Midlife Eating Problems

Excerpted from
Runaway Eating: The 8-Point Plan to Conquer Adult Food and Weight Obsessions
By Cynthia M. Bulik, PH.D., Nadine Taylor, M.S., R.D.

"Among the recent pressures on women, perhaps none is more severe than linking femininity with slimness and fitness.... Slim, trim, bright, beautiful, and driven are now the standards set for the modern middle-class woman . . ."

-James M. Mannon, Measuring Up: The Performance Ethic in American Culture

Liz, a 45-year-old interior designer and mother of two young children, began to use food to run away from the stresses in her life just after her marriage fell apart. Within a period of about 6 months, her life turned upside down. Besides having to adjust to being single again, Liz saw her workload double as she went from a part-time to a full-time schedule, requiring her to hire a live-in nanny. She found herself in the throes of a nasty custody battle, her finances were in disarray, and both children began to do poorly in school. Going from bad to worse, Liz's mother died, and Liz herself began going through early menopause. Some days she felt as if she was on an emotional roller coaster.

"Sometimes the only thing that can make me feel better is eating an entire box of chocolate-covered caramels," Liz admitted. But her Runaway Eating didn't stop there. When she felt particularly anxious or sad, she could eat 2 quarts of ice cream in one sitting, a dozen doughnuts on her way to work, or an entire jar of peanut butter by the spoonful. Her weight soared and she felt bloated and awful, but that didn't keep her from bingeing the next time.

"After I go on one of my eating jags, I'm always disgusted with myself, and I end up feeling even worse (make that a lot worse) than when I started," Liz sighed. "But still, I just can't seem to stop...." In the course of trying to find comfort, distraction, solace, and satisfaction through food-in short, using food to run away from her problems-Liz found that her eating habits had run away with her.

Problematic eating has long been considered the almost exclusive territory of troubled teenage girls and young women. We've all read about Karen Carpenter's self-induced starvation and Princess Diana's bingeing and purging. We've heard dramatic stories about the high-achieving teenage girl who starves herself down to 60 pounds, the stressed-out college student who binges and purges 10 times a day, and the driven gymnast who works out 8 hours a day, then goes home and does a 90-minute high-speed session on her stationary bike. You might think, as Liz once did, that these destructive, dangerous behaviors are just kid stuff and that once you've safely passed through your twenties, you're immune from such traps.

Yet an invisible class of problem eaters has been quietly growing in recent years: women in their thirties, forties, fifties, and beyond. In the past 5 years, psychologists nationwide have noticed a startling rise in the number of midlife women seeking treatment for eating problems. In March 2003, the New York Times reported that the number of over-40 patients at the Remuda Ranch in Arizona, the nation's second-largest eating disorder treatment center, had more than doubled since 1997. A similar increase was seen at the Cornell Eating Disorders Program in White Plains, New York- with twice as many midlife women motivated to get help than there were 5 years earlier. Part of the increase may be due to the growing availability of such programs and a decrease in the shame associated with reaching out for help. But beyond that, more and more women are realizing that problematic eating is ruining their lives.

Hard statistics reflecting the scope of midlife eating problems are difficult to come by, partly because most women don't seek help until their troubles become unbearable. We do know that of the 8 million Americans with bona fide eating disorders, a full 14 percent (more than 1 million people) are not teenagers. And surely this is only the tip of the iceberg. Full-blown eating disorders don't just suddenly appear out of nowhere; they develop gradually over a period of years or even decades. They also exist in degrees, ranging from very mild to very severe. Undoubtedly, millions of women suffer from the milder forms of disordered eating that can show up as occasional bouts of out-of-control eating, weight preoccupation, pathological dieting, bingeing, occasional binge-and-purge episodes, compulsive exercise, returning symptoms of former eating disorders, compulsive overeating, or other food-related behaviors.

Some midlife women with eating problems are carryovers, those who had eating disorders that they were never quite able to shed when they were young. In fact, according to a review completed in 2002, about half of those with anorexia nervosa and at least a third of those with bulimia nervosa carry their eating problems with them into the early and middle stages of adulthood. But many midlife women are developing problematic eating for the first time in their lives. Why? No one really knows for sure. It may be partly because today's midlife woman is more appearance conscious than women of previous generations. Unlike her mother or grandmother, the typical midlife woman today works outside the home.

She is competing with younger people every day for jobs, raises, power, and attention and may be loathe to ease into the "plump grandmother" role. Divorce or widowhood may have thrust her back into the singles market, where good looks are the trump card. At the same time, she may be dismayed to find her weight and her waistline steadily increasing, due in part to the hormonal changes of menopause. Fluctuating hormones may also cause changes in her appetite, contribute to blood sugar imbalances, and make her retain water. And statistics show that she is more likely than ever to be seeking help for depression, a condition commonly associated with problem eating. But perhaps the most important force behind her eating problems is the incredibly stressful life she leads.

Midlife Is Synonymous With Stress

If you're a woman between the ages of 35 and 60, we probably don't have to tell you that you're in what will likely be the most stressful period of your life. At no other time will you have so many responsibilities and experience so many major life changes. In many women, these stressors can trigger problematic eating behaviors. Let's take a closer look at some of the major midlife stress-inducers.

Raising Children

Depending upon when you started your family, your kids may be anywhere from toddlers to teenagers. And though they bring great joy, they also bring heavy responsibilities. Babies and young children need an incredible amount of care and attention. Older children may be more independent, but just coordinating their busy lives and getting them from place to place can be a full-time job, not to mention the sheer work of making sure they get meals, clean clothes, baths, and their homework done without going through a major meltdown. Teenagers bring their own problems and personalities into the mix. Their rebelliousness, increasingly complex lives, and endless interest in pushing it to the edge will, at the very least, test the limits of your tolerance.

No matter what stage your kids are currently in, one thing is certain: They all put unrelenting demands on your time, pocketbook, and patience. Although it's often extremely rewarding, raising kids is undeniably stressful.

Career Challenges

Midlife women also face unique career challenges. If you postponed your career to raise your children (or at least get them into kindergarten), you may find that getting a job now is tougher than you had imagined. Competition is particularly fierce in today's weak labor market, and even brand-new college graduates are having a more difficult time finding a job now than at any time during the past 20 years. The shaky economy and skyrocketing health insurance and pension costs have forced many employers to scale back rather than expand their businesses. They find it's a lot less expensive to increase the workloads of existing employees rather than create additional jobs. In this era of shrinking paychecks, weakening unions, and a smaller labor force, just landing a job can be a major accomplishment. Unfortunately, you'll then be competing with much younger people, fresh out of school, who have the ambition, time, and energy to devote their lives to work.

If you established a career first, then took several years off to start a family, you may discover that your old job is no longer available when you're ready to come back. Or that advances in technology have rendered your job skills obsolete. But even if you've never taken a break and continued to work straight through, once you enter midlife, you may find yourself fending off increasing numbers of young competitors for your job. And if you are a working mom, the special complications that go along with this role-taking extra time off to tend to sick kids, attend school events, or chauffeur the kids to appointments-may make you less attractive to many employers than your younger, unfettered colleagues. Plus, the issues you face as you fight your way up the career ladder can be more difficult to handle as you get older: poor-paying entry-level positions, long hours, ageism, and unfulfilling work.

Whether employed in high-powered careers or minimumwage jobs, midlife women have one thing in common: We're all faced with the endless and often irreconcilable problem of trying to meet the demands of both job and family. After all, as women we're the major caretakers for our families. If somebody has an emergency, needs to go to the doctor, or has to get picked up at a certain time, who else is he or she going to call? Because we are continually needed, we're constantly torn between our responsibilities at work and those at home.

Empty-Nest Syndrome

After years of doing countless piles of laundry, endlessly preparing meals, and begging your kids to clean their bedrooms, you may think it will be a relief once they finally move out of the house to go to college, start careers, or get married. But for many women, this event can be unexpectedly stressful.

When your grown kids move out, it's normal and natural for you to feel sad, bored, empty, anxious, and lonely-a condition called empty-nest syndrome. This is a major life transition as you move from being the super-responsible, always-needed mom to a woman whose child-rearing responsibilities are, for the most part, finished. Though still a mom, you may start to question your identity as you find yourself with more free time and fewer distractions. The upside is that you'll be free to focus mainly on yourself, your partner, and your own life.

Extended Parenthood

The flip side of empty-nest syndrome is dealing with a nest that doesn't empty soon enough. Back in the 1970s, the average man was married and on his own by age 23; the average woman, by 21. But today's kids are staying home much longer than ever before, either never leaving at all or boomeranging home after college, often living under their parents' roof until they are well into their thirties. In 2000, 12 percent of men and 5 percent of women ages 25 to 34 still lived with at least one parent.

In some cases, kids leave, start an independent life, then come back with grandchildren in tow, wanting to live with you until they get their lives back together. This translates to an extended period of stress, responsibility, and financial strain-not to mention an invasion of your privacy while you put off transitioning into the second half of your life. Some women find that they are never relieved of child-rearing duties. They go straight from raising their own kids to raising their grandchildren. According to the U.S. Census Bureau, in 2002 there were 3.7 million children under the age of 18 living in their grandparents' home. Sixty-five percent of those children had at least one parent also living in the household.

Caring for Aging Parents or Other Relatives

Another problem that's almost completely the province of midlife women is the caretaking of ailing parents. Between the ages of 35 and 44, almost one-fourth of American women become caregivers for their elderly parents, a figure that rises to one-third for those in the 55 to 64 age group. And being a woman makes it highly likely that this demanding new role will fall to you, rather than your brothers (if you have any). Adult daughters are three times more likely to assume the caregiver role than adult sons are, and when it comes to caring for the most-impaired parents, daughters are four times more likely to take up the mantle. Add this to a fullor part-time job (44 to 61 percent of adult daughters who are caregivers are also employed), plus the many other roles you play, and you have a very heavy load to tote.

Although you've always known your parents would age and eventually pass away, when the process actually kicks into gear, it may take you by surprise. After all those years of relying on good ol' Mom and Dad as your backup support system, the roles suddenly reverse and you're taking care of them. This is a difficult adjustment, particularly because your own plate is already filled to overflowing.

Right in the middle of dealing with a full-time job, soccer games, ballet lessons, your own hormonal swings, and backed-up plumbing, your mother may be diagnosed with Alzheimer's disease and have to give up driving, or your dad may go on dialysis. You have to take up the slack-accompanying them to doctor's appointments, doing their grocery shopping, taking over their bills, and arranging hospitalization or nursing home stays when necessary. When they finally pass away, you may find yourself awash in both grief and relief, unsure which is greater.

The decline and death of a parent inevitably brings up the issue of your own mortality. Suddenly there is no buffer between you, old age, and death. You are on deck, getting ready to take your place as a member of the older generation. It's a sobering time as you contemplate your own senior years. Are you going to end up with the same physical ailments, the same fading mental abilities, the same problems of old age as your parent had? Though it was once difficult to imagine yourself getting old, all at once it seems much more real.

Financial Burdens

Then there's the problem of how to finance this overloaded, wheezing, bursting-at-the-seams endeavor we call life. Paying bills is not a uniquely midlife phenomenon, but the bulk of society's financial responsibilities lies on our middle-aged shoulders. We bear the brunt of the cost of mortgages, taxes, insurance, day care, cars, lessons, tutoring, furniture, clothes, vacations, college, and weddings.

Although those in midlife have always assumed the greatest financial burden for supporting their families and communities, let's face it: The cost of living is a lot higher today than it was for our parents. Back in the 1950s and 1960s, people easily lived on one income. They had one car, they ate almost all meals at home, Mom may have made many of the clothes, they walked or rode bikes everywhere, and there was no such thing as day care. The total cost of an average home was about the same amount as a schoolteacher made in a year. Even wedding receptions were often backyard buffets that didn't break the budget. Today, the impossibility of living on one income has made it necessary for nearly three-quarters of all mothers with children under 18 to join the labor force, and many of us have already resigned ourselves to the idea of no retirement.

Relationship Troubles

Marital fights, separations, and divorce can happen at any time, of course, but they're particularly frequent during the high-pressure midlife years. Overburdened and overworked, husbands and wives may take each other for granted during these years, spending little time on the relationship because it's the easiest thing to ignore. Careers, children, and endless chores may demand attention right now-but the marriage can often be put on the back burner. Hungry for the love, admiration, or support that they're not getting at home, men and women alike can become vulnerable to infatuations. An exciting new person may appear who seems to fill a void or provide something they're not getting in their marriage. Some marriages give way under the stress; others soldier on. Either way, the midlife years are often a period of crisis within the marriage.

Midlife is also a time for reflection, a time to assess how far we've come and reevaluate where we're going. It could be that the physical changes associated with aging or illness, the death of a parent or a close friend, or the departure of children trigger some intense soul-searching. Some people find themselves asking, "Is that all there is?" They may feel they have topped out in their careers and are trapped in marriages that are no longer fulfilling or satisfying. They may want to escape the old life and start a new one while there is still time, and getting out of the marriage may be the first step. Certain events, such as the youngest child leaving for college, a job ending, or a parent dying, can seem like natural end points for a marriage.

Divorce and Singlehood

Research has shown that there are two high-risk periods for divorce: One spans the first 7 years of the marriage. The second occurs during midlife, when children (if there are any) are young teenagers, a period that some researchers have called the lowest point in marital satisfaction. In the last 30 years, divorce rates have soared, with almost half of first marriages crumbling by the time midlife rolls around. The yearly divorce rate in 2001 was nearly double that seen in 1960, and the proportion of divorced to married individuals has almost quadrupled since 1970, from 47 divorced per 1,000 married in 1970, to 180 per 1,000 in 2001. Clearly, divorce happens, it happens often, and it's not just confined to mismatched newlyweds.

When ranking stressful life events, experts continually put divorce near the top of the list, right under "death of a spouse." And, indeed, divorce can be like a death-the death of a way of life- bringing with it an endless array of stressors: the loss of a loved one, dealing with emotionally wounded children, custody battles, loss of financial status, moving, and adjusting to being single again. Parental pressures increase when a woman finds herself raising her children alone, sharing custody, or fighting with their father over child-rearing methods.

Upping the ante is the prospect of becoming a single person again and venturing into the dating world. The idea of being out there in search of a new partner is frightening for any midlife person. But women have it particularly tough in our current youth-and-beauty-worshipping culture, where they can find themselves competing with women half their age for men who are their contemporaries. Many newly divorced women fall into pathological dieting, excessive exercise, or problem eating behaviors as a reaction to the stress, in an attempt to regain their youthful figures, or for both reasons.

Menopause

It's really unfair that just when we're confronted with mounting family, career, and financial burdens, we also have to face the physical and emotional changes brought about by menopause. Over a period of months or even years, your menstrual periods will become irregular and finally stop completely. As your levels of the hormones estrogen and progesterone fluctuate, the delicate balance that exists between them can be thrown off, triggering anxiety, depression, emotional hypersensitivity, fatigue, hot flashes, migraine headaches, increased sensitivity to pain, and sleeplessness, just to name a few symptoms.

You may also start to worry about losing your sexuality or sexual attractiveness once you're no longer in your reproductive prime. You may wonder if you're less womanly once you've gone through menopause-if men will still find you attractive or if you're losing an important part of your identity. Menopause can bring about changes in the way you look, feel, and respond physically and emotionally. Luckily, by paying attention to your eating and exercise habits, and seeing your doctor regularly, you can do much to ease menopausal symptoms and stay comfortable and confident.

Aging

As you ease into your middle years, it's inevitable that you will notice certain physical signs of aging. Your overall strength declines somewhat, and your muscles can get strained and sprained more easily as they become weaker and less resilient (especially if you don't exercise regularly). You may gain weight more easily and find it harder to lose those extra pounds because of the age-related slowing of your metabolism. In fact, researchers at the University of Pittsburgh, studying 485 premenopausal women ages 42 to 50, found that the women's weight increased an average of 5 pounds over a 3-year period, with 20 percent of the group showing a weight gain of 10 or more pounds. Eight years after menopause, the average woman weighed 12 pounds more than she did at the start of the study.

Yet due to a redistribution of fatty tissue, the fat in your face seems to disappear with no effort at all, leaving sagging skin and increased wrinkles in its wake. Your abdominal muscles become softer, your breasts start to lose firmness, your skin and hair may thin and dry out, and age spots can appear on the areas of your body that have seen the most sun. As women who live in a culture that worships beauty and youth, most of us find these changes unsettling, at the very least. But for some, they are devastating.

Women whose identities depend upon their looks (such as actresses and models) can be thrown into a panic by age-related changes. But even the woman down the street, whose livelihood isn't related to her looks, can experience anxiety or a sense of mourning as her youthful face and body begin to show signs of aging.