There are many stereotypes when it comes to eating disorders or issues around food more generally.
One stereotype is that it’s something that affects those in their teens and early 20s. And that as people get older, they simply grow out of it. Kind of like a rebellious streak and as one matures, clarity strikes and you move on.
Well, this stereotype is downright incorrect. Eating disorders and food issues affect people all across the age spectrum.
Sometimes these issues develop in childhood and adolescents and sadly are still alive and kicking into midlife and beyond.
Other times, midlife is a time when these issues rise up. For example, someone has dieted on and off over the years, but it’s not until their mid or late 40s that the disorder really takes over.
When I look back at the clients I have worked with over the last couple of years, somewhere between one-third and one-half are at midlife or above (I’m defining this as 40 or above). And considering I haven’t written exclusively or specifically about this segment of the population this statistic says a lot.
Last week on the podcast I spoke with Michelle Viña-Baltsas. She is someone who struggled with food and her body for decades. In her early 40s she finally found peace and for the last decade has been helping others do the same. It was a great discussion, so if you haven’t listened to it yet I highly suggest you check it out.
This is actually what I want to look at as part of today’s blog.
I will answer this question using my own client experience, as well as the expertise shared by Michelle. These days I tend to work mostly with eating disorder recovery, while Michelle works more with disordered eating and dieting recovery. So together, we have this topic well covered.
(Note: Michelle has a fantastic guide called Body Compassion Guide: 12 Tips for Cultivating Body Acceptance in Midlife & Beyond which I highly suggest checking out here and some of the ideas in this article were informed by her guide.)
Before I look at the differences in recovery at midlife and beyond, I think it would be useful to look at the similarities. Because I honestly believe that there are more similarities than differences with recovery, irrespective of the age someone is at.
Whether we are talking about dieting or an eating disorder, this takes a physical toll on the body. Fundamental to recovery is the importance of nutritional rehabilitation, which is eating to give the body energy, not just for today but to make up for the debt that has ensued and the physical repair that the body has been missing out on.
And this is important, even if you have been bingeing. Or you live in a larger body. Too often it can be thought that this only applies if one is visibly emaciated or “looks like they have an eating disorder.” But this is not true.
This ties into the point above, that restriction needs to end for recovery to happen. And this is true whether this is the supposedly more extreme version of restriction, where calories are kept at levels much below the needs of the body. Right up to the supposedly more innocuous forms, like cutting out most carbs because you’re following a paleo diet.
It also includes ending mental restriction, which is where you eat food without giving yourself full permission to do so. So, eating the piece of cake but chastising yourself while doing so.
I’ve written a whole episode on the topic of restriction, which you can check out here (you can listen to it or read the transcript). It goes into the topic in a lot more detail.
Whether we are talking about dieting or disordered eating, fear is at the heart of it. It can be fear of:
This fear leads to avoidance and the longer this avoidance is kept up, the more the fear grows. This means that the counter-intuitive solution to this issue is to do the thing that you fear and to do it repeatedly until it is no longer scary. Something I talk about more in this podcast and this blog post.
When this is done, it leads to neural rewiring, which is the structural reshaping of the brain.
(Note: Much of the neural rewiring will also come from the nutritional rehabilitation, something I talk about in this episode about how restriction affects brain function.)
The practice of dieting or the entrenchment of an eating disorder greatly impacts one’s connection to satisfaction. It can become feared because if something is satisfying, it must be because you are eating the “wrong” food. Or you are being lazy and weak-willed.
One of the lessons Michelle took from her training as an intuitive eating counsellor is the importance of the principle of satisfaction (it’s the fifth principle of intuitive eating). And this can be directly connected to food, as I cover in detail here, but is equally important in other areas of life.
(Note: I believe recovery from dieting or an eating disorder is being able to fully embrace all the principles of intuitive eating. Something I go through in this episode with Elyse Resch, one of the co-founders of Intuitive Eating.)
I’m a big believer in the adage that “people keep their problems for a reason.” As Michelle talked about during our conversation, as painful as her bingeing was, the thought of giving it up was equally painful. It was her way of coping and she didn’t have a better way of dealing with this at her disposal.
So recovery, whether from dieting or an eating disorder, is understanding what this is doing for you. And then learning healthier ways of being able to deal with this situation.
Body Image is at the heart of all issues around food. And this is especially true when we fully understand the complexity of body image. As Michelle talks about in her body compassion guide body image includes:
Our body image isn’t a constant but shifts depending on a multitude of factors. Recovery, therefore, is about working on the factors that go into our body image as well as understanding the triggers that affect how it changes.
While not every person who has dieted or has an eating disorder has a fraught relationship with exercise, it affects the vast majority of people.
At one end of the spectrum are those who are compulsive and struggle to cut down on movement: it has become a compensatory tool to “manage the damage” done by eating.
At the other end of the spectrum are those who struggle to exercise. There is so much baggage and shame connected to it, that it’s avoided at all costs.
Therefore, the goal with recovery no matter where you are on this spectrum is to reach a more positive and intuitive relationship with exercise. For those at the compulsive end of the spectrum, this usually means a total break for a time as a starting place for building a better relationship with it.
The final commonality with recovery at any age is the importance of acceptance. Acceptance isn’t about liking but is about learning to allow without resistance. It is being able to see what is without the struggle to change it.
So much of the resistance to recovery is because of the inability to accept what has or what may occur. The weight gain, the changing of identity, the uncomfortableness of the recovery process, that you’ve been pursuing something for years or decades that you are now turning your back on.
But whether it’s recovery from a career of dieting or an eating disorder, acceptance is needed for this to occur.
So now with the similarities out of the way, let’s look at some of the differences or challenges that being in midlife or beyond brings up.
Midlife is a point of life when there is a significant shift in hormones. While many of these hormones are thought of as “reproductive hormones” their real impact is on all systems of the body, not just reproduction. Affecting skin, bones, fat distribution, brain function, mood, and sleep, to name just a few areas.
This means that recovery can be taking place at a time of great change. A time that most likely would have been difficult without the addition of recovery. And so, in midlife, when knocking up against challenges, there can then be the question of “is this because of recovery or is this because of midlife?”
And while this question is common, it’s largely irrelevant. Because if we come back to the idea of acceptance, it doesn’t matter what is driving this change. What’s important is accepting that this change is occurring.
The exception to the above is when something can be done to remedy the situation. For example, depression or low mood could be caused by low amounts of hormones and taking HRT could be useful in ameliorating this.
One of the benefits of youthfulness is the body’s ability to bounce back. Certain hormones are at higher levels which naturally promote recovery and repair. Metabolism is naturally at a higher rate when younger, again assisting in the repair process.
This means that recovery is often slower in midlife and beyond. Now, part of this can be because of how long the dieting or eating disorder has gone on for. If someone is in midlife and it developed in their teenage years, this is a much longer time that this has caused damage to the body.
But even for someone who develops issues in midlife, because of the hormonal and metabolic changes that occur with ageing, recovery is going to be slower.
The older someone is, the longer certain habits and beliefs may have been around and they can feel normal or true. While this can be a huge advantage for the things that truly enhance your life, it’s an obstacle for those ways of thinking or behaving that negatively affect your experiences.
This means that in midlife there can be an increased amount of unlearning that needs to take place. And unlearning ideas that have been believed for a really long time.
The good news is that this doesn’t prevent recovery. In Michelle’s case, she struggled with food and body for over three decades. Dieting, bingeing and an unhealthy relationship with exercise were a mainstay in her life for as long as she could remember. But despite this, she was still able to change.
On average, life is simpler when younger (although I know for many younger clients their life feels anything but simple).
During midlife, there are often more plates that are spinning like children (whether still young, teenagers or in their young adulthood), ageing or ill parents, divorce or a relationship that requires help, a mortgage, grief, and a stressful point in their career (or thinking about re-entering into the workforce after years dedicated to children).
These obstacles mean that you are stretched thin with multiple people and problems vying for your attention. The luxury of free time and space that is often available to someone younger is not an option.
Again, this doesn’t prevent recovery but can simply make it more challenging.
As we age, we are more likely to get ill. At age 50 or 60, our chances of being diagnosed with high cholesterol, high blood pressure, diabetes, arthritis, or cancer are much more common than in our 20s or 30s.
Often a reason that dieting or an eating disorder developed in the first place is connected to health. And it’s often a reason that these persist as well, for the fear of becoming unhealthy (as ironic as that may be when someone is so physically and mentally impaired and is already in a state of unhealth).
And so when someone is going through the recovery period and one of these conditions is diagnosed, it’s easy to feel that everything was fine beforehand and that recovery is the reason for the “deteriorating health.”
This is then made more complex by the fact that being in a depleted and malnourished state doesn’t always show up on a blood test (something I cover in this episode). A blood test can give a clean bill of health despite the abundance of symptoms.
But then recovery starts and despite the actual improvements in health, now the blood tests look worse, with elevated cholesterol or blood glucose numbers for example. Not to mention the medical fatphobia and the potential comments of doctors.
All this means that midlife and beyond can be a time when there can be a greater onslaught of medical challenges that adds to the ambivalence and second-guessing about whether recovery is the right thing to be continuing with.
I started this article talking about one stereotype of issues with food, namely that this is a young person’s issue. And that by midlife, you have your shit together.
This can mean that it can feel harder to reach out or open up about issues connected to food and body in midlife.
We can look at another example to see how this plays out. For example, the often-quoted statistic is that males make up 1 in 10 of those with an eating disorder. But the reality is that eating disorders affect males at a much higher percentage than this statistic.
Part of the reason it appears so low is because of the stigma of eating disorders being a “female thing”. But another part is that eating disorders can often look different in men, with a striving for masculinity rather than thinness, and hence it’s missed being seen through the narrow categories and definitions for eating disorders.
And I feel the same is happening with eating disorders and chronic dieting in midlife and beyond. There is a stigma that makes people less likely to come forward. But also, as a society, we have been so captured by the pursuit of health and longevity that these issues are missed despite hiding in plain sight.
Our standards of beauty are very much connected to youthfulness. And often food issues are an attempt to move closer to these (impossible) standards of beauty.
Now, with recovery at any age, there is no guarantee on the body you’ll find yourself in after you’ve wholeheartedly stopped dieting or you’ve fully recovered. This is part of the acceptance piece I mentioned earlier; it’s accepting that your body is going to do what it’s going to do.
But in midlife, the likelihood is infinitely higher that you are not going to match up to society’s ideal. Now, I should add, that this is mostly not about recovery, but the impossibility of standards – if society values the appearance of a 20-year-old, and yet you’re 50, there isn’t anything you can do to change this.
But despite this, it doesn’t change the grief that can be felt. And the illusion of control that dieting or an eating disorder can be incredibly alluring.
Recovery can be difficult at any age and being in midlife and beyond can offer unique challenges. But despite this, it is not an impossibility and I truly believe that recovery is possible at any stage of life.
To quote Michelle “Learning to prioritise who we are instead of how we look gives us opportunities to experience a more joyful life where our bodies, food and movement fall into their proper place in our lives instead of occupying so much emotional real estate.”
If you’d like to reach this more joyful place, I’d love to help. (Michelle does too).
I’m a leading expert and advocate for full recovery. I’ve been working with clients for over 15 years and understand what needs to happen to recover.
I truly believe that you can reach a place where the eating disorder is a thing of the past and I want to help you get there. If you want to fully recover and drastically increase the quality of your life, I’d love to help.
Want to get a FREE online course created specifically for those wanting full recovery? Discover the first 5 steps to take in your eating disorder recovery. This course shows you how to take action and the exact step-by-step process. To get instant access, click the button below.
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