Barbara Mangweth-Matzek

Pathological eating and body dissatisfaction in middle-aged and older women

Purpose of review To summarize the recent literature examining eating disorders, eating behavior, and body image in middle-aged and elderly women. Recent findings A small but evolving literature has begun to address the epidemiology, features, and potential treatment of eating disorders and related body-image concerns in middle-aged and elderly women. Preliminary findings suggest that pathological eating behaviors and frank eating disorders are surprisingly common in older women, as are associated body-image disturbances. Older women appear less likely to exhibit anorexia and bulimia nervosa and more likely to exhibit binge eating disorder and eating disorder not otherwise specified. The prevalence of such conditions in older women has likely increased in recent decades. On many indices of disordered eating and body image, older women with eating disorder resemble younger women with similar conditions, although older women exhibit certain unique concerns, such as dealing with menopause and with aging. Summary It appears that clinicians should be alert for eating and body-image disorder even in women well beyond the younger age range in whom these disorders have traditionally been described. Subsequent research should consider treatment strategies tailored for older women with eating disorders.

Epidemiology and treatment of eating disorders in men and women of middle and older age

Purpose of review We summarized recent literature on the epidemiology and treatment of eating disorders in middle-aged and older women and men. Recent findings The prevalence of eating disorders according to DSM-5 criteria is around 3.5% in older (>40 years) women and around 1–2% in older men. The majority of those eating disordered persons are not in treatment. There are new terms like ‘perimenopausal eating disorders’ and ‘muscularity-oriented eating disorders’ indicating the impact of the aging process and sex-specific differences. Summary Disordered eating and eating disorders occur in both women and men of all ages. Medical complications because of age, the stigma of eating disorders in a still ‘untypical’ age, and the glorification of sports activity often hinder the recognition of eating disorders in midlife and older persons. Treatment approaches should consider treatment strategies tailored for older women and men, addressing the context of midlife and aging.

Eating disorder symptoms in middle-aged and older men.

OBJECTIVE Few studies have assessed symptoms of eating disorders in older men. METHOD We administered anonymous questionnaires to 470 men, aged 40-75 years, in and around Innsbruck, Austria, to assess eating behavior, body image, and exercise activities. We defined current eating disorder symptoms (EDS) as (1) BMI < 18.5; (2) binge eating; (3) binge eating and purging; or (4) purging without binge eating. RESULTS Of the 470 men, 32 (6.8%) reported one of the four eating disorder symptoms. The 32 men with eating disorder symptoms, compared to the 438 men with normal eating, showed significantly greater pathology on scales assessing eating behavior, exercise addiction, satisfaction with body shape, and weight. However, the EDE-Q cutoff score for eating disturbance identified only three (9%) of the EDS men. DISCUSSION Symptoms of disordered eating, sometimes involving purging via excessive exercise, do occur in older men, and may be missed by conventional instruments.

Eating disorders in men: Current features and childhood factors

BACKGROUND: Disturbed interactions with one’s body and with other persons are two major features in eating disorders. This study was designed to assess current and childhood characteristics of eating-disordered men. METHODS: The authors interviewed 32 men with eating disorders (anorexia nervosa: N=9, bulimia nervosa: N=15, eating disorders not otherwise specified: N=8) and 43 control participants with no such history similar in age and educational status. The Structured Clinical Interview for DSM-IV was used to assess Axis I disorders and a self-designed interview to assess actual social and sexual characteristics and childhood body-focused and social behaviors including sexual and physical abuse. RESULTS: The two groups differed significantly with regard to clinical, sexual and social features, with a three times higher rate of psychiatric disorders, fewer sexual and social relationships in the index group than in the controls. Eating-disordered men differed significantly from controls on most measures of body-focused and social behaviors, displaying higher rates of thumb sucking, nail biting, auto-aggressive behavior, and nudity as a familial taboo during childhood, as well as less parental bodily caressing than did controls. The index group reported significantly poorer relationships to their parents, fewer friends and persons of trust, and more often had adjustment problems at school than did their counterparts. CONCLUSIONS: Our data show that disturbed interactions with one’s body and with other persons in eating-disordered men are associated with a body-denying and distant family climate7/14/2013 4:48PM and an auto-aggressive, anxious and inhibited social behavior during childhood.

Aging male symptomatology and eating behavior

Abstract Objective: The literature on eating disorders in older males is still very limited. We assessed the relationship between aging male symptomatology and eating behavior in middle-aged and older men. Method: We distributed anonymous questionnaires to men aged 40–75 years living in or near Innsbruck, Austria, covering demographic items, current eating disorder symptoms (as defined by DSM-5), and associated measures of eating pathology, body image, and sports activity (including exercise addiction). We also administered the Aging Males’ Symptoms scale (AMS), and classified respondents as “high-AMS” (AMS score ≥37; N = 82) or “low-AMS” (AMS score <37; N = 386). Results: High-AMS men reported a significantly higher mean current BMI, a greater prevalence of eating disorder symptoms, higher scores on the Eating Disorder Examination Questionnaire, greater risk of exercise addiction, and more negative body image than low-AMS men. Discussion: We found a marked association between aging-male symptomatology and eating-disorder symptomatology in aging men. Our findings suggest that clinicians should carefully inquire about eating disorder symptoms in men aged 40 and above reporting aging-male symptomatology. Importantly, several men in the study reported “purging” via excessive exercise (as opposed to the more common methods of vomiting or use of laxatives or diuretics), and therefore this should be a subject of inquiry in clinical evaluations. To pursue these findings, subsequent studies of eating disorders in older men should consider assessing endocrinological measures, particularly testosterone levels, and should use longitudinal designs.

Verhaltensauffälligkeiten mit körperlichen Störungen und Faktoren (ICD-10 F5)

Die im ICD-10 Kapitel F5 erfassten Diagnosen sind in der Tabelle 1 zusammengefasst. Aus didaktischen Grunden wird den Schlafstorungen ein eigenes Kapitel (siehe Kapitel 12) gewidmet. Zudem sind die hier aufgefuhrten sexuellen Funktionsstorungen (F52) erganzt durch Storungen der Geschlechtsidentitat (F64), Storungen der Sexualpraferenz (F65) sowie sexuelle Reifungskrisen F66.