Male eating disorders in midlife—possible links between excessive sports and hormones

AbstractAlthough eating disorders were long considered a typical female disorder, it is now clear that men are also affected. However, the literature on eating disorders in men is still very limited, and the actual extent is not known. Even less is known about the epidemiology of eating disorders in older individuals. In this focused review, we will present an update of the available data on disordered eating and eating disorders in middle-aged and older males. In addition, we will highlight the relationship of eating disorders with excessive sports as a purging method of choice for this age group and discuss the impact of age-related hormonal imbalances in aging men

Update on the epidemiology and treatment of eating disorders among older people

Purpose of review: We reviewed the recent literature on the epidemiology and treatment of eating disorders among middle-aged and older women and men.Recent findings: Recent studies show that among older female persons, the prevalence rates with full diagnoses of eating disorders based on DSM-IV or DSM-5 criteria are between 2.1 and 7.7%, and among older men less than 1%. These studies show that the prevalence of eating disorders decreases by age in women, but it does not get towards zero even in very high age. Middle age, with a peak around 50, is also a critical time for the occurrence of eating disorders in men. Women who reported severe menopausal symptoms showed more eating disorder pathology compared with those with low symptoms during menopausal transition.Summary: Eating disorders do occur in middle and older age of both sexes. Shame and stigmatization have decreased, and medical awareness and explicit assessment of eating behavior in all age groups have developed. What puberty is for eating disorders in adolescence and young age is menopausal transition for midlife women. Also in men, associations with hormonal disturbances are possible. Treatment approaches should consider treatment strategies tailored to older women and men, addressing the context of midlife and aging.</p

Epidemiology and treatment of eating disorders in men and women of middle and older age

Purpose of review We summarized recent literature on the epidemiology and treatment of eating disorders in middle-aged and older women and men. Recent findings The prevalence of eating disorders according to DSM-5 criteria is around 3.5% in older (>40 years) women and around 1-2% in older men. The majority of those eating disordered persons are not in treatment. There are new terms like 'perimenopausal eating disorders' and 'muscularity-oriented eating disorders' indicating the impact of the aging process and sex-specific differences. Summary Disordered eating and eating disorders occur in both women and men of all ages. Medical complications because of age, the stigma of eating disorders in a still 'untypical' age, and the glorification of sports activity often hinder the recognition of eating disorders in midlife and older persons. Treatment approaches should consider treatment strategies tailored for older women and men, addressing the context of midlife and aging

Pathological eating and body dissatisfaction in middle-aged and older women

Purpose of review To summarize the recent literature examining eating disorders, eating behavior, and body image in middle-aged and elderly women. Recent findings A small but evolving literature has begun to address the epidemiology, features, and potential treatment of eating disorders and related body-image concerns in middle-aged and elderly women. Preliminary findings suggest that pathological eating behaviors and frank eating disorders are surprisingly common in older women, as are associated body-image disturbances. Older women appear less likely to exhibit anorexia and bulimia nervosa and more likely to exhibit binge eating disorder and eating disorder not otherwise specified. The prevalence of such conditions in older women has likely increased in recent decades. On many indices of disordered eating and body image, older women with eating disorder resemble younger women with similar conditions, although older women exhibit certain unique concerns, such as dealing with menopause and with aging. Summary It appears that clinicians should be alert for eating and body-image disorder even in women well beyond the younger age range in whom these disorders have traditionally been described. Subsequent research should consider treatment strategies tailored for older women with eating disorders

Prevalence of eating disorders in middle-aged women

Objective: Little is known about the prevalence and correlates of eating disorders (ED) in middle-aged women. Method: We mailed anonymous questionnaires to 1,500 Austrian women aged 40-60 years, assessing ED (defined by DSM-IV), subthreshold ED, body image, and quality of life. We broadly defined "subthreshold ED" by the presence of either (1) binge eating with loss of control or (2) purging behavior, without requiring any of the other usual DSM-IV criteria for frequency or severity of these symptoms. Results: Of the 715 (48%) responders, 33 [4.6%; 95% confidence interval (CI): 3.3-6.4%] reported symptoms meeting full DSM-IV criteria for an ED [bulimia nervosa = 10; binge eating disorder = 11; eating disorder not otherwise specified (EDNOS) = 12]. None displayed anorexia nervosa. Another 34 women (4.8%; CI: 3.4-6.6%) displayed subthreshold ED. These women showed levels of associated psychopathology virtually equal to the women with full-syndrome diagnoses. Discussion: ED appear common in middle-aged women, with a preponderance of binge eating disorder and EDNOS diagnoses as compared to the "classical" diagnoses of anorexia and bulimia nervosa. Interestingly, middle-aged women with even very broadly defined subthreshold ED showed distress and impairment comparable to women with full-scale ED. (c) 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:320-324