Eating Disorders: Not Just a Teen Problem
More and more women are struggling with anorexia and bulimia well into their 30s and beyond. Here's why.
You might think of anorexia and bulimia as adolescent disorders, but it's a
problem plaguing adults, too. Anorexia, in which people have an intense fear of
gaining weight and drastically restrict their food intake, cuts across ethnic
and socioeconomic boundaries. But it strikes mostly women: About 90% of those
with the condition are female, and about 20% of women still struggle with it
into their 30s and beyond.
While there's no hard data on how many adult women have symptoms of
anorexia, the National Eating Disorders Association (NEDA) says that body image
dissatisfaction is a risk factor for clinical eating disorders. And it's on the
rise in midlife women, more than doubling from 25% in 1972 to 56% in 1997,
according to the most recent data available from NEDA. In fact, about 30% to
50% of teens who have anorexia don't recover by their early to mid-20s.
What causes anorexia? The latest research shows the illness has more to do
with your brain than with societal influences or the way you were parented.
"When people with anorexia get hungry, their brains are not getting the right
signals," explains Walter H. Kaye, MD, professor of psychiatry at the
University of California, San Diego School of Medicine and head of UCSD's
Eating Disorders Program.
The Anorexic Brain
Specifically, new brain imaging studies indicate that people with anorexia
have abnormal functioning of the serotonin and dopamine systems. Serotonin is a
brain chemical that plays a role in satiety, impulse control, and mood, while
dopamine causes us to be attracted to positive stimuli. Brain scans have found
that people with disordered eating -- and even those who have recovered -- have
difficulty discriminating between positive and negative feedback. They are put
off by things that most people find pleasurable, such as good food. And being
forced to eat only increases the aversion to food.
The persistence of these malfunctions could provide a clue to why the
disorder can persist long past the teen years, Kaye says. It's difficult for
people with anorexia to maintain healthy eating habits, for example, because
hunger doesn't cause them to find food appetizing. Kaye hopes this information
will lead to new treatments, such as exercises to increase flexibility in
thinking. "These temperaments won't go away," he says, "but we can manage