When you can’t face a cupcake for fear of fat

After a lifetime of dieting, many middle-aged women have eating disorders, writes

‘NO pasta, thanks. I think I’ll eat lettuce this week.” Teenage girls are not the only ones who will starve themselves to look thin in selfies. Many women go into their 40s with an eating disorder.

Roughly one in seven British women aged 40 to 50 has had an eating disorder in her lifetime and 3% of them have an active eating disorder, research among 5 300 women found.

There are limited statistics on the long-term impact of eating disorders in South Africa.

Disordered eating habits or behaviours exist along a spectrum, from repeat dieting and restrictive eating behaviours (like eliminating food groups) to clinical eating disorders such as anorexia.

Many of the middle-aged women with elements of “disordered eating” are professionals, supermoms or both, adept at balancing competing demands on their time but not at balancing their dieting.

Registered dietitian Sarah Chantler, an associate with Shelly Meltzer & Associates, a dietary practice based at the Sports Science Institute of South Africa, said: “I see traits of disordered eating a lot in late midlife and in the recurrent dieter. This often occurs in women who are very good at their jobs and run their homes like troupers but they really struggle with food and weight.”

Sometimes picky eating habits can be confused or overlap with disordered eating behaviours.

Julia* reached her 40s unaware — like many women — that she had developed disordered eating habits and a skewed body image.

Becoming chubby in adolescence, she kicked off a cycle of dieting with a Weight Watchers programme and shed kilos. In her suburban school class in Cape Town, every second girl was on some fad diet.

In her mid-20s she enrolled in Weigh-Less and got lean despite being a healthy weight and fit when she joined the programme.

After her first child, she joined SureSlim and lost excess pregnancy weight.

But wanting to be thin kept her dieting for decades after she had a healthy body mass index.

Only in her mid-40s did she begin to choose food based on appetite, nutritional value and pleasure rather than what was judged to be “good” or “bad” for losing weight.

She was lucky that her disordered eating patterns were mild: she was untouched by the feelings of failure that typically affect dieters.

Chantler said that the restriction-binge cycle of dieting could have a negative impact on the mental side of eating

“They start to not trust themselves. I see women who are anxious about eating food and getting fat.”

Often, older women will seek help only once this cycle of dieting and restrictive eating has not worked. By then their metabolic system is also slowing down, which makes it harder to lose weight.

However, more than two-thirds of the women in the British study had not looked for help or received treatment for their disordered eating.

Teenagers and young adults are well known to have eating disorders but the researchers were surprised at the high proportion of women in their 40s with this behaviour.

Lead author Dr Nadia Micali from the University College of London said: “Active eating disorders are common in midlife, both due to new onset and chronic disorders.”

Weight Watchers group leader in Johannesburg Joy Capon said the people who joined the programme generally had an unhealthy relationship with food or they would not need to lose weight.

“All of us in middle age have grown up with the idea of dieting. Many of them have grown up with the ‘no pain, no gain’ philosophy, that you must starve to lose weight.

“The whole concept of dieting is a problem. If you go on a diet, you are going to go off it. I have to change the mindset from dieting to healthy eating.”

Capon said their lifestyle eating programme aimed to be nonrestrictive and did not deny members food they enjoyed, to fit in with how they lived.

She said: “Most of them have lost control and we try to restore that sense of control about what to eat and how much.”

Talk show queen Oprah Winfrey declared recently that she had solved her lifelong battle with her weight and made peace with food after adopting the Weight Watchers programme.

In a magazine cover story she revelled in the fact she can eat bread and drink wine and stay healthy.

Capon said many people had adopted bad habits over a lifetime and their programme worked to modify these and get them on track.

Other popular weight-loss programmes have their own constructive approaches to support members to reach a healthy weight.

Clinical eating disorders are at the end of the spectrum and the researchers found several triggers linked to anorexia, bulimia, binge eating and purging disorder.

Micali said: “They were all associated with childhood unhappiness and parental separation or divorce during childhood.

“We also found that death of a carer could increase the likelihood of purging disorder and that sexual abuse during childhood, or a fear of social rejection, was associated with all eating disorders.”

A good mother-daughter relationship was associated with 20% less chance of developing bulimia, this study showed.

Maybe it’s time for the supermoms, and their children, to relax about food. Let them eat cake.

* Not her real name

The whole concept of dieting is a problem. I have to change the mindset Eating disorders ‘were all associated with childhood unhappiness’