MINNEAPOLIS — Kelli Smith was nervous as she walked into the Philadelphia treatment center, seeking help at last for her anorexia. Looking around at the other patients, she was struck by how young they seemed.
“I just kind of looked around and I thought, ’Oh, where is someone my age?’ ” recalls Miss Smith. At 31, she found herself face to face with teenagers and twentysomethings.
Eating disorders such as anorexia and bulimia have long been considered diseases of the young, but experts say in recent years that more women have been seeking help in their 30s, 40s, 50s, and older. Some treatment centers are creating special programs for these older patients.
Most of the older women seeking treatment have had the problem for years, said Dr. Donald McAlpine, director of an eating disorders clinic at Mayo Clinic in Rochester, Minn.
“The epidemiology is pretty clear that anorexia and bulimia both peak in the late teens, early 20s,” yet a lot of patients “continue to be symptomatic right on through to middle life.”
People who study eating disorders suggest several reasons for more woman older than 30 seeking treatment for what is typically a young woman’s problem: growing public awareness, social pressure to be thin and an aging group of baby boomers.
In the Minneapolis suburb of St. Louis Park, Park Nicollet Health Services’ Eating Disorders Institute saw 43 patients age 38 in 2003 … about 9 percent of its total patients. For the first six months of this year, the institute treated nearly 500 patients older than 38, about 35 percent of its total.
The Renfrew Center, a network of treatment centers in the eastern U.S., said about 20 percent of the 522 patients treated at its Philadelphia center in 2005 were 30 or older. In 2006, about 13 percent of the 600 patients were in that age group.
“Whatever this is — if it’s an increased awareness, if it’s a response to being in midlife — those numbers are staggering,” said Carol Tappen, director of operations for the Eating Disorders Institute.
Women older than 30 who seek treatment tend to fall into three categories, said Holly Grishkat, who directs outpatient programs at Renfrew.
Some have had an eating disorder for years. Others had a disorder in remission that resurfaced because of new stress in life. A third group, the smallest of the three, includes women who develop an eating disorder late in life.
Of Renfrew’s patients older than 30 in 2005, about 60 percent first suffered from an eating disorder at 18 or younger. Nearly 20 percent said they were 30 or older when they first encountered the problem.
While body image is an issue for any age group, women older than 30 are dealing with problems that teens don’t have, such as work, divorce, stepchildren and aging parents.
They also are dealing with an aging process, or childbirth, that changes the way they look.
“One day, [a woman] wakes up and the kids are gone and she has a sense that nobody really needs her. She looks in the mirror and she says, ’My body is shot,’ ” Miss Tappen said. “This woman says, ’You know, that’s it. I’m going on a diet.’ ”
The Eating Disorders Institute is building a new facility, set to open in 2009, that will offer a treatment track for mature patients.
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