FORBES.com, GoogleNews.com, by Meghan Casserly, September 27, 2011 — For a growing number of professional women, food issues take center stage mid-life.
When coworkers would pop into Alison’s office at lunchtime to ask if she wanted take-out, the petite advertising executive would look up from the piles of papers on her desk and say sure, and ask for a turkey on rye. But instead of being eaten, the sandwich would be slipped away in a desk drawer until quitting time, and eventually make its way into the hands of her husband. “It’s extra,” she’d tell him nonchalantly. As if no one suspected a thing.
In reality, Alisonwasn’t eating anything at all. The 49-year old married Chicagoan was in the thralls of an on-and-off lifelong battle with anorexia that she could trace back to middle school. And everyone around her knew she was self-destructing—everyone except herself.
Not Your Daughter’s Eating Disorder
Eating disorders including anorexia nervosa, bulimia nervosa and more recently orthorexia have long been associated with body-conscious teenage girls. In recent years, however, treatment centers have seen a significant uptick in the number of women seeking treatment later in life—from 30s to 60s. The Renfrew Center, the country’s first and largest residential treatment network has reported an increase of over 42% in the past five years.
Now three years out of treatment, Alison is among the growing cohort of middle-aged professional women who have struggled with the painful and life-threatening condition. Once a self-professed “huge perfectionist” over-achiever (“I was in the office until the lights were turned out”), Alison left her planned career path for the slower pace of non-profit work upon completing treatment in 2008, something experts say that’s not uncommon. For patients, treatment centers and psychiatrists are able to pinpoint significant stress triggers that serve as catalysts for the dangerous disease. Not surprisingly, career can be at the top of the list.
Holly Grishkat, Ph.D., is the director of The Renfrew Center in Radnor, Penn., where she specializes in mid-life eating disorders and has seen career anxiety as one of several stress triggers that plague older women. But like most issues for working women, it’s not just the job, but the “juggle” that causes untold amounts of stress.
The Quest For Control
“It can be a high pressure job situation with a divorce, an illness, a child leaving home,” says Grishkat, listing the litany of life change that strike mid-life. “It could be work and an aging parent. For this age group there’s a lot of anxiety to ‘keep it together.’ They’re grappling for something to hold onto. For many, the eating disorder is something they have complete control over in an otherwise out-of-control time.”
“To this day when I feel my stress levels go up, my first thought is how to restrict [my diet],” says Karen, a 40-year-old human resource professional in a Texas-based financial firm. Out of treatment just three months, Karen is struggling with her health in the wake of severe anorexia that left her with biting stomach ulcers and an inability to have children. In three months she has been admitted back into the hospital on six occasions for medical problems related to the disease. “I’m on the right path,” she says of her recovery, but the behavioral pattern is hard to fight. “The minute stress hits me my first focus is how can I restrict? How quickly can I binge and purge?”
Like Alison, Karen’s life was career focused. “I have always been the first to volunteer for extremely stressful projects,” she says, “even to the point of making up projects so that I could immerse myself in work.” Similarly, she had struggled with food as a teen but never been diagnosed with an eating disorder until her 40s; experts agree that it’s rare for these conditions to make their first appearance in middle age. “Maybe they had body image issues when they were young, but it’s exacerbated by a stress later in life says Melissa Pennington Ph.D., the medical director of eating disorders at Texas Presbyterian Hospital.
When Karen’s husband became ill in 2008, she says she began grasping at straws, and food was her first attempt at control. As her weight began to drop dramatically, she continued to restrict, even in front of coworkers. “If I’ve eaten 25 cashews a day” she remembers thinking, “I’ve eaten.” An obsession with drinking water (15 to 20 16-ounce bottles during a workday) landed her in the emergency room where she learned she had flushed her system of all nutrients.
She eventually lost close to 100 lbs and was so weakened by a bout with bacterial pneumonia that she lost consciousness and awoke days later, intubated and hospitalized, suffering from nutrition-related seizures. “A month later I was finally able to accept that I need help.” It wasn’t until several weeks into treatment that she had the realization that would save her life. “We did an exercise where you had to spend a whole day in your bathing suit,” she recalls. “You had to stand in a 360 degree mirror and then draw what you saw. I started to cry—what have I done to myself? What have I allowed to take control of me?” For the first time Karen accepted that in her quest for control—to control her diet—she had in fact relinquished control of her own life to a vicious disease that was hell-bent on killing her.
Admitting Defeat—And Asking for Help
Both Karen and Alison attest that asking for help was the most difficult thing they had ever done. “Especially in the finance world, in an office full of Type-A men, I never wanted to come across as weak,” Alison says. Rehabilitation experts concede that for older patients, admitting defeat and asking for help can be a major roadblock—but it can ultimately be their saving grace.
Unlike young patients who are generally brought in by concerned parents, most adult patients come in of their own volition. Whether as the result of a health crisis or simply a conscious decision that they are risking their lives, there’s generally a motivation among the older set, says Dr. Ira Sacker, a leading authority in eating disorder treatment in the U.S. “There’s much less denial.”
“The most difficult thing for a woman my age to do is to ask for help,” says Alison, who admits that in addition to the control aspect of her eating disorder she also struggled with body image issues about aging. “Someone would tell me, ‘60 is the new 30.’ And what I would hear was ‘When you’re 60, you’d better look 30.’” In the advertising industry where she worked at the height of her disordered eating, the fast-pace of technology and turnaround of employees left her self-conscious of her capability and appearance compared with younger female colleagues. “It was a recipe for disaster for me,” she says of her decision to leave advertising for the non-profit world. “Much as it took everything in my soul to say I needed help, it was horrifically difficult to look at my career and say ‘I can’t do this anymore.’”
In the three months Alison spent in treatment at The Renfrew Center—crying through meals, spending three weeks in a wheelchair because she was too weak to walk–she says the biggest struggle was learning a new way to identify. “I realized the business cards, career, status—all those things are second to my life. I used to equate my job title with my value and my worth an in conjunction with my eating disorder it was killing me. Three years later when people ask me ‘What do you do?’ it takes everything I’ve got not to answer ‘I live my life.’” Alison’s new career revolves around mentoring and support for other women struggling with eating disorders and addiction—another affliction she has overcome.
Karen has years to go until she reaches Alison’s level of recovery. Just three months out of an inpatient program, she’s still weighing her employment options while battling through daily reminders of her lowest times—force ulcers recently ruptured, making her home look “like a crime scene” and the occasional fall has left her prone to concussions in her still-weakened state. But by sticking to her doctor-prescribed meal plan she sees light at the end of the tunnel for both herself, physically and mentally. “I’m not 20, I can’t just bounce back. But every day I’m stronger. I may weigh less than my German Shepherd,” she laughs, “But I’m getting there.”