 months, a study* published in BMC Medicine has found.

The study included 5,320 UK women and 15.3% of them reporting having had an eating disorder at some point in life but less than 30% of these had sought help or received treatment for it. The women completed a questionnaire that recorded each eating disorder they had experienced in their life. Women who reported having ever had any symptoms of eating disorders were interviewed, as well as an equal number of women who reported never having had symptoms.

Life events and interpersonal sensitivity were associated with all eating disorders; childhood sexual abuse and poor parenting were associated with binge/purge-type disorders; and a good mother-daughter relationship was protective for bulimia nervosa.

Christopher Fairburn, professor of psychiatry at the University of Oxford, said: “This is a novel study with good methods and a large sample population. The researchers have done a good job, however, it is particularly difficult to use interviews to retrospectively diagnose people. Essentially you’re asking people about how they felt or behaved 10, 20 or 30 years ago and then using a series of criteria to determine whether they would have had a certain diagnosis at that time. Retrospective diagnoses can be accurate if the feature being assessed is unambiguous such as being extremely underweight or repeatedly making oneself vomit, but they are prone to overdiagnose conditions.

He added: “If one focuses solely on those diagnoses one can be confident about, it still looks as though about 9% of all middle-aged women have had an eating disorder at some point in their life and that 1.9% of middle-aged women have met diagnostic criteria for one in the past 12 months. These are really high figures and are important – there really aren’t any other studies of this quality and size looking at this age span, which is why we haven’t seen this before.

“We also see from this study that very few of these women have had treatment. We knew this for teenagers but this is the first data we’ve seen across this wide age group. These women should know that a large proportion of them can be helped and that they are not alone or unusual in having an eating problem in middle age.”

Around 40-50% of women with anorexia can be cured completely, and the cure rate is as high as 60-70% in women with bulimia nervosa or binge eating disorder.

* Micali N, Martini MG, Thomas JJ, et al. Lifetime and 12-month prevalence of eating disorders amongst women in mid-life: a population-based study of diagnoses and risk factors. BMC Medicine 201715:12, published: 17 January 2017. DOI: 10.1186/s12916-016-0766-4

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