By Rebecca Lester, Washington University in St. Louis

“No one expects a grown woman in her 40s to have an eating disorder. That’s for teenagers, right? Well, guess what – it happened to me.”

Alexa, a 44-year-old real estate agent, was telling me about her struggle with non-purging bulimia, which has come to control her life. We spoke in 2024 at a coffee shop as part of my ongoing research on eating disorders.

The names of my research subjects have been changed for this article to protect their identities.

“I didn’t understand what was happening for a long time,” Alexa said. “It didn’t even occur to me that it could be an eating disorder.”

She is not alone. A 2023 study estimated that over 9 million American women over 40 develop eating disorders. Some had eating disorders earlier in life and experience a resurgence at midlife. Others develop them for the first time in their 40s or older.

I am an anthropologist and licensed therapist who has researched and treated eating disorders for the past 30 years. I have also recovered from an eating disorder myself. I wrote a 2021 book about how contemporary clinical approaches to eating disorders can harm people and keep them sick. One of the things I uncovered in my research is that older women with eating disorders often fly completely under the radar, leading to increased health risks and even death.

My research leads me to conclude that this is due to health care providers’ misunderstanding of the cultural and existential factors affecting women in midlife, which can make this a time of increased risk of developing an eating disorder.

By the numbers

The numbers around eating disorders at midlife are sobering: Rates of eating disorders among middle-aged women have increased in recent years. As many as 13% of American women over 50 have eating disorder symptoms, slightly more than the percentage diagnosed with breast cancer.

One study found that 71% of women ages 30 to 74 wanted to be thinner, although 73% of them were at clinically normal weight for their height and age. Research shows that although anorexia, an eating disorder characterized by the severe restriction of calories, becomes less common after age 26, bulimia, where patients binge and then purge food from their bodies, doesn’t reach its peak until age 47. Binge eating disorder, or habitually eating excessive amounts in one sitting, can continue to plague women into their 70s.

Lack of treatment

Despite the prevalence of eating disorders in older women, they are often the least likely to get help.

In fact, flagrant symptoms of an eating disorder can be missed in these middle-aged people. At 52, Janelle, a schoolteacher, has struggled with anorexia for the past four years. Because she is petite, her slight frame hasn’t raised any alarms for medical professionals.

“My doctor told me I couldn’t possibly have an eating disorder because I’m too old,” Janelle told me. “I know I’m anorexic. I was anorexic as a teenager, so I know exactly what this is. My doctor just said I should consider myself lucky because a lot of women my age actually gain weight.”

This doctor’s response is emblematic of problems in eating disorder treatment more generally in the U.S. Though tools to assess patients for eating disorders are available, most physicians and even psychiatrists receive little, if any, training in their use. Learning to identify and respond to eating disorders requires that they go through additional – and costly – specialized training.

As a result, many hold erroneous popular stereotypes about these conditions, and so women with eating disorders aren’t getting the help they need.

Beyond stereotypes

In the popular imagination, eating disorders center on things young women supposedly care about; namely, being thin and attractive – specifically, attractive to men. This stereotype is a holdover from 19th- and 20th-century understandings of hysteria, which was thought to particularly afflict young women who craved but also feared male sexual attention.

According to this paradigm, middle-aged women are thought to be out of the sexual game, so to speak, so they ought to be immune to illnesses that focus on appearance.

This perception of eating disorders is not only wrong, but also dangerous because clinicians often don’t recognize these issues in women who don’t fit this stereotype.

In reality, eating disorders are deadly conditions that emerge from a convergence of genetic susceptibility, psychological factors, family environments, life events and cultural values. And they affect people of all genders, sexual orientations and races across the socioeconomic spectrum and the lifespan.

Although the drive for thinness often is the most obvious feature of these conditions, what I have found in my 30 years of research on this topic, including talking to over 200 patients with eating disorders, is that these illnesses are at heart about desperately trying to feel worthy of existing.

A concern with body shape, then, often reflects a much deeper existential crisis that can arise during times when a person’s identity is shifting as their body is changing. One of those times is adolescence. Another is middle age.

Seeking identity in middle age

Outwardly, eating disorders in middle age look a lot like eating disorders at any other age. But the body concerns and identity dilemmas associated with middle age are different from those that plague adolescence and young adulthood.

As women age, their metabolism slows down, their bodies don’t work the way they used to, and they visibly begin to wear their life experience. Questions of mortality and the meaning of life can come to the fore. It’s often a time of shifting dynamics within families. For those who have children, middle age is typically the time when those children are becoming more independent or leaving home. This is also a time when aging parents may require care.

At the same time, for women in particular, the pressures to remain fresh, fit and firm despite aging are monumental. The popularity of treatments like Botox, dermal fillers, Ozempic and the massive anti-aging industry have exploded as this over-40 market has been cultivated.

“We’re supposed to look 30 forever,” said Shelly, a 51-year-old marketing professional struggling with anorexia. “You’ve heard of the ‘middle-age spread’? There’s no way I’m going to let that happen to me.”

A woman’s worth

Progress in gender equality notwithstanding, women’s social worth in modern Western culture is still disproportionately determined by appearance and sexual and reproductive capacities.

It is not surprising, then, that looks and youth become the focus of existential distress for many women over 40. As older women struggle to secure a sense of value in a youth-obsessed world, food and eating can become a focus of attention that ultimately becomes destructive.

This doesn’t mean these women are vain or superficial. Rather, they have picked up on what their culture values, and they have internalized the message that thinness is a way to attain that.

“Our culture doesn’t value older women the way other cultures do,” observed Kaytlin, a 47-year-old office manager struggling with disordered eating. “The idea that older women should be revered for their wisdom and influence is foreign to us. Instead, we become invisible.”

My hope is that dispelling some of the erroneous assumptions that have driven both public perception and clinical practice about these illnesses will help women get the care they need.

This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Rebecca Lester, Washington University in St. Louis

Read more:

• Mounting research documents the harmful effects of social media use on mental health, including body image and development of eating disorders
• Friday essay: ‘I was unseen, even to myself’ – as many as half of people with anorexia are autistic. Fiona Wright is one of them
• Eating disorders are about emotional pain – not food

Rebecca Lester does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Feature Image: Changes in identity in midlife can increase the risk of developing an eating disorder. muratseyit/E+ via Getty Images

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By Matthew Redmond, Université de Lille

In the acknowledgments of her 2024 novel “All Fours,” Miranda July explains that she was inspired by a series of conversations about “physical and emotional midlife changes” with several women close to her.

“And while there is almost no trace of these actual conversations in the book,” she adds, “they made writing it more necessary.”

The novel finds a middle-aged mother choosing to leave home and drive across the country in search of herself. Sound a little hackneyed? Maybe that’s why she gives up after about 30 minutes, pulling into a dingy motel and instead trying to turn back time from her new home base, the appropriately chosen Room 321.

In this bland environment she undergoes a physical and spiritual awakening – a dance to the Muzak of time. Whether remodeling her motel room or defying libidinal decline with a nearby Hertz rental car employee, July’s protagonist, who talks a lot about respiration – “I breathed in; I breathed out” – finally breathes life back into herself.

Along the way, “All Fours” frames middle age as something that must be felt and communicated afresh, one powerful, awkward, minutely recorded sensation at a time.

Easier said than done. Some clichés are like planets, their gravitational pull too strong for all but the most propulsive acts of creativity. Middle age is one of these. The changes often associated with being in your 40s and 50s – gray hairs, career doldrums, time’s squeaky-wheeled chariot drawing near – can seem as inevitable as aging itself.

And yet, as my research on the construction and representation of aging has shown, the middle years aren’t what they used to be, nor what they will one day become.

Inventing midlife

The history of middle age begins as far back as the eye can read.

In classical Western literature, the middle of life is represented as a time to live and die magnificently.

The heroes of Greek epics – Odysseus, Achilles, Ajax – are always middle-aged, and none of them loses sleep wondering about his life choices or whether his skills are falling off. Nor does Homer worry much about conveying how these men became who they are. Wily Odysseus, we can only assume, was wily pretty much from the cradle.

Beowulf, the hero of an early Anglo-Saxon poem, likewise does not show signs of slowing down until old age, when a dragon proves too much for him to kill without help from a much younger man. Embarrassing.

The middle phase of life, these works imply, is the time when people are most themselves, with the greatest abundance of skill and purpose that life will ever confer.

Even Shakespeare saw midlife as little cause for anxiety. Among the “seven ages of man” described in “As You Like It,” middle age corresponds roughly to the part of “the justice,” a man with “fair round belly” and “wise saws” who sounds a little quaint, perhaps, but also content; it is only during the sixth age, with the approach of what Shakespeare calls “second childishness,” that a major shift occurs and quality of life starts to drop.

The birth of crisis

Then everything changed. The Industrial Revolution gave rise to a new bourgeois class that, when not reeling from the latest market crash, had time and money to burn.

Middle-class leisure, unlike the aristocratic kind that greeted one at birth, required shifting gears, from a full-steam-ahead search for one’s place in the world to the relative stagnancy that came with having found it.

This kind of whiplash was enough to make a crisis of midlife: a deep-seated feeling of anxiety about the value of one’s achievements, the meaning of existence and the proximity of death.

While the actual term “midlife crisis” was not born until 1965, thanks to 48-year-old Canadian psychoanalyst Elliot Jacques, its gestation stretched across the 18th and 19th centuries. Romantic poets such as John Keats and Percy Shelley, who died at 25 and 29, respectively, taught readers to covet the summer of life with almost desperate intensity, and even a slight chill in the air became cause for dread.

The Victorians, perhaps sensing that Britain’s empire could not stay young and virile forever, took this Romantic dread and ran with it. In the 1853 novel “Little Dorrit,” 41-year-old Charles Dickens portrays 41-year-old Arthur Clennam, who gloomily meditates on what he’s done with himself and how little it’s gotten him:

“‘From the unhappy suppression of my youngest days, through the rigid and unloving home that followed them, through my departure, my long exile, my return, my mother’s welcome, my intercourse with her since, down to the afternoon of this day with poor Flora,’ said Arthur Clennam, ‘what have I found!’”

For Clennam, a jaded merchant who recently vacated his position with the family firm in search of some greater purpose, taking stock of one’s life seems a painful but necessary exercise. He also takes another kind of stock, investing in a Ponzi scheme that plunges him, with most of London, into a state of financial crisis that mirrors his personal one.

A generation later, in the U.S., Theodore Dreiser’s 1900 novel “Sister Carrie” tells the story of George Hurstwood, a successful businessman whose life begins to unravel the moment he stops working long enough to question its real worth.

Both Clennam and Hurstwood eventually take up with a 20-something woman – one finding regeneration in that relationship, the other dishevelment and death.

In another time, both men might also splurge on a red Corvette.

Future midlife

What about middle-aged women in the 19th century?

In a way, there were none. The critic Sari Edelstein, in her 2019 book “Adulthood and Other Fictions,” encourages readers to think about adulthood not as a biological fact but as a cluster of political rights and privileges conferred on some people in the U.S. – usually white men – and largely withheld from others, such as women and people of color.

While race, class and marital status profoundly impacted women’s experience of midlife, one fact remains constant for much of the century: the absence of full adult status under the law. Even as they matured, women were kept little.

They were also portrayed as such. Popular novels such as “The Lamplighter” and “The Wide, Wide World” retraced time and again the approved boundaries of a married woman’s life, which extend no further than the home. Unmarried women and widows could hold property and manage their own financial affairs, but the period literature far too seldom represents their point of view. Not until the advent of second-wave feminism, and works such as Doris Lessing’s 1974 novel “The Summer Before the Dark,” did middle-aged womanhood become a topic more openly and creatively explored on paper.

For all that creative labor across the past century, the English-speaking world has been largely resigned to the idea of middle age as a dreadful, isolating crisis.

This is likely due in part to the midlife crisis’s amazing elasticity – the way it stretches to accommodate shifting cultural contexts and the rise of whole new artistic forms. Few other topics seem to lend themselves so generously to esoteric offerings and crowd-pleasing genre fare, to the page and the screen. (For my money, one of the best films about midlife crises is Martin Scorsese’s “Casino.”)

If not a crisis, what else could midlife be?

Perhaps the gateway to something universal.

While the narrator of “All Fours” suffers plenty of distress and ennui, she never uses the word “crisis” without scare quotes. She’s clearly holding out for another kind of midlife.

That faith is rewarded in the last chapter, when she watches a dance recital and feels the “warm, hallowed feeling” from her hotel retreat “gilding the whole neighborhood, the whole city … The whole universe? Yes…”

She reflects: “If 321 was everywhere then every day was Wednesday, and I could always be how I was in the room. Imperfect, ungendered, game, unashamed. I had everything I needed in my pockets, a full soul.”

Her consciousness expanding and contracting between the scale of the universe and that of her own pockets, July’s narrator does more than regenerate. Rising and falling, part St. Teresa and part Lady Macbeth, she embraces both the ecstasy and the tragedy of life and is twice empowered.

It is a midlife metamorphosis.

This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Matthew Redmond, Université de Lille

Read more:

• John Keats’ concept of ‘negative capability’ – or sitting in uncertainty – is needed now more than ever
• The real midlife crisis confronting many Americans
• How old would you want to be in heaven?

Matthew Redmond does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Feature Image: The term ‘midlife crisis’ didn’t enter the lexicon until 1965, but its gestation stretched across the 18th and 19th centuries. Paul Taylor/Stone via Getty Images

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Wanda Haynes,

Certified Sommelier

Brunello di Montalcino “known as Brunello” is a dry full-bodied red wine from Tuscany. Its name is derived from the Italian word for “brown”.  By Italian law Brunello must be made from 100% Sangiovese grapes.

What does it taste like?

Brunello di Montalcino is a bold wine with high acidity, and tastes of wild berry, licorice, star anise, and espresso.

Assertive tannins are present in a younger version and aging will allow the harsh tannins of Brunello to mellow.

By aging several years, the flavors become that of dried figs, candied cherries, hazelnuts, and sunbaked leather. The tannins become smooth, and the acidity is richer.

A meat lovers pizza loaded with salami, fennel sausage, and Italian ham known as prosciutto. Spicy gorgonzola, Parmigiano-Reggiano, and vegetable soup pair lovely with a glass of Brunello.

The bottles label may read DOCG:

Denominazione di Origine Controllata e Garantita DOCG is the highest classification Italian wines can be awarded.

The classification ensures controlled production methods and guarantees quality with each bottle.

The post Discover the bold flavors of Brunello di Montalcino: a guide to Tuscany’s iconic red wine appeared first on The Cincinnati Herald .

By Sheri Riley

Herald Contributor

I get asked what my secret is to look like I haven’t aged much. I have been in the cosmetic industry for a very long time. I am not a physician or dermatologist, or even an esthetician. A lot of people ask me how do you keep your skin looking so bright? With so many skeletal issues one would never know I need a hip replacement just by looking at me. Here’s what has helped me:

#1. Good genetics.

While I received many bone and arthritis issues from my Dad, both of my parents have the most beautiful skin. A lot of genetics play a key role in our health. The skin is the largest organ on the body and what people see at hello. Your hair, skin, nails and teeth all are visible signs of someone’s genetics and health.

#2. Learning to drink more water.

Our bodies are made up of 70% water. Just like if we neglect to water our plants, if we neglect our bodies of water we will surely die. The body cannot function properly without water. Water is essential for our survival. It wasn’t until I wasn’t really drinking enough of it that I realized my body was dry from the inside out. I was lacking oxygen to my bones, and my gut lining I noticed was holding fat. Water literally detoxes your body.

#3. Eating a diet rich in healthy fats and leafy greens.

 I have always eaten a balanced diet. For us women, eating healthy fats as we age are extremely important. Avocados, beans, nuts and leafy greens are extremely important to healthy skin, bones and hair. Beauty isn’t in a bottle. It starts with your diet. And it is a lifestyle. And don’t throw away the other half of the avocado! Use it on your skin as a mask!

#4. Learning to be kind to myself.

Studies have shown that those who laugh, play, and maintain a relatively positive attitude have lived in their 90s and 100s. Optimism brings so much divine energy and allows blessings into our lives. Why do you think those who laugh maintain a youthful demeanor? I personally have struggled with negative self-talk in my youth, perfectionism and wanting to fit in. In my older age there comes wisdom with life lessons that if you are not being kind to yourself, chances are some of your self-criticism will rub off on others. Be your biggest cheerleader.

#5. The mind is as much a part of good health as it is drinking water.

Just like our bodies are made of 70% water and cannot function without it, our minds manifest and shape our realities. The body cannot live without the brain. Keeping the appointment for your physical to your primary care physician is important. The same in keeping the “check in” visit with your therapist is even more important. I’m an advocate for therapy. Make time to meditate. Do some brain exercises, like puzzles to stimulate the mind. Read books. Keeping my mind sharp has always been just as important to me as my body.

#6. SLEEP. REST. RECENTER.

I have struggled with lack of sleep for as long as I can remember. Lack of sleep can cause achy bones, dry or inflamed skin, mood swings and even depression. You are essentially blocking your body to naturally repair itself. Here are some things that helped me get back to a better sleeping pattern; not eating after 8p, going to bed at the same time every night, shutting off my social media once I’m in the bed, removing the television from my bedroom. Sleep is so important for brain function and for your body’s natural rest state to repair itself.

#7. Products always come last!

Always study ingredients in products before using them. And find out what works for you. Literally, products have always been my last resort!

#8 Oils.

No matter if you have oily skin or dry, there is a great oil for the skin for everyone. I swear by avocado, sweet almond oil and castor oils! There is a reason why older women look like they never aged!! #9. Sunscreen. I don’t care how light or dark you are, what’s going on underneath the skin can apply to anyone! Wearing sunscreen is extremely important and should be a part of your medicine cabinet, on your shelf in your bedroom and always on you before you leave the door!

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