Food and Weight Preoccupation in Midlife

Food and Weight Preoccupation in Midlife

Never before has there been such a focus, for young and old alike, on physical appearance as a mark of success and belonging. A cultural ethos of "self-improvement" dominates our bookshelves and our airwaves. Who can resist this? Women in midlife face challenges to our identities and self-concepts resulting from biological changes, life events and a culture in which healthy, strong images of older women are largely absent. For those of us who lack a constant and vigilant healthy self-image, the message of taking control over one's body as a means of controlling one's life is seductive.








Dieting makes the body and the mind hungry and often results in:
• preoccupation with food
• binge eating
• irritability
• depression
• fatigue
• social withdrawal
• poor concentration
• increased use of tobacco, and caffeinated beverages.

These are also symptoms of life-threatening eating disorders.

Fact: The risk of dying from heart disease is 70% higher in those with fluctuating weights than in those whose weight remains stable, regardless of initial weight, physical activity and lifestyle.
 
The extent of disordered eating
Eating disorders and weight preoccupation can and do affect individuals of all ages, classes, racial and ethnic backgrounds, sexual orientations, abilities and occupations, although girls and women make up 85-95% of those diagnosed with clinical eating disorders.

1.    While the most common age of diagnosis for eating disorders among women is between the ages of 14 and 25, studies reveal that individuals in their 70s can exhibit attitudes and behaviors congruent with eating disorders, with one study reporting a first-time diagnosis of anorexia nervosa for a woman in her early 90s.

2.    While the dangers associated with food disorders for teenaged girls are widely known and well documented, what is not so widely known is that approximately 79% of deaths related to anorexia occur in individuals over 45 years of age.

3.   However, not much attention has been paid by researchers to midlife women as a population for whom disordered eating is a serious problem. This may be because most first diagnoses and interventions for eating disorders are among teens and young adults. But it is precisely midlife and senior women for whom these earlier treatments for eating disorders have not worked, or whose disordered eating never received appropriate diagnosis and intervention in the first place - or who turn for the first time to self-harming manipulation of food and weight as adults.

Disordered eating patterns are complex conditions with multiple causes: social, individual, familial and biological factors all contribute in unique ways to developing and maintaining eating disorders in specific individuals. Consequently, disordered eating can be interpreted not as mere problems with food and weight, but as a complex expression of how an individual sees herself in the world, and a response to how she experiences that world.

Turning Body Shame into Body Pride:
• Identify what things you have been putting off for when you're thin; make a list and start doing them now!
• Find creative outlets for your feelings around your body: write about them, paint, read the writing of others, share feelings with a friend.
• Think about how you treat yourself and your body. Think of ways you can be gentle with yourself: massages, hot baths, wearing favorite colors, fabrics and styles are all ways of pampering your body.
• Enjoy being in your body. Do activities you like: dancing, yoga, meditation, karate, swimming, biking.
• Make friends with your body. You've tried wishing or hating body parts away, which hasn't worked - now try being gentle and compassionate.
• Behave like a person who is comfortable with her body. Watch what happens to the way you walk, interact, eat.
• Look through books or at paintings in a gallery. Notice and appreciate images of larger women and surround yourself with images that reflect your natural body size.
• Read books, web-sites and magazines (ensure that they are credible and not trying to sell you diet products) that look at the causes of body shame and how to overcome it. Listings are available at www.nedic.ca

 
Issues that increase our vulnerability to disordered eating
No one is immune to the overwhelming messages about weight and appearance, most evident in the advertising that surrounds every aspect of our public and private lives. We are exposed to approximately 3,000 advertisements a day, delivered via newspapers, television, magazines, the Internet and direct mail. Most sell an image of perfection, which especially for women includes a slender, toned, young body. This pervasive and unrelenting image of thinness and youth as symbols of a woman's success and worth combines with a cultural imperative of lifelong self-improvement. Ever new - or recycled - self-improvement and self-help methods dominate talk shows and best-seller lists. A huge number of these are specifically related to achieving a youthful, slender and toned appearance. "Fat" in our culture evokes - and even represents - fear: fear of being inferior, rejected, marginalized. The fear is internalized, and affects individuals regardless of size. "Fat" becomes a feeling, a judgment, rather than a simple descriptive adjective.

Implicit in much of what we see, hear and read around us are myths about food and weight. Few exhortations to lose weight address the biological set-point to be within a particular weight range that we each inherit. Few address the fact that our bodies will vigorously defend this set-point weight, so that dieting is a winning prospect only for the diet industry.

Weight is regained in 95% of cases, and in some cases, more is added. Then we feel frustrated, guilty, our self-esteem and sense of efficacy plummets even further, leading to renewed weight-loss behaviors, and for some of us, clinical eating disorders. Ironically, and as a consequence of dieting behaviors, obesity has reached its highest rates ever at a time when there has never been a greater emphasis on, and bigger industry for, weight loss and manipulating body shape and size.

Allied to "self-improvement" as a moral imperative is the notion that physical appearance can and should be manipulated as readily as we can manipulate our physical environments. Botox injections, liposuction and the like are advertised widely as safe and viable options for remaining young looking and hence desirable. The competitive edge that looking youthful seems to promise the working woman, or the woman dating again after many years, may drive many into the gym, diet centers and operating rooms. In a world where midlife women are largely identified with deteriorating minds and bodies, normal, graceful and engaged lives are seen as anomalies. Some women turn to rigorous weight management practices in the effort to deal with the difficulties they experience in navigating this time of change and loss of youth.

At the very time when one's biological drives are about to slow down, or are slowing down, many midlife women experience competing societal and individual pressures. These may include dealing with changes we face in self-image, time and psychic energy when children leave home. Conversely, as more adult children remain in the family home, some women may long for their own psychic and physical space, free of the demands of parenting, and struggle with the changing roles that come with having adult children.

On the other hand, many women today have later-life children. The birth rate in the United States for women between 40 and 45 increased 81% between 1980 and 1995. 

Midlife moms face other challenges, such as addressing the needs of young children while they themselves are facing hormonal and environmental changes. Some may want to do everything "perfectly", leading to unrealistic self-demands, which can lower one's sense of competence and self-esteem, and again may lead to seizing control over something that seems manageable: food and weight.

Biological drives to slow down may also compete with social/professional impulses to review life and re-energize our midlife transitions. If we face the prospect of retirement or loss of work, we may feel overwhelmed by feelings of fear, loss and uncertainty. Culturally sanctioned food and weight manipulation may be our tool of choice for presenting an energetic and self-disciplined façade while masking our difficulties with such challenges.

Many midlife women are also coping with the needs of aging parents. Increased demands on time and consideration of multi-faceted issues, such as negotiations with medical/health professionals and the need to advocate on behalf of both children and aging parents often deplete one's resources and lead to a sense of incompetence or inability to cope, especially when normal experiences and processes related to aging are termed "deficits." This may be exacerbated for those who must also deal with personal illness, disability or other marginalizing experiences, such as loss of employment, independence, or transition into a new country as an immigrant or refugee.

Warning Signs of an Eating Disorder:
• excessive concern about weight, shape and calories
• guilt, shame or secrecy about eating
• strict avoidance of certain foods, particularly those considered "fattening"
• feeling fat regardless of body-size
• the person's sense of her/his worth is determined by degree of weight and food control.

How You Can Help
If you think someone you know has an eating disorder:
• Know the warning signs of an eating disorder.
• Let the person know you are concerned and there to help.
• Focus on the person's overall well-being, not food and weight.
• Find out what services are available in your area.
• Learn as much as possible about eating disorders - the more you know, the more you can help.
• Be a friend, a parent, etc. -- not a policewoman.
• Be patient and compassionate: overcoming food and weight issues takes time and courage.

Final thoughts
Midlife women who engage in patterns of disordered eating may have lived with long-standing food and weight issues that were never resolved, or have struggled intermittently with these issues and relapse during times of duress. Disordered eating at midlife may also be a reversion to our earlier strategies for "coping" with stress. Some of us may also develop dysfunctional food and weight practices in later life in response to specific midlife challenges or insults to self-perception, for example.

When hormones fluctuate at the same time as family, work and social demands increase, the lack of a supportive environment and constructive coping strategies may catapult us (back) into problematic food and weight control behaviors. Memory lapses, poor concentration, fuzzy thinking, all related to life-stresses and/or hormonal fluctuations, may contribute to a sense of incompetence, fear, anxiety, and a need to take back control.and how better, we are told, than through restrictive dieting and weight management practices. These practices can become all-consuming and impact severely our life and well-being, and that of our family.

Sadly, in-line with our cultural ethos of "self improvement," excessive physical exercise and restrictive eating are perceived as adaptive and healthy: signs of much vaunted self-discipline. The often-invisible damage that disordered eating and exercise creates includes diminished physical and mental health and well-being, impaired family, social and professional lives, which impact on the larger community.


Merryl Bear is the Executive Director of The National Eating Disorders Information Centre.

This article first appeared in A Friend Indeed (July/August 2003), the newsletter for women in menopause and midlife.