Thin Gray Line

By By Michelle Lodge

For a decade starting at age 40, headaches, chest pains, fainting spells, hair loss and severe anemia plagued Eileen Binckley. During that period, she consulted an internist, a rheumatologist, a hematologist and a neurologist. All declared Binckley healthy. It wasn't until she was 50 that a therapist friend identified the problem: anorexia.

Unbeknownst to the specialists, Binckley had been spending every waking moment obsessing about food, her weight and ways to avoid eating. At times she consumed only 300 to 500 calories a day. She exercised compulsively, waking at 4 a.m. to take three-hour walks near her home in suburban Philadelphia. All that behavior is typical of patients with the eating disorder anorexia. But her doctors missed the symptoms because, she says, none of them had ever asked Binckley about her diet and lifestyle.

Anorexia is still considered primarily a young woman's disease, but Binckley is among a growing number of aging Americans diagnosed with the disorder. Although statistics aren't available on just how many Americans over 50 suffer from anorexia, therapists and rehabilitation centers that specialize in eating disorders report that every year, they're ministering to more middle-aged and older patients, mostly women. The condition strikes people across ethnic and economic lines. Says Margo Maine, a psychotherapist and an eating-disorder specialist based in West Hartford, Conn., and a co-author of The Body Myth: Adult Women and the Pressure to Be Perfect (Wiley; 2005): "Anorexia is an equal-opportunity disease."

Two years ago, the Renfrew Center of Philadelphia initiated a program tailored to those at midlife and beyond with food problems. Along with sessions on nutrition and body image, the program addresses the particular challenges that older women face, from the normal signs of aging like wrinkling and sagging to marital issues such as divorce and domestic violence. The center found that when younger women are absent, older patients are more likely to focus on their own health rather than on nurturing their younger counterparts.

Marcia Johnson, 62, of Wellington, Fla., a married mother of three and a former dancer, received a diagnosis of anorexia a dozen years ago, although she now recognizes that she showed symptoms of it by puberty. Binckley and Johnson note that their nonstop focus on food and body image slowed down when they were cooking meals for their growing children. Then as middle age set in, a sense of loss--a feeling that's particularly acute for anorexics at midlife--set off a flare-up. "The loss of order--brought on by a change in job status, marriage, children--can cause an anorexic's symptoms to worsen," explains David Herzog, director of the Harris Center for Education and Advocacy in Eating Disorders at Boston's Massachusetts General Hospital. The departure of her college-age children led to Johnson's most dangerous bout. Unhappiness at work caused Binckley's symptoms to kick in again. For others, it can be the end of a marriage or the start of menopause. Men aren't immune, and for them, the sexual dysfunction that can come with aging often serves as a trigger.

Still, many doctors, like Binckley's, fail to spot the potentially fatal problem in an older person because they're not looking for it. And in a country where obesity seems to be running rampant, a featherweight figure is often prized. "A doctor may see a slender patient and say, 'Here's one without that problem,'" explains Andres Pumariega, a psychiatrist at the Reading Hospital and Medical Center in Pennsylvania. "It's become a silent epidemic."

Having received the correct diagnosis and treatment, Binckley is now robust, content and at ease. Her headaches and fainting spells are long gone. Her weight, once a wispy 100 lbs. on a 5-ft. 4-in. frame, ranges from 125 lbs. to 135 lbs. The biggest change, however, is that she's free of the tormenting worry about her body and what she eats. "Overall, I am happier and enjoying life like never before," she says. "To use food as a metaphor, life is delicious."