Anorexia * Bulimia * Binge Eating Disorder * Exercise Bulimia

An Ugly Midlife Crisis for Women

More middle-age women are seeking treatment for anorexia, bulimia and binge-eating disorder then ever before, especially in our community.  You starve yourself, proudly dropping pounds, losing inches, and it feels too good to ever stop. Or, you eat whatever you want, more than you want, until you feel like your belly will bust wide open. Then, discreetly sneak away from your family and friends to the safest bathroom and purge until you feel dizzy, even faint.

Perhaps, you are trapped in a vicious cycle of binge eating for days on end until finally you are so wrought with exhaustion and humiliation all you can do is sleep for an entire week.

When we think about those at risk for anorexia, bulimia and binge-eating disorder, we tend to think of impressionable adolescent girls or typical teenagers struggling with body image, desperate to resemble the thin, beautiful women on television and in magazines.  But, in recent years, physicians and psychologists across the country have witnessed a dramatic rise in eating disorders among women in their 30’s, 40’s, and 50’s. A new study from the Eating Disorder Center in Denver confirms that an increasing number of women in mid-life (30 — 65 years of age) are indeed suffering and struggling with these dangerous and potentially deadly disorders.

Dr. Lisa Elconin, Internal Medicine Specialist, sees so many middle-aged women with eating disorders she has made the disease a medical specialty in her practice of predominantly female patients.

Are you shocked to know that this potentially dangerous problem is “out of control” in our community? Yes, right here in Oakland County. Or, do you pretend “not to know”?

Anorexia: The Self-Starvation Syndrome

It’s not so easy to be carefree about food and exercise. It’s especially not for 1 out of 100 people who suffer from Anorexia Nervosa, constantly stressed about how each bite of food and how each minute of exercise will affect their bodies.

Anorexia is characterized by self-starvation.
People with Anorexia greatly fear weight gain or being “fat.” (They believe they are fat even when–often times, but not always–they are very thin.) Therefore, such people obsessively limit their food intake and obsessively exercise. By manipulating their diet, people believe they will feel in control of what sometimes may seem uncontrollable, and believe the control will help ease tension, anger and anxiety in their lives. But, in truth, such control leaves people feeling more defeated, as many aspects of their lives suffer and fall apart.

Here are some signs of Anorexia:

1. Not eating or eating very little

2. Exercising a lot

3. Weighing food and counting calories

4. Taking diet pills

5. Eating very small amounts of only certain foods

6. Moving food around the plate instead of eating it

7. Talking about weight and food all the time

8. Not eating in front of others

9. Being moody or sad (a consequence of malnutrition and stress)

10. Not wanting to go out with friends

When a body does not get sufficient energy from foods that it needs, it slows down. According to Dr. Lisa Elconin, an internist and eating disorder specialist, “Complications of anorexia are multitude and include osteoporosis, infertility, cardiac abnormalities, arrhythmia’s, severe constipation and gastric motility problems and death.”

Here are some other possible effects on the body:

1. Hair can become brittle

2. Anemia

3. Weak Muscles, Bone Fractures

4. Kidney failure

5. Low potassium and magnesium

6. Menstrual cycle stops

7. Cardiac Arrest

The culture of flawless perfection, familial pattern of eating disorders, life changes or stressful events, personality traits, such as self-hatred, and biology are all factors that may cause Anorexia.

About 90 % of people affected by the disorder are women, with the onset more commonly in teens and young adults. However, as society becomes more and more focused on the ideal of perfection, men are also becoming more widely affected. Furthermore, even though the disorder initially emerged in affluent, white women decades ago, Anorexia is no longer limited to any race, religion or gender. As the world and technology has picked up speed, so has the disorder, affecting more and more people annually.

Elconin states, “Anorexia is a disease just like cancer, heart disease and high blood pressure. It needs to be viewed as a disease for proper treatment and management. It is often beyond the control of the individual with the disease. The severity of anorexia may vary and so does its prognosis. Anorexia often is slowly manifested and denied adamantly by the affected individual.  The seriousness of this disease must be appreciated and addressed as soon as it is suspected.”

“Re-feeding” is when weight restoration is attempted through increased caloric intake. Elconin explains, “This is a very tricky time and needs to be monitored carefully by qualified specialists because during re-feeding severe electrolyte disorders can occur. This can lead to irregular heart beats and death–as was in the case of Karen Carpenter.”

Treatment must be multidisciplinary, involving nutrition specialist, primary care physician, a psychiatrist or psychologist, and most importantly family and friend support. It can be in or outpatient.

Bulimia: The All-Or-Nothing Disorder

You tell yourself, I’m not going to eat any of ‘that’ food today. I’m only going to drink liquids. I’m not going to give into those cravings.

By 3 p.m. your resolve fades and you reach for anything and everything to tame the cravings. Chips, candy, ice cream, leftovers, bread… The fullness at first feels great and satisfying. But soon your stomach is stretched beyond what it should and you feel six-months pregnant. Your determination to be thin has been replaced by your shame and anger. That’s when you sprint to the toilet with a finger down your throat, or rush to your pill cabinet for laxatives, or toss on your sneakers to workout, fearful of gaining weight and therefore doing anything to reverse the binging effects.

The cycle has started again.

Bulimia is an eating disorder characterized by drastically overeating and then purging, fasting or exercising as a way to rid of the calories. People who have bulimia usually hide their eating habits because they are ashamed by their lack of control.

These are multiple signs of bulimia:

Eating secretly

Eating unusually large amounts of food

Eating uncontrollably

Going back and forth between overeating and fasting (having the all-or-nothing attitude)

Going to the bathroom after meals

Using laxatives

Smelling of vomit

Exercising excessively

Discoloration of teeth

Fluctuating weight

These are some potential effects on your body:

Weight gain

Abdominal bloating

Broken blood vessels in your eyes



Mouth sores


Esophageal ruptures and tears

Loss of menstrual cycle

8. Constipation from laxatives

People who are bulimic believe the only way to reverse weight gain is by unhealthily ridding of the calories. However, this is not entirely true. If a person vomits directly after eating, only about 50% of the consumed calories will be eliminated from the body. Laxatives are even less effective, only eliminating about 10% of the calories.

While poor body image and self-worth greatly influence bulimia, there are many other major causes, including psychological, biological, and social factors. Therefore, there is no single cause. It takes a great deal of work to heal and stop this bulimia cycle. However, it can be done! Cognitive-behavioral therapy not only helps determine unhealthy behaviors but also identifies the thought patterns that promote such thoughts.

Binge Eating

We live in a society of over-consumption. Enormous homes, cars for each season, super-sized meals. You name it, we do it.

It seems we want to show what we have because we want everyone else to know what we’ve accomplished. However, as much as quantity is emphasized and valued, in one instance, it is not always so. This is food. Yes, people enjoy eating and dining well. But don’t enjoy doing it at the expense of their physical appeal.

Binge eating is the most common eating disorder. A binge is often defined as eating in an uncontrolled and quick manner, feeling intensely guilty about it, and feeling embarrassed by the amount you ate so you hide it. (Please note that just because you overate, does not necessarily mean you binged.)

The social pressure to look good and succeed may influence people to use food as a comfort or as a means to beat themselves up. Often times, being angry, sad, bored, worried, or stressed can trigger a binge.

It is unknown for sure what causes binge eating disorder. Some studies suggest the disorder is genetic. This may be because emotional instability and chemical imbalance are genetic and using food as a vice is an easy way to “deal” with distress.

Binge eaters are typically caught in a vicious cycle. They diet to lose weight, restricting what they will and will not let themselves eat. Then, they jump off the wagon and eat everything in sight, but feel intensely guilty and depressed because of it. And, finally, they will get back on the wagon, starting the cycle all over again. Sometimes, if a binge eater is bulimic, part of the cycle also involves starving themselves or using laxatives as a way to harshly rid the body of the food that may cause unwanted weight gain.

An unhealthy, inconsistent eating pattern can greatly affect people’s physical and emotional bodies. Studies have shown that binge eaters have more health problems, trouble sleeping, stress, and suicidal thoughts than people without an eating disorder, and also experience joint pain, digestive problems, headache, muscle pain, and menstrual problems. Another consequence of the disorder is skipping work, school, or social activities to either binge eat or because people feel too ashamed.

According to The National Eating Disorders Association It is estimated that approximately 25 million Americans struggle with binge eating. Of those people, women are more likely than men. This is an significant number because if you do binge, it is important to know that you are not alone…and, in fact, many people have the same insecurities.

Exercise Bulimia

Exercise bulimia is hard to diagnose since everyone talks about how great it is to exercise. If you do more, isn’t that good? Not if you’re taking it too far. If you use exercise to purge or compensate for eating binges (or just regular eating), you could be suffering from exercise bulimia. Of course, knowing how much exercise is too much is something you may end up learning the hard way, but if you pay attention to your body, there are warning signs that you’ve taken exercise to the max.

Compulsive exercising has to do with control, much the same way people with eating disorders use food as a way to take control of their lives. But, it can turn into an endless workout if you’re not careful since many women never feel satisfied with their bodies or their fitness levels, no matter how much they exercise. Exercise Bulimia will be explored in depth in a future article this month.

Seeking help and guidance is essential. It is important to understand why you are using food in this way.  You must seek treatment to achieve recovery – There is hope!

For support please contact Your questions and concerns will be confidential!

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  1. I wonder if my husband is a binge eater…..can you cover more on the men sometime in the future?

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