Eating disorders common among women in mid-life

Recent findings indicated eating disorders were common among women in mid-life and risk factors differed among eating disorder subtypes.

“Our study shows that eating disorders are not just confined to earlier decades of life, and that both chronic and new-onset disorders are apparent in mid-life,” Nadia Micali, MD, PhD, MSc, of Icahn School of Medicine at Mount Sinai, New York, said in a press release. “Many of the women who took part in this study told us this was the first time they had ever spoken about their eating difficulties, so we need to understand why many women did not seek help. It may be that there are some barriers women perceive in health care access or a lack of awareness among health care professionals.”

To assess lifetime and 12-month prevalence of eating disorders, lifetime health care use and childhood, parenting and personality risk factors, researchers conducted a two-phase prevalence study of women in mid-life. The study cohort consisted of 1,524 women from the U.K. Avon Longitudinal Study of Parents and Children.

Weighted lifetime prevalence of eating disorders was 15.33% and 12-month prevalence was 3.61%.

Among full-threshold disorders, DSM-5 anorexia nervosa was the most common lifetime eating disorder (3.64%), while binge-eating disorder was the most common 12-month eating disorder (1.03%).

New-onset eating disorders accounted for 41.6% of 12-month prevalence diagnoses.

Median age of onset for first eating disorder diagnosis was lowest for anorexia nervosa (16 years) and highest for sub-threshold binge-eating disorder (26 years).

The majority of the cohort reported eating disorder onset before the birth of their first child.

Experiencing death of a carer was associated with a 7-fold increased risk for purging disorder.

Parental separation or divorce in childhood was associated with increased risk for bulimia nervosa, binge-eating disorder and atypical anorexia nervosa.

Child sexual abuse was associated with all disorders with binge-eating behaviors.

Sexual abuse by a non-stranger was twice as common among individuals with anorexia nervosa binge-purge disorder and had comparable prevalence to sexual abuse by a stranger among those with bulimia nervosa and binge-eating disorder.

Childhood unhappiness was associated with increased risk for anorexia nervosa-restrictive, bulimia nervosa, binge-eating disorder and purging disorder.

Childhood experiences were positively associated with all eating disorders, with a 4% to 10% increased risk per unit score increase.

Participants who reported low maternal warmth had increased risk for bulimia nervosa, binge-eating disorder and sub-threshold binge-eating disorder and purging disorder. Conversely, those who reported high maternal warmth were 20% less likely to develop bulimia nervosa, compared with those who reported lower maternal warmth.

Risk for anorexia nervosa binge-purge, binge-eating disorder, sub-threshold bulimia nervosa, atypical anorexia nervosa and purging disorder was higher among women who reported a more oppressive parental relationship.

Researchers found a marginal association between IQ and lifetime anorexia nervosa binge-purge, with a 4% increase in risk for the disorder for every one-point increase in total IQ (OR = 1.04; 95% CI, 1.01-1.07).

“The early risk factors we assessed were associated with different eating disorders. Anorexia, bulimia, binge-eating and purging disorder were all associated with childhood unhappiness, and parental separation or divorce during childhood seemed to increase the risk of bulimia, binge-eating disorder and atypical anorexia,” Micali said in the release. “We also found that death of a carer could increase the likelihood of purging disorder and that sexual abuse during childhood, or a fear of social rejection, was associated with all eating disorders.” – by Amanda Oldt

Disclosure: Micali reports no relevant financial disclosures. Please see the study for a full list of relevant financial disclosures.