Eating disorders such as anorexia nervosa and bulimia are typically thought of as diseases that affect young people, but these conditions are an often unrecognized problem among elderly adults as well. If you are the caretaker of a senior relative, it’s important to be aware of the signs, causes, consequences and treatments of these conditions.

How Common Is This Problem and Why Does It Occur?

Elderly women are more likely than elderly men to suffer from an eating disorder, but the condition occurs in both sexes. It has been reported that almost 85% of long-term-care residents, 62% of hospitalized elderly patients and 15% of community-dwelling older adults are malnourished, which can signal an eating disorder.

Eating disorders have many causes. While younger people often struggle with a distorted body image, the underlying issues for the elderly can include the following:

• The natural, gradual loss of appetite that comes with age
• Changes in taste or smell (75% of adults age 89 or older have significantly impaired senses of smell and taste)
• An undiscovered illness or infection
• Side effects of prescription drugs (loss of appetite is a reported side effect of over 250 medications)
• Digestive and oral complications that may make it difficult to eat (gastrointestinal tract problems occur in 50–75% of the elderly)
• Forgetting to eat due to cognitive problems such as dementia or Alzheimer’s disease
• Difficulty cooking or getting to the grocery store, as well as the lack of funds to pay for food
• The death of a loved one with whom meals were shared
• Psychological conditions such as depression, grief and loneliness
• The desire to regain a sense of control (this is especially common among nursing home residents)
• A history of eating disorders (only 50% of those with eating disorders by age 20 reported being cured of those conditions)
• In severe cases, a form of “silent suicide”

Serious Health Consequences

Regardless of the reasons, eating disorders can be especially hazardous among the elderly because they may already be in a weakened state of health. Older people who aren’t getting the nutrition they need typically have lowered immunity, so fighting off illness and infection is more difficult. An additional danger is that the side effects of prescription drugs may be more severe and the risk of overdosing increases.

Weight loss in long-term-care facilities has been associated with a higher risk of functional decline, frailty syndrome, poor quality of life and mortality. Sadly, 30–40% of elderly adults with eating disorders will end up dying from those conditions. In America, 78% of the deaths due to anorexia occur among the elderly, not the young.

Recognizing an Eating Disorder

It can be difficult to identify an eating disorder in older adults, and the condition often goes unrecognized by health care providers and family members. The following signs can be clues that your loved one has an eating disorder:

• ·Significant change in weight (up or down) over a short period of time
• Disappearing after a meal or rushing off to the restroom immediately after eating
• Possessing boxes of laxatives, diet pills or diuretics
• The desire to eat in the bedroom alone rather than dining with others
• Food items going missing
• Sensitivity to cold
• Excessive hair loss
• Dental damage
• Heart problems
• Gastrointestinal complaints

How to Help Your Loved One

If a doctor or health care professional has determined that an elderly person is suffering from an eating disorder, proper management of the disease is essential. Usually, it’s best to treat the underlying issue (for example, depression related to the loss of a loved one).

Patience and compassion are of the utmost importance when dealing with an older adult who has an eating disorder. It’s recommended that you work closely with their medical team to create a plan to help them improve their health. Some specific strategies may include:

• Lifting dietary restrictions on high-fat or high-salt food
• Adjusting your loved one’s diet so that they are served more of the foods they like
• Serving several small meals throughout the day, rather than just a few big meals
• Using additives to improve the smell, appearance or taste of food, especially if your loved one has lost some of their sense of smell or taste
• Encouraging them to socialize and be active, including eating with others
• Making sure they participate in rehab or other activities to help build their strength and endurance

Eating disorders are not a normal part of aging, and they can have serious health consequences. Fortunately, they can be treated, improving your loved one’s health and quality of life.