Health Team

Expert: Major life changes could trigger midlife eating disorders

Posted July 24, 2013

— Nearly 228,000 women in North Carolina suffer from an eating disorder, according to the National Eating Disorders Association, and experts say a growing number of adult women are dealing with anorexia and bulimia.

The Renfrew Center, which has eating disorder clinics across the country, including in North Carolina, added a midlife treatment track after seeing a 42 percent spike in patients over 30 in the past decade.

At Carolina House, an eating disorder clinic in Raleigh, about 50 percent of its patients are older than 30, according to organizers. The eating disorders program at the University of North Carolina at Chapel Hill reports a similar trend. 

“What we’re seeing a lot in midlife is we’re seeing major changes, like divorce in midlife or infidelity of a spouse. Or menopause is another major trigger for eating disorders in older women,” said Dr. Cynthia Bulik, founding director of the UNC Center of Excellence for Eating Disorders.

When UNC’s eating disorder unit opened in 2003, Bulik says, she thought it would mostly help adolescents. Now, more than half the patients are over age 30. The shifting demographic prompted her to write the book: "Midlife Eating Disorders,” which focuses on genetic factors.

“I often say genes load the gun and environment pulls the trigger,” Bulik said. "So what we see is there are environmental triggers that are facing midlife individuals and seem to be pulling the trigger for the underlying predisposition to an eating disorder."

For Molly Carrier, turning 30 was a turning point in her health. After having her second baby, the Raleigh mother struggled to juggle two young children and her demanding job as a paramedic. She coped by dieting.

“It’s kind of like a lot of women, where you gain a little bit of weight with the first pregnancy and you gain a little more with the second pregnancy. (It’s) kind of hard to take it off because you’re busy,” Carrier said. “I found having control over my weight and my eating made me feel like I had control over my life.”

That so-called control quickly spiraled out of control, and Carrier says she soon became “like a robot.”

“I found I could not eat a certain amount of calories a day and I couldn’t go to bed at night unless I exercised for an hour and a half,” she said. “I missed out on a lot of things my kids were doing, because I had to exercise. I became so malnourished, I couldn’t think straight, and there are whole blocks of things I can’t remember.”

After a few years, a friend confronted Carrier about her shrinking size.

Molly Carrier Expert explains possible triggers for adult eating disorders

“I said, ‘No, of course I don’t have a problem. I’m fine. I’m very healthy. I’m very fit. Everything’s great. Look how wonderful my life is,’ and she said, ‘OK, I dare you to go out and have a meal with me and then go home and not exercise,’” Carrier recalled. “And I thought, ‘No problem. This will be a snap.’ (But I) couldn’t do it. I was sobbing on the floor because I wanted to do those things that helped me feel in control.”

Carrier decided to talk with a doctor, who confirmed that she had an eating disorder – anorexia nervosa. Experts say anorexia has the highest mortality rate of any psychiatric disorder.

“It took a long time for me to accept that was actually what was going on,” Carrier said. “My thought was, ‘Well, I’m not 13 years old and trying to look like a fashion model. This is not an eating disorder. This is a way of life. This is healthy.”

In 1998, Carrier sought help at the Renfrew Center and spent the next decade in and out of treatment at the center’s Charlotte and Philadelphia locations.

"Treatment isn't going to be a quick fix. Treatment does take time," said Paula Edwards-Gayfield, site director at the Renfrew Center of Charlotte. "Not only in treatment are you addressing these stressors, you're also learning how to nurture yourself. You're also identifying what's normal (and) balanced meals, so you're working with a nutritionist. You're working with a psychiatrist. You're working with a therapist."

Now 48 years old, Carrier is still in recovery. “I did then, and still now, have a lot of body distortion,” she said. “I feel extremely large … I’m hoping someday I will look in the mirror and see what other people see, but I’m working on it.”

Carrier credits her family, doctor, nutritionist and therapist for being her support network. Experts say finding that support is critical to any recovery.

“A lot of parents and spouses will say to us that, ‘At first, I thought they were just being healthy. They were eating healthier foods, cutting out junk foods.’ All of a sudden, it was like a switch turned off, and there is a line when it goes from healthful to being obsessional,” Bulik said.

Top 10 signs of an eating disorder: (Source: National Eating Disorders Association)

1) Drastic weight loss
2) Preoccupation with counting calories
3) The need to weigh yourself several times a day
4) Excessive exercise
5) Binge eating or purging
6) Food rituals, like taking tiny bites, skipping food groups or re-arranging food on the plate
7) Avoiding meals or only wanting to eat alone
8) Taking laxatives or diuretics
9) Smoking to curb appetite
10) Persistent view of yourself as fat that worsens despite weight loss


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  • readme Jul 29, 2013

    I think we blow this WAY out of proportion and then completely downplay the obesity epidemic, which is about a thousand times more serious. If a woman is five pounds "underweight" (like half a billion healthy women in China), she is deemed to have a disease, but we're too PC to say anything about the numerous people walking around weighing 300 pounds.

  • tyres91 Jul 26, 2013

    You are correct. Like many other mental illnesses and addictions, a willingness to admit the problem and even accept help is necessary to achieve recovery.

  • btneast Jul 26, 2013

    the illness is complicated and devastating. And recovery is long and hard, not achieved by 'bucking up'.

    Yes and no. It is complicated and devastating, but you can't treat someone who either won't accept the reality or won't get they have to "buck up" and A) accept they are sick and B) get treatment. It takes a come to Jesus moment internally.

  • tyres91 Jul 26, 2013

    This article will go a long way to educating people about the realities and dangers of eating disorders. It is not a choice, the illness is complicated and devastating. And recovery is long and hard, not achieved by 'bucking up'. The more people talk about it, learn, understand, the easier it will be for people to seek and recieve treatment.

  • WRALwontdeletemyaccount Jul 25, 2013

    Life is not a "disorder"... it's just hard.

  • mmitch91762 Jul 25, 2013

    fishon, I know what the article is about. It can happen children and teens also for the same and other reasons. If all people had to do was to stop eating sugar and eat vegies and exercise then there would'nt be eating disorders.

  • PDMARTIN Jul 25, 2013

    that's right adults. It's amazing how everyone these days has to have a syndrome or a complex or some other off the wall addiction. I'm not being insensative, just realistic. Look it's as simple as you don't eat you die, you eat too much you die.

  • androiddj Jul 25, 2013

    stop eating sugar
    eat healthier, vegetables, less meat
    get some exercise

  • fishon Jul 25, 2013

    Nice comment pappy1. As someone who has a child that had a eating disorder you just don't get it. Pray it never happens to someone you know.

    This article is not speaking of a children's disorder. It is about people not being in control of themselves due to some change in their lives.

  • Conservative Jul 25, 2013

    And now, we need a $10 billion study to tell people they need to watch what they eat!