We often see the onset of anorexia nervosa during adolescence, but it is certainly seen among adults, sometimes well into their 70s. Depending on the severity of the disorder, many sufferers don’t make it to that age. Anorexia nervosa has the highest mortality of any mental health diagnosis. Binge eating disorder and bulimia nervosa are more likely to start during late adolescence or in young adulthood, and can also continue into later life. Cone Health sees many patients with eating disorders who are in their 50s and beyond.
Only about 1 out of 10 patients diagnosed with anorexia nervosa is male, but there is a higher prevalence of binge eating disorder in males. Most men with eating disorders are heterosexual, but LGBT males are at higher risk of all types of eating disorders.
There is a perception that distorted body image always accompanies eating disorders. While it is a prevalent component of eating disorders, it is not universally true. There is also a difference between body distortion and body dissatisfaction. The latter is undoubtedly fueled by the unrealistic beauty ideals promoted in the media, where images that have been digitally altered for both thinness and shapeliness are pervasive.
Many people who are hypercritical of their bodies fall into the trap of believing that self-criticism will eventually make them so disgusted with themselves that they’ll start exercising or eating right. All that negative thinking can, in fact, be motivating, but only in the short term. The reality is that criticism makes us feel bad, and when we feel bad, there is a part of our psyche that wants to feel better. For some, that means reaching for comfort in the form of food, otherwise known as emotional eating.
Emotional eating is using food in response to emotions, usually negative ones, independent of physical hunger, and it often involves sweets.
To intercept emotional eating, you should first bring mindfulness to the food decision. Ask yourself if you feel hungry, angry, anxious, lonely, tired, bored or depressed. If you can answer yes to one of more of those, the next 2 questions are, “What do I truly want?” and “What do I truly need right now?” With this analysis, you may find a much more effective way of making yourself feel better rather than resorting to food. In practice, it is more complicated, of course, but this is a good starting point.
Our community is fortunate, as Cone Health has a team of registered dietitians, primary care physicians and therapists and counselors who specialize in treating eating disorders. Cone Health also offers “Living Well: Managing Non-Hunger Eating” classes in Greensboro, Alamance County and Rockingham County.
Jeannie Sykes, PhD, RD, LDN, is a registered dietitian at Cone Health Family Medicine Center and a member of Cone Health Medical Group. She received a Bachelor of Science in nutrition from the University of Vermont in 1976, and a Master of Public Health Nutrition from the University of North Carolina at Chapel Hill in 1980. Sykes earned a PhD in nutrition from the University of North Carolina at Greensboro in 1986. She has worked at Cone Health Family Medicine Center since 1990.