WUNRN
Artist
Judith Shaw writes:
Meltdown (left): I think of my heart as a pilot light. Puzzled
(center): Recovery is the ongoing process of sorting how the pieces fit
together. Still puzzling. Missing Piece (right): A nagging
sense of being incomplete was ever present for me growing up in adulthood.
More than 10 million
Americans suffer from anorexia, bulimia and other eating disorders. And while people tend to
think such problems are limited to adolescence and young adulthood, Judith Shaw
knows otherwise.
A 58-year-old yoga
instructor in St. Louis, Ms. Shaw says she was nearing 40 when she decided to
“get healthy” after having children. Soon, diet and exercise became an
obsession.
“I was looking for
something to validate myself,” she told me. “Somehow, the weight loss, and
getting harder and firmer and trimmer and fitter, and then getting recognized
for that, was fulfilling a need.”
Experts say that
while eating disorders are first diagnosed mainly in young people, more and
more women are showing up at their clinics in midlife or even older. Some had
eating disorders early in life and have relapsed, but a significant minority
first develop symptoms in middle age. (Women with such disorders outnumber men
by 10 to 1.)
Cynthia M. Bulik,
director of the Eating Disorders Program at the University of North Carolina,
Chapel Hill, says that though it was initially aimed at adolescents, since 2003
half of its patients have been adults.
“We’re hearing from
women, no matter how old they are, that they still have to achieve this
societal ideal of thinness and perfection,” she said. “Even in their 50s and
60s — and, believe it or not, beyond — women are engaging in extreme weight-
and shape-control behaviors.”
Younger or older,
patients tend to engage in the same destructive behaviors: restricted eating, laxative abuse, excessive exercise and binge eating. And the trigger is often a
stressful transition — in a young person, perhaps going away to college or living
through her parents’ divorce; in later years, having a baby, sending a child to
college or going through her own divorce.
“I think there is a
probably much higher percentage than we’ve been able to identify,” said Tamara
Pryor, clinical director of the Eating Disorder Center of Denver, who has been
studying about 200 cases of midlife eating disorders. “I think out there in the
workaday world there are a large percentage of women who just fly under the
radar. They are subclinical and you don’t question them, because in so many
other areas of their life they look so functional.”
One concern, she and
other experts say, is that as women get older they are more adept at concealing
the problem, and symptoms may be attributed to aging rather than to an eating
disorder.
For instance, when a
thin adolescent stops menstruating, doctors typically raise questions about
weight and eating habits. But in Ms. Shaw’s case, they assumed it was early menopause. When she developed anemia and osteoporosis, they didn’t guess that the true
cause was years of malnourishment.
And though one
doctor suggested that Ms. Shaw looked as if she needed to “eat a cheeseburger,”
most praised her efforts to keep her weight down and her commitment to
exercise.
“One of the things
we’re working very hard to do is to make sure this stays on physicians’ radar
screens so they can recognize and distinguish between menopause-related
changes, real health problems and eating disorders,” Dr. Bulik said. “Often
they don’t ask the question because they have in their mind this stereotypical
picture of eating disorders as a problem of white, middle-class teenagers.”
For Ms. Shaw, diet
and exercise overtook her life. She spent more and more hours at the gym — even
on family vacations, when she would skip ski outings with her husband and sons
in favor of workout time.
“None of my friends,
my ex-husband, no one ever said anything,” she said. “It was no one’s job to
fix me, but I wish someone had said to me: ‘I miss you. You’re gone. You’re so
obsessed.’ ”
Finally, a yoga
instructor sounded the alarm after Ms. Shaw had twice fallen, breaking an elbow
and then later her pelvis. “There’s nothing left of you,” the instructor told
her. “Only you can decide if you’re going to change that by feeding yourself.”
At 53, carrying just
85 pounds on her 5-foot-3 frame, Ms. Shaw checked herself in to an eating
disorders program.
In treatment, she
struggled with writing exercises aimed at helping her identify the origins of
her illness. Instead, she began creating art, starting with a life-size
silhouette of her body, covered with cut-out newspaper headlines like “Help
Wanted,” “Conceal” and “Find Real Value.”
Later, she created a
plaster cast of her thighs. Like many others with anorexia, she had thought her
legs were too big; now she could see how thin she had become.
Last year Ms. Shaw’s
art went on display at Washington University in St. Louis, and now her
exhibition, “Body of Work: The Art of Eating Disorder Recovery,” can be seen
through mid-April at the Center for Eating Disorders at Columbia University
Medical Center in Manhattan.
“It’s certainly not
the typical story, but we’re hearing about it more commonly,” said the center’s
director, Dr. Evelyn Attia. “We need to let everybody know that it’s possible
to develop these illnesses across the life span.”
Ms. Shaw says she
often notices women who appear to be too thin or obsessed with exercising, and
she hopes that telling her story will help others see the problem in
themselves.
“In the course of my
day, I can spot it,” she said. “I am 25 to 30 pounds heavier, but I feel
lighter. The weight of those emotions is what it was really all about.”