Chicago Tribune Heidi Stevens column

Sept. 16--Eating disorders have long been considered a disease that affects young women and adolescents, but experts say women in midlife are increasingly vulnerable to the tangled and potentially fatal scourge.

"Women with midlife eating disorders have been invisible sufferers, but it's a problem we're seeing more than ever," says Adrienne Ressler, a specialist at The Renfew Center, a residential facility with 16 national locations designed to treat anorexia nervosa, bulimia nervosa, binge eating disorder and related mental health problems. "Eating disorders were categorized early on as a problem affecting affluent, Caucasian adolescents, and it's been difficult to break through that myth. But the numbers are definitely changing."

"In 2001, 10 percent of our residential population was made up of women age 35 and above," Ressler said. "By 2003, 26 percent were midlife and older."

The National Eating Disorders Association says one-third of inpatient admissions to specialized eating disorder centers are for those 30 or older.

The jump is due, in part, to women's increased willingness to seek help, Ressler says. But it also speaks to unrealistic beauty standards that are intensifying, rather than diminishing, as women reach midlife.

"The pressure to be thin and have a perfect body becomes stronger than ever," Ressler says. "Meanwhile, the older you get, the farther and farther removed you become from whatever the current standard of beauty is."

Combine that with common midlife stressors -- teenagers, college costs, career transitions, marital dissatisfaction, aging parents -- and you've got an environment ripe for a disease that is largely triggered by anxiety, Ressler says.

"Midlife eating disorders can be part of a chronic illness they've had their entire lives," she says. "Maybe they've been dealing with chronic anxiety or depression and an eating disorder gets revived or triggered by specific midlife events."

Close to 50 percent of people with eating disorders meet the criteria for depression, according to the National Association of Anorexia Nervosa and Associated Disorders.

Ressler emphasizes the importance of seeking help for a midlife eating disorder, given the mental and physical health complications triggered by depleting your body of nutrients.

"The biggest thing we can do is to normalize this population and let them know there are lot of women just like (them)," she says. "Women have often spent their lives putting themselves last, but they need to know they are important enough to get help and take care of themselves."

One of her favorite quotes, Ressler says, comes from the author Mary Ann Evans, who wrote under the pen name George Eliot in the mid-1800s.

"It's never too late to be what you might have been," Ressler says. "I think a lot of midlife women think it's too late to take care of themselves or start to feel good. But it's never too late."

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