Older Adults Can Have Eating Disorders Too
Picture someone with一种饮食障碍，你可能会想到一个饥饿的十几岁的女孩，挨饿，吹嘘，以避免增加体重。
虽然饮食障碍是十几岁的女孩和年轻女性中最常见的，但老年人也有这些疾病，包括首先在生活中介绍生活障碍的人以及几十年来处理疾病的人。
触发器
究竟有多少老年人有饮食障碍是未知的。一项研究发现，3.8％的女性60至70岁符合饮食障碍的标准。审查48例患有饮食障碍的50岁或以上的人报告发现，发现这种疾病的平均年龄约为68。
压力性生活事件和抑郁症可以引发老年人的饮食障碍。家庭关系的变化，亲人死亡，丧亲丧亲，医疗疾病，变得越来越少的社会活跃，对生活的控制感觉不那么少，身体外观也可能有所贡献。
The symptoms and health consequences of eating disorders in older adults are similar to those in younger people. However, older adults are more likely to have coexisting medical illnesses or cognitive problems that could mask or exacerbate the eating disorder or complicate treatment.
For example, an older person might frequently experience dysphagia (difficulty swallowing), and therefore might limit how much or how often they eat.
Types of disorders
在美国精神病协会定义的八种类型的饮食障碍中，老年人最有可能具有厌食症神经症，贪食症，或狂犬病患者。
神经性厌食症。厌食症患者严重限制一下t the amount of food they eat, and as a result, they weigh substantially less than what is “normal.”
To determine a person’s normal weight, doctors calculate the body mass index (BMI), which is based on weight and height. According to the Centers for Disease Control and Prevention, a BMI of 18.5 to 24.9 indicates a healthy weight. The BMI of a person with anorexia nervosa could range from approximately 17 (mild anorexia nervosa) to less than 15 (extreme anorexia nervosa).
But simply being underweight doesn’t mean a person has anorexia nervosa. To be diagnosed with anorexia, you also must have a distorted view of your body weight and shape.
厌食症的人认为自己是脂肪，即使它们危险地薄。它们通常对肥胖的恐惧感到强烈的恐惧，但节食通常没有帮助减少这种恐惧。
In fact, a person may get even more worried about being fat even as they lose weight. In people with anorexia, self-esteem is often tied to their weight—losing weight is viewed as admirable, and gaining weight is a failure.
Other symptoms of anorexia include brittle hair and nails; dry, yellowish skin; lanugo (growth of fine hair all over the body); lethargy; and constipation. People with anorexia may develop muscle wasting/weakness, thinning bones, low blood pressure, and organ failure.
厌食症神经瘤可能是致命的。每十年，大约5％的疾病死亡，无论是饥饿还是自杀。
神经性贪食症。贪食症的人有狂犬病的剧集（在短时间内消耗异常大量的食物，通常是两个小时或更短的），然后采取措施来弥补暴饮暴食。
通常一个人被诊断出患有暴食症的经验s such episodes once a week for about three months. During these episodes, the person feels they can’t stop eating once they start, nor can they control what or how much they eat.
呕吐是一种最常见的人贪食症的人补偿了狂犬病。它们也可能滥用泻药，利尿剂或灌肠;快速地;或过度锻炼。像那些厌食症的人，贪食症的人们基于身体形状或体重的自尊。
Symptoms of bulimia nervosa include irregular menstrual cycles, stomach problems such as acid reflux, dehydration, worn or decaying teeth as a result of frequent vomiting, and electrolyte imbalances. Rare but potentially fatal consequences of bulimia are heart problems, stroke, and tears of the esophagus. People with bulimia are also at risk of suicide.
暴饮暴食症。People with binge eating disorder experience episodes of binge eating that they feel they can’t control, but unlike people with bulimia, they do not engage in behaviors to compensate for their overeating.
Other specified eating disorder.This diagnosis applies to people who have the symptoms of an eating disorder, but do not fully meet the official criteria for any specific disorder. For example, this diagnosis might be given to a person who has the symptoms of anorexia but has a normal body weight, or to a person who binge eats, but does so less than once a week.
治疗
研究人员尚未对特殊饮食障碍的治疗有效性。一般来说，医生建议心理疗法帮助饮食障碍的人们了解他们的疾病，体重增加，提高他们的饮食习惯。
A family-based psychotherapy called the Maudsley Approach works well for adolescents with eating disorders, but its effectiveness in older adults hasn’t been studied.
用于治疗饮食障碍的其他形式的心理治疗包括：
•Cognitive behavioral therapy, which focuses on changing the thoughts, beliefs, and values that perpetuate the eating disorder
•Dialectical behavior therapy, which teaches skills to use to replace poor eating habits, such as mindfulness, becoming more effective in relationships, and tolerating distress
•接受和承诺治疗，强调识别一个人的核心价值观，并致力于创造目标以实现这些价值观，同时承认痛苦和焦虑是生命的正常部分
也使用药物，通常与心理治疗组合使用。抗抑郁症氟西汀（Prozac）是唯一特别批准治疗特异性饮食障碍的药物，贪食性症状。
Because people with eating disorders frequently have symptoms of depression, antidepressants are often used as treatment, including citalopram (Celexa), sertraline (Zoloft), venlafaxine (Effexor), and duloxetine (Cymbalta).
在某些情况下，患有饮食障碍的人可能被规定的抗皱药物，例如苯并二氮杂卓（Xanax）或洛拉西泮（Ativan）。
饮食障碍的迹象
如果您认为您或您所爱的人可能会有饮食失调，请询问以下问题：
•你强迫自己呕吐，因为你觉得不舒服了吗？
•Do you worry you have lost control over how much you eat?
•您最近在三个月内失去了14磅以上的时间吗？
•当别人说你太瘦时，你相信你是胖吗？
•你会说食物占据你的生活吗？
一项小型研究发现，两个或更多这些问题回答“是”的人很可能有饮食障碍。
其他可能的饮食障碍的迹象包括秘密饮食或害怕在别人面前吃东西，吃完后消失，为不吃东西做出借口，维持不寻常的食物仪式，如切割食物进入非常小的碎片或过度咀嚼每咬，强制锻炼身体。
患有饮食失调的人也可能会经历抑郁症，焦虑和强迫症的症状。
Getting help
任何怀疑他们可能有饮食障碍的人都应该要求他们的医生进行彻底的评估。由于饮食障碍的并发症对于老年人来说可能特别危险，因此提示诊断和治疗至关重要。
If you think you or a loved one might have an eating disorder, the National Eating Disorders Association offers a helpline at 800-931-2237.
