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Responding to a recent paper in BMC Medicine, Professor Chris Fairburn offers his thoughts on new evidence that suggests 'high figures' of women experience an eating disorder in middle age.

On 17 January 2017 the paper 'Lifetime and 12-month prevalence of eating disorders amongst women in mid-life: a population-based study of diagnoses and risk factors' was published in BMC Medicine.

Professor Christopher Fairburn, Professor of Psychiatry at the University of Oxford and head of CREDO, The Centre for Research on Eating Disorders at Oxford, gave these observations:

The authors worked out that about 15% of middle-aged women have had an eating disorder at some point in their lives, 3.6% having had one in the past 12 months. If one focuses solely on those diagnoses one can be confident about, it still looks as though about 9% of all middle-aged women have had an eating disorder at some point in their life and that 1.9% of middle-aged women have met diagnostic criteria for one in the past 12 months. These are really high figures and are important – there really aren’t any other studies of this quality and size looking at this age span, which is why we haven’t seen this before.
- Prof Chris Fairburn

“This is a novel study with good methods and a large sample population. The researchers have done a good job, however, it is particularly difficult to use interviews to retrospectively diagnose people. Essentially you’re asking people about how they felt or behaved 10, 20 or 30 years ago and then using a series of criteria to determine whether they would have had a certain diagnosis at that time. Retrospective diagnoses can be accurate if the feature being assessed is unambiguous such as being extremely underweight or repeatedly making oneself vomit, but they are prone to overdiagnose conditions.

“We also see from this study that very few of these women have had treatment. We knew this for teenagers but this is the first data we’ve seen across this wide age group. These women should know that a large proportion of them can be helped and that they are not alone or unusual in having an eating problem in middle age. They shouldn’t feel weird. 40-50% of women with anorexia can be cured completely - and the cure rate is as high as 60-70% in women with bulimia nervosa or binge eating disorder. So there really should be more publicity about this. GPs should be on the lookout and women should be told about this so that they can choose to seek help and know that there are treatments that can help them.”

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