The frequency of eating disorders goes down somewhat between adolescence and midlife. But bulimia is not that rare at age 50. In fact, the National Institute of Mental Health reports that rates of bulimia may not fall off that much until after age 60. Eating disorders probably appear throughout our lives because eating is such a big part of life, no matter how old we are.
Recent reports suggest that today more women in their 40s and 50s seek treatment of an eating disorder than any time in the past. But it's not clear why. Epidemiologists (doctors who study the patterns of diseases or health risks) are likely doing a better job of tracking eating disorders at various ages. People are more aware of eating disorders today, so they may recognize the symptoms more in themselves or their loved ones. Rates of eating disorders may have gone up because of changes in what our culture sees as an ideal body image. Or the 50-somethings of today may simply be more comfortable seeking help than their mothers did.
With bulimia, a person binges over and over, feeling a loss of control over eating. Then the person takes some action to prevent weight gain, such as vomiting, using laxatives or diuretics, or exercising excessively. This pattern may come about in women who have had life-long issues with eating, weight, or body image. Or it may be a new symptom of an old problem, for example, adding vomiting to an established pattern of binging.
If the problem is brand new, it's better not to assume too much. People who develop new symptoms in midlife may have had a major life change that needs to be addressed — like a major stress or loss, or a medical illness.
Whether or not the symptoms are brand new, a woman with bulimia should talk with her doctor. This can help rule out a medical illness. It can also help guard against medical complications of bulimia, such as wearing away of the tooth enamel (from repeated vomiting), esophagus damage, or changes in the balance of salts in the bloodstream.
The usual next steps are mental health treatment with talk therapy and nutritional counseling. Group meetings can provide education and support. The antidepressant fluoxetine decreases binging and purging behavior in some people with bulimia. It also may relieve symptoms of depression or anxiety.
Most women do find significant relief through the use of one or more of these approaches.