One night, Katie ate a "stew" of leftovers—stale pasta, wrinkled grapes, half a can of refried beans and week-old slices of beef. Other nights, she gnawed on frozen food without defrosting it...or microwaved it and then ate it so fast that it scalded her mouth. Sometimes she ate from the trash can. Why?

Because, she thought, if she could make food repulsive or tasteless enough-or even dangerous enough—she might not binge again. Yet more often than not, the next night she would go on another binge-alone in her kitchen, shoveling down food until she was painfully full...and completely disgusted with herself.

Katie may sound like a teenager in trouble. In fact, she's an adult-49 years old and suffering from binge-eating disorder (BED). Along with bulimia (bingeing that is followed by forced vomiting, overusing laxatives, excessive exercising or fasting and anorexia (self-starvation), BED is one of three major eating disorders. Many people have never heard of BED-though it affects more than three times as many women as bulimia does and about four times as many as anorexia does. BED is widely unrecognized because people primarily binge alone, in ashamed secrecy.

Eating disorders afflict at least 10 million Americans, most of them female. While no exact figures are available, some treatment facilities report that the number of midlife women seeking help has tripled or quadrupled in the last five years. Among these women, as many as half may have BED.

Hidden Problems

In adult women, an eating disorder typically appears when a stressful transition—a divorce, a move, a parent's death—either triggers the recurrence of an adolescent eating disorder or launches a new one. In the face of intense or chronic stress, people are prone to return to familiar bad habits—and for many women, those involve food.

An eating disorder can have serious emotional and social consequences. A woman with BED or bulimia isolates herself because she is too embarrassed to eat in front of family or friends, so she stays home when others go out in order to be alone with her food. A woman with anorexia isolates herself because she doesn't want the temptation of being around food and she worries that others will notice how little she eats. Among women with eating disorders, self-loathing is common.

In addition, eating disorders carry grave health risks...

  • BED can lead to obesity, with all the accompanying health problems, including increased risk for hypertension, high cholesterol, heart disease and stroke...diabetes...gallbladder disease...sleep apnea and respiratory problems ...and breast, endometrial and colon cancers.
  • Bulimia can cause nutritional deficiencies...weakened immunity...erosion of tooth enamel, periodontal disease and inflamed salivary glands...muscle spasms...chronic constipation...pancreatitis... inflammation and possible rupture of the esophagus...permanent damage to the heart or kidneys...and electrolyte imbalances that can lead to heart failure and death.
  • Anorexia can lead to dehydration and malnutrition...weakened immunity.. infertility ...osteoporosis...damage to the heart and kidneys...and death from starvation.

Hope For Healing

It's never too late to develop an eating disorder-and it's never too late to seek help. Confide in your doctor, and ask for a referral to a mental health professional.

Resource: The National Eating Disorders Association (800-931-2237, provides referrals to doctors, counselors and residential treatment facilities in your area. Approaches to treatment include…

  • Cognitive-behavioral therapy (CBT). There is more scientific evidence for the effectiveness of this therapy than there is for any other, particularly in treating BED and bulimia. CBT helps you to recognize the circumstances, emotions and thoughts that trigger a binge or other problem behavior, and then to change that behavior-for instance, by phoning a friend or going for a walk instead.

Referrals: National Association of Cognitive-Behavioral Therapists, (800-853-1135, www.

  • Interpersonal therapy. In one-on-one sessions with a psychologist or psychiatrist, you talk about your past and your relationships. Over time, you come to understand the underlying causes of your eating disorder so that it no longer controls you.
  • Adult in patient treatment. Some clinics offer programs specifically for women over age 30, including the Renfrew Center, with eight facilities on the East Coast (800-736-3739, and Remuda Ranch in Wickenburg, Arizona, and Milford, Virginia (800-445-1900,
  • Support groups. Meeting regularly with a group of adult women who also are combating eating disorders can provide a social network of sympathetic friends, practical advice for overcoming the problem and a sense of self-worth when you help another woman who is suffering,

Contact: Eating Disorder Referral and Information Center (858-792-7463, www.edreferral com).

  • Medications. Drugs appear not to be very effective in treating most eating disorders. However, if you also are depressed, antidepressant medication may help you feel more optimistic, which in turn may help you gain control over your eating. Ask your doctor or a psychiatrist about this option.
  • Creative endeavors. An eating disorder keeps you isolated and secretive. Healing from such a disorder involves projecting your voice and personality into the community. Join a writers' group, take a class in art or dance, or get involved with an organization that advocates for a better world.

If one type of therapy does not help you, don't just give up—try a different approach. With the right help, you can recover.

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