Developing anorexic tendencies later in life

I was wondering if anyone here has experienced this.

Most people with eating disorders on this forum seem to be very young indeed. I never had any concern with my weight whatsoever as a youth. My natural adult BMI was 24, and of course I thought it would be nice to be slimmer, but I never even bothered to try a diet. I knew I had a healthy diet and I felt well, so that was that...

Three years ago, when I was roughly 37, I went from a BMI of 24 to 18, during a period of severe stress (over roughly a year). I did not undereat intentionally. It just happened. But since then, I have developed what I understand to be anorexic tendencies. I don't meet the criteria for anorexia and I have not been assessed yet so I don't know if I have an eating disorder. I do have medical complications usually associated with anorexia.

Anyway, I was wondering if anyone else on this forum is having to face something similar at about the same age. I am 41. I have done my best to increase my calorie intake in the last few weeks, but I am now very close to giving up. It is such hard work and I feel I might just forget about counting calories and go back to eating very little; it was much easier and less time-consuming.

Perhaps, there are other people in a similar situation and we could share tips and support each other? Or perhaps not. Let me know!

Edit: I should probably add that my BMI is currently 19.

I think you have to examine cause and effect...  In your case I suspect that the stress or depression is the cause and the weight-loss, eating problems & malnutrition complications are the symptom.  In other people it starts off all about the weight-loss ... but they then develop the mental condition and follow-ons as a result of malnutrition. 

An example of what I mean... My cousin became anorexic at the age of 33 as a result of an undiagnosed (and quite severe) psychotic illness.  Since being successfully treated for the illness, she no longer has eating problems.  If she'd been treated solely for anorexia and the mental illness overlooked or ignored, she'd probably be dead by now.

It is ultimately all linked.  The poorer & more inadequate your diet the bigger the risk of malnutrition and the bigger the risk of impaired cognitive function.  If you have a mental condition (such as depression) that needs treating medically then the bigger the risk that you will lose interest in food.  

I think all you can do is your level best to tackle the food from your side.... better nutrition, regular meals, adequate calories (2500 I'd suggest rather than 1800) .... and talk to your doctor about treating any underlying causes at the same time.

changed my mind about what i wrote.

Original Post by gi-jane:

I think you have to examine cause and effect...  In your case I suspect that the stress or depression is the cause and the weight-loss, eating problems & malnutrition complications are the symptom.  In other people it starts off all about the weight-loss ... but they then develop the mental condition and follow-ons as a result of malnutrition. 

An example of what I mean... My cousin became anorexic at the age of 33 as a result of an undiagnosed (and quite severe) psychotic illness.  Since being successfully treated for the illness, she no longer has eating problems.  If she'd been treated solely for anorexia and the mental illness overlooked or ignored, she'd probably be dead by now.

It is ultimately all linked.  The poorer & more inadequate your diet the bigger the risk of malnutrition and the bigger the risk of impaired cognitive function.  If you have a mental condition (such as depression) that needs treating medically then the bigger the risk that you will lose interest in food.  

I think all you can do is your level best to tackle the food from your side.... better nutrition, regular meals, adequate calories (2500 I'd suggest rather than 1800) .... and talk to your doctor about treating any underlying causes at the same time.

I did the Hospital Anxiety and Depression test (HADS) and my GP says I am not depressed but score highly on anxiety (which he attributes to still having too much stress). I am on a waiting list to see a clinical psychologist, but that won't be before the autumn... That's why I thought it might be nice to chat with people in a similar situation, if there are any, while waiting.

Is there a correlation between undereating and stress/anxiety (as opposed to depression - I have thankfully never suffered with depression)? If there was, then I would breathe a sigh of relief as I would begin to understand the source of my problems with eating.

Also, how on earth can I eat 2500 calories when I can't even get to 1800?

I don't have specific advice.  But I do know that anxiety is often caused by not feeling in control.  Since we feel out of control, or rather that there are things that are not in our control, the natural reaction to to try to get / maintain control. 

For some people diet and or excercise is one area where one can gain control.

Of course that is an over simplification.  But it makes perfect sense that your sysmptoms bagan to show at a time your life was stressful. 

Original Post by nat1968:

Is there a correlation between undereating and stress/anxiety (as opposed to depression - I have thankfully never suffered with depression)? If there was, then I would breathe a sigh of relief as I would begin to understand the source of my problems with eating.

Also, how on earth can I eat 2500 calories when I can't even get to 1800?

Behaviour is affected by diet... by nutrition.  There have been quite a few tests which, if I were a little nerdier, I'd dig out vast swathes of internet links for you but you'll just have to take my word for it.  The famous one (and waddaya know, I found it) http://bjp.rcpsych.org/cgi/content/full/181/1 /22  studying the effects on prisoner anti-social behaviour by supplementing the diet with vitamins and minerals reported quite profound improvements.  The study was the latest in a long line of work started during WWII in Britain where children were fed supplements of cod liver oil and orange juice to see if (amongst other things) it improved behaviour.

So if malnutrition can make people more anti-social it's not too great a leap to conclude that anxiety and stress levels are also affected.  Vicious circle really... stress puts you off your food.... lack of food exacerbates stress.

You could get up to 2500 cals from where you are now quite easily.  That extra avocado.  The ounce of nuts, make it three.  Drink a pint or two of full-fat milk over the course of the day, have some dark chocolate.... all kinds of simple things that really wouldn't touch the sides.  Watch that fibre content, eat a lot more oily fish and maybe add a big juicy multivitamin to your iron tablet.

Original Post by madamq:

I don't have specific advice.  But I do know that anxiety is often caused by not feeling in control.  Since we feel out of control, or rather that there are things that are not in our control, the natural reaction to to try to get / maintain control. 

For some people diet and or excercise is one area where one can gain control.

Of course that is an over simplification.  But it makes perfect sense that your sysmptoms bagan to show at a time your life was stressful. 

Yes, that does make a lot of sense to me (won't bore you with why), although why choose diet and/or exercise as a way of regaining some of that control is a mystery. Perhaps it is because our bodies are effectively who we are in this world, how our existence manifests itself, and so controlling that can feel to some extent as a way of controlling our existence... Dunno... There are other areas of my life where I have a lot of control, such as in my professional life, but perhaps too many responsibilities for someone who is already gobbled up by three young children etc. etc.

Original Post by gi-jane:

You could get up to 2500 cals from where you are now quite easily.  That extra avocado.  The ounce of nuts, make it three.  Drink a pint or two of full-fat milk over the course of the day, have some dark chocolate.... all kinds of simple things that really wouldn't touch the sides.  Watch that fibre content, eat a lot more oily fish and maybe add a big juicy multivitamin to your iron tablet.

Thanks once more!

I get the point and will do my best not to give up on the effort to eat properly. But at the moment my fear of gaining weight is much too strong to start contemplating a 2500 cal diet. I will need a lot more work to get there, and possibly will have to wait for professional support for this...

Anorexic behaviours can be caused by undereating - In a famous study where men were starved to (IIRC) 80% of their natural bodyweight they began to demonstrate behaviours associated with disordered eating - body dismorphia, binging and purging, self-harm (one even chopped off three of his fingers.)

Fortunately this also means that for someone like you, whose ED-type habits were possibly caused by lack of food in the first place, the behaviours can be readily reversed... The hard bit is eating healtily and gaining weight so your mind can see things clearly again.

Why do you fear gaining weight?  You know that you looked good with a BMI of 24, even a BMI of 19.5 or 20 would be a weight gain and you probably looked very healthy but still slim at both of those.

This is one potential sign of an eating disorder, but isn't necessarily one.  Also there are many other eating disorders than anorexia.

Here's a link to our expert on Eating Disorders.  There's also a lot of information in a stickied post at the top of the Health and Support Forum.

Well, there clearly are not lots of people with a similar problem around here, but that's a good thing!

I am so glad I started the thread anyway, because for the very first time, thanks to your answers, I have started to get an insight into what's been happening to me. And this is invaluable help.

It saddens me slightly that for so long I have blamed myself and tortured myself with guilt for something that does not appear to be entirely my own fault... But at least I can begin to see light at the end of the tunnel.

I can't wait for the day that I will get help, but in the meantime I will have to do what I possibly can to eat better, as GI-Jane suggests.

smwhipple, you are obviously right, but if being rational worked, then I would not be in need of help. I came out of work around 8pm after a pretty horrendous day where many things went wrong and I had roughly a 1000 calories left to go.

My first thought was: 'I am absolutely starving, I need food urgently'

My second thought was: 'No, I am not eating anymore today. I don't deserve food after a day like that!'

My third thought was: 'Remember what you read on CC about the effects of malnutrition'

I then got to the rail station and thought a hot panini would be nice. I wanted a whole one but only bought a half one, because at the last minute, I thought a whole one might make me gain weight...

That's the sad truth about what this illness or whatever it is does to one's mind.

I am very grateful for your support. I am really glad that I found this site.

I'm sorry you are going through this right now.  Eating disorders can occur to anyone regardless of what age we are--I had one when I was a teenager and then again when I was 25.  The relapse was mostly due to stress, anxiety, and a godawful digestive disorder that made eating very difficult--thus bringing back the eating disorder.  (It's amazing what problems can occur overtime due to stress & anxiety).

You are not to blame for what has happened to you and as you have mentioned in your original post, an eating disorder doesn't just pop up one morning--it accumulates over time and that's why it can be so difficult to get out of at first.  As far as increasing your calorie intake...my personal favorites used to be almonds, peanuts, dried fruit, avocado, and organic peanut butter (no hydrogenated oils--hooray!).  Ensure Supplement drinks are also an easy way to add some much need calories & nutrients--I used to live off those and they really helped me.  I've been recovered for quite some time now at a healthy weight and you will be able to do that as well.  You're already making the steps to gain your health back and that is something to be proud of. 

P.S.  I know I'm not quite the age you were referring to, but I wanted to reach out with my support & wish you the best of luck in gaining your health back.

Thank you for your kind post, Tahitisweetie123.

Are these Ensure Supplement drinks prescription only, or are they available off the counter?

My mother is borderline anorexic and has some sort of image disorder.  It's gotten WAY worse since she's retired a year ago.

She has a thin frame; i'll give her that -  she's 5' and weighs 106 pounds at age 60.  She tells me how much she weighs almost every time I see her or talk to her.  She will sit at the table and watch every one eat while barely eating anything.  She'll eat everything low salt and not allow my father to have any 2nd helping (man i feel bad for him!!)

This is her daily diet:

Breakfast:  Cheerios whole grain (1 cup) w/ skim milk

Lunch:  Low salt PB on 1 slice of flax seed bread

Dinner:  Some type of white meat (exactly one portion), 1/2 baked potato, and a steamed veggie.

Whenever everyone is at the table I watch her eyes literally dart around looking at what people are eating.  She makes this "sucked cheek" in look whenever she talks about weight I guess to make herself feel thin?

Who knows....I feel like a fat monster around her-  I'm 140 and can't shed those last poundage after julia. 

Prior to julia she always said I was big boned and that I'd never have issues giving birth b/c my hips were so wide.

It's a constant with her.  She eats like a bird and is completely obsessed with her weight and image.

Well, I'm no expert, very clearly, but isn't that a BMI of 20.7, which is not that bad really for someone with a small frame? She must be eating a bit more than that or she would disappear altogether, don't you think? Perhaps she is simply weight obsessed, like the overwhelming majority of women. Anyway, as I said, I am probably the worst person to comment on other people's eating behaviours at the moment. But maybe it is not as worrying as all that...

Are these Ensure Supplement drinks prescription only, or are they available off the counter?

You can get Ensure from any grocery store or pharmacy and are usually in the aisle for vitamins, power bars, and SlimFast drinks. 

sorry this is so off topic-i just have to say;;; VANESSA! you ROCK man, that must have sucked growing up. you are so strong to persevere through that kind of influence. My mother was into a healthy lifestyle, eating healthy and excerisizing, but health was just really the background of our lifestyle, not the center, and she STRONGLY enforced that i should never do anything soley for image... if it weren't for her influence, i wouldn't be who i am today. i'd be pretty clueless. i really admire you

Original Post by tahitisweetie123:

Are these Ensure Supplement drinks prescription only, or are they available off the counter?

You can get Ensure from any grocery store or pharmacy and are usually in the aisle for vitamins, power bars, and SlimFast drinks. 

Excellent, thanks! I really need to go to a shop without the kids one day so I can have a proper look at these things.

Sorry Vanessa1031, I hope my answer didn't come across as unsupportive; I was just trying to reassure you...

Could anyone tell me, if I got to a daily calorie intake of 1800/2000 with a varied and flawless diet, but kept my BMI at 19, would that be sufficient to get out of mental problems associated with malnutrition? Or is it imperative to gain weight as well, even if the average calorie intake for an adult is meant to be roughly 2000?

I strongly suspect my GP forgot to write a referral letter, so I will probably have to sort out this eating problem myself.

Thanks!

Original Post by tahitisweetie123:

Are these Ensure Supplement drinks prescription only, or are they available off the counter?

You can get Ensure from any grocery store or pharmacy and are usually in the aisle for vitamins, power bars, and SlimFast drinks. 

Hi again Tahitisweetie123,

Are you in the US? All I could find around here was SlimFast and some gluten-free or glucose-free stuff. I did not dare to ask, as I wasn't sure how to explain what it was. I am wondering if we have these Ensure Supplements here in the UK. Do you think that using Slimfast drinks would be just as good?

If not, I'll try and go into town at some point to check out a bigger Boots, or perhaps Holland & Barrett's.

Edit: I did an internet search on both websites (Boots & H/B) but there are no results for Ensure. What would be the equivalent in the UK? Does anybody know? Thanks!