What most people don’t read or hear about is the reported increase of eating disorders among older people, particularly women. Little information is readily accessible, but there appears to be a real uptick in cases of older people struggling with eating disorders yet to be fully addressed. The disorder presents itself with similarities and differences to the disordered eating attributes present in younger women, but because older people are more vulnerable in many ways, an eating disorder in midlife and beyond can be much more dangerous. A simple-appearance of weight loss among the older women may possibly be overlooked as a symptom of a different issue.
A recent interview was held with Jennifer Lombardi, a licensed marriage and family therapist who serves as the Executive Director for Summit Eating Disorders and Outreach Program (SEDOP), a Sacramento-based program dedicated to the prevention and treatment of eating disorders. Jennifer has been with SEDOP for 11 years and has extensive experience as a primary therapist in crisis interventions, and in conducting individual and group therapy sessions. Jennifer also holds professional seminars and trainings in the field for professional development of other therapists, and conducts outreach programs in the schools particularly on the topics of eating disorders and body image issues to adolescents. Jennifer herself has recovered from an eating disorder over 19 years ago, and was inspired and motivated to create a program that has the needs of the patient always in mind. On Saturday, August 10th SEDOP held its 1st Annual Alumni Retreat in Folsom.
Jennifer is looking forward to expanding SEDOP’s outpatient program facilities to continue to provide the highest level of care services.
What is the population age range you serve? We have worked with patients as young as nine years old all the way up to age 60. It kind of breaks down in three separate groups: we have the significant adolescents, the young adult or college-age students, and we always have our women who are over the age of 40. It’s interesting to note also that most people think we serve only adolescent girls, but the majority of our female patients are over the age of 18. For example in the last few months we have about a quarter of the women admitted to our partial hospitalization program that are ages 40 and above. For us, we’ve always known that’s a population that absolutely struggles with eating disorder behavior. Many of them have been struggling off and on since they were teenagers because they didn’t necessarily have treatment options that were available to them, mainly because they didn’t exist or because of insurance coverage. For a lot of them, it is their first time coming into a structured treatment setting.
Do you feel that the older women require special attention or different treatment than the younger patients? I always say that people should be aware of the differences because I myself have worked with people in that age category and if they have been struggling for many years, they begin to wonder if it’s too late to seek proper treatment. I say absolutely not, that it’s never too late because people can always recover, and do. Sometimes the older patients have more obstacles or challenges in terms of being able to balance their life outside of treatment such as work or raising children. What we try to do is provide them support as some patients can take a medical leave from work. If it concerns help with a parity diagnosis we can support patients in that way. Often times they don’t want to burden their families or loved ones with having to take on extra responsibilities so that they can come into treatment. The interesting thing is that most people struggling with eating disorders have no trouble going above and beyond to help other people out in similar difficult situations. This gives them an opportunity to allow people in their lives to sort of return that favor.
Is there a lot more depression among the older women around this disorder? In terms of risk factors for developing eating disorders, anxiety and depression are things that we commonly see in a person’s history that often times pre-date the onset of the eating disorder. For us as treatment professionals, we look at the eating disorder as one component and we also consider these other underlying factors. Sometimes the eating disorders get better, but other underlying issues such as the anxiety or depression begin to surface. We talk about all of that up-front, and let the patient know that we are not here to just talk about the eating disorder, but to also look at things with a holistic perspective.
Do you feel there is family support for the patients? Yes, one of the things we actually require when they come into our treatment program is that they have somebody from the outside involved. Often times it is a family member such as a parent, sibling, or spouse. We also like to educate their support system so that they know how to support recovery and what to say and what to look for in case of a relapse.
What brings the older women in mostly? Is there a referral system? Yes, we have seen a shift and their primary care physicians often refer the patients to us. In the last five years I’ve been here, a lot more physicians have referred to us which tells me that they are becoming more aware that these are issues that need to be addressed and dealt with head-on with appropriate treatment.
Have you seen that some women in the higher income brackets don’t want to include anyone or let it be known their condition? Yes, absolutely. One of the challenges is that people who are struggling don’t necessarily recognize the medical complications that can go hand-in-hand with an eating disorder. So one of the things we do during the assessment is that we actually have their vitals taken and checked, then have lab work completed. Often times in the assessment, we offer them education to help them understand their behavior. They don’t have to tell anyone they have an eating disorder, they can say they have a medical condition for which they are receiving treatment, which is a likely possibility due to the medical complications that accompany many eating disorders. Sometimes people don’t know how severe their associated medical conditions could become.
Are the patients having trouble having insurance coverage for this condition? We have worked hard for many years with insurance companies to inform them that this condition is evidence-based. The insurance companies want to make sure that the services offered by treatment providers are adequate and appropriate. We are fortunate in California to have parody law, which states that there are certain mental health conditions that need to be treated from a medical perspective. Eating disorders fall under that category.
For more information regarding Summit Eating Disorders and Outreach Program, please contact them at: 3610 American River Drive, Suite 140, Sacramento, CA 95864 Telephone: (916) 574-1000