Eating disorders are not just a teen issue. They can emerge or reappear in midlife and well into older age, sometimes after a major change such as retirement, bereavement, illness or a move. Because weight loss may be praised in later life, the warning signs can be missed. Paying attention, without judgment, can make a difference.
Common symptoms
Look for changes in eating that persist beyond a few days. Skipping meals, strict food rules, cutting out whole food groups and eating in secret are red flags. So is significant weight loss or gain, especially when paired with fatigue, dizziness, feeling cold, constipation, hair thinning, mouth sores or dental changes. Some older adults over-exercise, for example pacing for hours or insisting on long workouts despite pain or medical advice. Others may misuse laxatives, diuretics or diet pills. Mood shifts matter too. Consider changes like anxiety around meals, irritability, shame about body shape, social withdrawal and a strong fear of “losing control” with food.
What families can watch for
You know your person so trust your spidey sense. Notice looser clothing, a shrinking grocery list, rigid routines around mealtimes and new rituals such as cutting food into tiny pieces or pushing it around the plate. Pay attention if meals are avoided with I already ate, or I am not hungry. Frequent weigh-ins, body checking in mirrors and repeated talk about being “good” or “bad” with food can signal distress. Keep an eye on falls, delayed wound healing and new dental problems. If you help with shopping, watch for large amounts of low-calorie items, caffeine, artificial sweeteners or bulk purchases of laxatives.
Start the conversation
Lead with care, not policing. Try saying something like “I have noticed you seem more tired and you have been skipping meals, I am concerned about your health, can we talk about it?” Focus on how eating supports strength, energy and independence. Avoid arguments about numbers on the scale. Offer to sit together with a trusted clinician and be willing to listen.
Treatment that works
Begin with a primary care visit to rule out medical causes of weight change, for example thyroid issues, depression, pain, dental concerns or medication side effects. If an eating disorder is suspected, a team approach is best, physician, registered dietitian, and therapist experienced with eating disorders. Evidence based therapies such as cognitive behavioural therapy for eating disorders and interpersonal therapy can be adapted for older adults. Nutrition therapy aims to restore a regular pattern of eating, stabilize weight as medically indicated and address micronutrient needs, calcium and vitamin D are common gaps. A medication review can reduce drugs that suppress appetite or upset the stomach. Bone health checks, fall risk screening and gentle strength training help protect function. If grief, loneliness or caregiving stress are present, include support groups or counseling. Severe cases may need day programming or short inpatient care.
One last note
Recovery is possible at any age. Small, consistent steps count, regular meals, flexible thinking, social connection and compassionate support.
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