Longitudinal research suggests that clinically significant disordered eating found in young adult women may, in some instances, continue into later life. The duration of the illness may be longer in older adults and some older men may also be affected by this issue.

Research indicates that eating disorders may present in a number of ways in older adults:

• Severe cases of an earlier onset eating disorder without a period of recovery
• A relapse of a past eating disorder
• Late onset

• Sexual abuse
• Non-sexual trauma or abuse such as having experienced violence in childhood
• Major depression, depressive symptoms or past depression
• Stress
• Negative body image
• Health and medical problems
• The loss of loved ones due to death or divorce
• Reduced social activities, changes in relationships with family and friends
• Marked biological and developmental changes – menopausal status and ageing anxiety
• A fear of being overweight
• A higher frequency of dieting behaviours
• Distorted daily thoughts about food
• Weight-related teasing in childhood and adulthood
• Weight dissatisfaction
• Binge eating, extreme weight control and body checking behaviours

In addition to the medical, physical and psychological issues associated with eating disorders, individuals may experience:

• Difficulties in relationships, limited contact with friends and extended family
• Difficulties confiding in others and in talking openly about feelings
• Limited time devoted to leisure activity

Treating older adult women affected by eating disorders may involve education about the ageing process and how to manage unresolved issues. Denial of symptoms may be a feature in some cases, and as such, a challenge in the treatment process. Low body image and disordered eating in middle-aged and younger people should be not be viewed as support for a ‘one size fits all’, treatment approach.