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I recently attended an Instagram Live session hosted by BEAT (the UK’s leading eating disorder charity) with guest Gerome Breen, Chief Scientist of the Eating Disorders Gene Initiative. The conversation was an informal and enjoyable introduction to the genetics of eating disorders.
What wasn’t wonderful were the comments from adults with eating disorders in the live stream, which included frustration at being denied treatment, as well as embarrassment about their eating disorders. food and the feeling that they did not deserve treatment for them.
While statistics show that most eating disorders develop in adolescence or early adulthood, older adults (over 30) also develop eating disorders. Eating disorders in adults are no less serious or debilitating. Some surprising statistics:
- In the United States, most anorexia-related deaths occur in adults over the age of 80.11
- The percentage of men who die of anorexia nervosa is more than double the reported prevalence rate of 10%.11
Yet adults with eating disorders generally don’t get the access to treatment (or the respect) they need and deserve. The stigma of being an adult with an eating disorder can discourage many people from seeking help. This is shown in the Apple TV comedy-drama, Physicalwhere the adult female protagonist nervously assures her friends that she gave up that “childhood thing” (bulimia) years ago, while hiding her binge-purge cycles.
The scientific community, unfortunately, also overlooks adults with eating disorders. Therefore, the neuroscience of eating disorders in adults has not been fully explored.
Developing an eating disorder as an adult
Eating disorders in adulthood are often a continuation of a previous eating disorder, a relapse, or a more severe version of earlier struggles with food, exercise, and image. bodily.
Because eating disorders carry both genetic and biological risk factors, an older adult is less likely to randomly develop an eating disorder without warning signs (eg, body image, anxiety, depression). Nevertheless, there are exceptions.
One is sleep-related eating disorders, which can develop at any age.6 Although we know that these diseases often manifest as sleepwalking, sleep-related periodic limb movement syndromes, or overuse of sleeping pills, the exact neurological factors that contribute are unclear. Some Possibilities Are Dopaminergicseven or serotonergic dysfunctions.8 However, much more research is needed to understand what causes sleep-related eating disorders.
Additionally, aging brings risk factors that can increase an individual’s vulnerability to developing an eating disorder. For example, the acuity of sensory experiences (eg, taste, smell, vision) decreases with age.12 This can lead to reduced food intake in older people, which could contribute to the development of eating disorders in those most susceptible.
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Adult Eating Disorders in Women
As women age, they encounter new risk factors for eating disorders. These vary, as women now have a range of lifestyles to pursue (eg career, family, world tour). Maine et al. (2015) acknowledge this beautifully, blending the biological (weight gain, hormonal changes, aging) with the social (marriage, divorce, family, finances, career, self exploration).9
Nevertheless, women unfortunately still bear the bulk of family responsibilities (pregnancy, childcare, child care, care for the elderly) and household responsibilities (cleaning, cooking). As a result, they often neglect their own health, which can make them more vulnerable (via stress, depression, anxiety) to eating disorders.
Risk factors specific to aging also exist. Like puberty, the transition to menopause brings new biological susceptibilities to eating disorders, including hormonal changes.2
In a study of women matched for demographics, menopausal status, and weight history, it was found that perimenopausal women had a significantly higher prevalence of eating disorders, self-reports of “self feeling fat” and higher dissatisfaction with body shape compared to premenopausal women.1 This, again, highlights biological and environmental intersections that may increase susceptibility to eating disorders across the lifespan.
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Adult eating disorders in men
Information on eating disorders in adult males is sparse at best. This could be because eating disorders in men are often disguised as athletic activity.3 Another reason could be the stigma of men with eating disorders.
Nevertheless, we know that muscular problems are not the only risk factor for eating disorders in adult men. On the contrary, one study found that in addition to muscularity, men between the ages of 19 and 84 show a range of body image symptoms (eg, weight and shape) and behavior (eg, excessive exercise and dietary restrictions).4 This shows that eating disorders in adult men are complex. Therefore, more research is needed to understand the biological (and environmental) factors that contribute to these variations in adult men.
Unfortunately, few if any studies specifically explore the role of the brain in eating disorders in a sample of adult men. Therefore, we can only speculate using relevant research as a guide.
We know that men who experienced eating disorders in adolescence or early adulthood can develop gonadal changes, which can lead to a sustained drop in testosterone later in life.5 Since testosterone has been shown to be a protective factor against eating disorders, this reduction in testosterone production may increase susceptibility to the development of eating disorders in adulthood; it could also contribute to a relapse of an eating disorder or the continuation of a previous disorder in adolescence.2
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Likewise, since certain neurological, blood, gastrointestinal, and/or liver changes may result from early eating disorders, we cannot rule them out as potential risk factors for the development of eating disorders. in adults.5 For example, gastrointestinal disorders can contribute to eating disorder-like symptoms (eg, food avoidance), which include changes in eating habits. This, coupled with the additional distress, pain, and poor gut health that these illnesses cause, could turn into a real eating disorder in people at risk of developing an eating disorder.ten
Another possible risk factor for the development of an eating disorder in adults is stunting, which is a consequence of eating disorders in early life.5 It is possible that being less developed than others may contribute to lifelong body dissatisfaction, potentially contributing to the development of eating disorders in adult men.
Researchers, unfortunately, have not thoroughly explored the neurological (and related) underpinnings of eating disorders in adults. Therefore, this article can only highlight preliminary findings and speculations about possible risk factors for the development of eating disorders in these populations.
Given the destructive nature of these illnesses, however, it becomes imperative to understand and treat adults with eating disorders. While most eating disorders develop early in life, these diseases become more deadly as they persist in aging bodies. Therefore, eating disorders in adulthood have added urgency and need to be taken seriously.