Michele Schmidt’s eating disorder started early.
"I was worrying about my weight as early as fifth or sixth grade," the 34-year-old Mesa woman said. "I was involved in ballet and competitive ice skating, and there is a lot of emphasis placed on body image in those sports."
In junior high school, she restricted her food intake.
"In eighth grade, I started going through adolescence," she said. "Some girls can’t wait to get their first bra. But to me, it was the most scary time of my life."
When she went to summer camp that year, she stopped eating. And when she returned home, her horrified mother took her to the doctor, who diagnosed anorexia.
"A lot of men and women hide it for a long time before anyone finds out," Schmidt said. "For me, it was very obvious. But at the time, it was not something I was willing to admit."
Twenty years later, Schmidt has joined the increasing number of women who developed eating disorders in adolescence, but waited until later in life to get them under control. While recent studies show that eating disorders are striking girls at ever-younger ages, experts predict that the next largest group of sufferers will be middle-aged women. The anxieties of midlife — career, raising children, divorce, infidelity and aging — can revive eating disorders that have been dormant for many years.
"We never believed that there such a thing as a midlife eating disorder, because we weren’t seeing it," said Dr. Edward Cumella of Wickenburg’s Remuda Ranch, the country’s second-largest treatment facility. "But over the last five years, we’ve seen our number of patients over 40 more than double to 7 percent of the total."
No one knows why. But psychologists believe that cultural pressure to look 20 when you’re 40 has never been as intense as it is now. Cosmetic surgery, BOTOX and personal trainers have created 40-plus celebrities like Demi Moore and Madonna who make women fearful of showing their ages.
"Eating disorder symptoms are the same for older and younger women," Cumella said. "And both appear to be triggered by life transitions. For the teen, it’s a fear of growing up. For someone near midlife, it’s the fear of getting old."
Cumella also said increased awareness of eating disorders has spurred some who suffered for years to seek treatment. As Schmidt approached her 30th birthday, she saw herself falling apart.
"The eating disorder was not working for me anymore," she said. "It was seriously interfering with life. I knew that if I kept going down that road, I was not going to live. When I was younger, people would tell me, ‘You can die from this,’ and I’d think, ‘Good. Put me out of misery.’ But there finally came a point where I did not want to die. I wanted to live."
Anorexia has the highest mortality rate of any mental illness, said Dr. Stephanie Evans, a doctor of internal medicine for CIGNA Medical Group of Arizona.
"Anorexics have a 6 percent chance of dying over a 10-year period," Evans said.
Evans said long-term eating disorders can lead to osteoporosis and damage to tooth enamel. Women with eating disorders also have a higher rate of complications during pregnancy, including low birth weight babies and premature birth.
"The good thing is that it’s never too late to get treatment," Evans said. "Women need to know that their life can be significantly improved and they don’t have to live this way."
Treatment for eating disorders often requires a multifaceted approach, including medication, counseling, nutritional advice and hospitalization, Evans said. And, as Schmidt learned, it can be a lengthy process.
"The first time I went in for treatment as an adult, I was thinking I’d go into the hospital and be cured," she said. "I’d get out, come back home, go to some meetings, see a nutritionist and be all better. But that’s not how it was. Two years into it, I was right back at square one."
When Schmidt got back into treatment, she learned there was no quick fix.
"I had lived with my eating disorder for so many years, it became ingrained in my brain and it takes time to transform those negative thoughts into different ones," she said. "I just learned that I have to think about taking care of myself and be open and honest with other people. It’s a lifelong process and something I have to think about every day."
Types of eating disorders
• Anorexia nervosa — People with anorexia have a fear of gaining weight; they impose self-starvation. Almost 4 percent of women in the United States experience anorexia at some point in their lives.
People with anorexia can be divided into two groups:
1) Restricting — People lose weight by severely limiting the amount of food they eat, primarily through dieting and fasting.
2) Binge eating and purging — People regularly binge, then purge by vomiting or using laxatives, diuretics or enemas.
• Bulimia nervosa — People in this group binge, then compensate by vomiting or using laxatives, diuretics or enemas. Others compensate by fasting or exercising excessively.
An estimated 1 percent to 4 percent of women will develop bulimia at some point. Bulimia may be more difficult to spot than anorexia because people with the condition usually have a normal body weight, even though they might want to be extremely thin.
• Binge-eating disorder — People — generally those who are at least mildly obese — frequently and rapidly eat an excessive amount of food, often until they’re uncomfortably full. Some 2 percent to 5 percent of Americans have this disorder, although the prevalence is higher among obese people. This disorder hasn’t yet been officially classified as a formal psychiatric diagnosis.
Source: National Eating Disorders Association
How to help a friend or loved one
• Collect information. Find treatment resources. Get help from support personnel.
• In a caring and nonjudgmental way, tell the person what you have observed and suggest they seek appropriate physical and psychological assessment.
• If the person denies there is a problem, consult with supervisors, treatment resources or the National Eating Disorders Association at (206) 382-3587 or www.nationaleatingdisorders.org.
• As the person begins treatment, be natural and caring — but do not discuss eating, weight or appearance. Do not insist that the person eat or change attitudes.