The World's Oldest Anorexic

Do not assume that only young women and girls develop anorexia nervosa. For one thing, males can also become anorexic, and apparently, there are no limitations to age of onset. A 92-year-old woman, described by clinicians from Manhasset, NY in a professional journal, showed up at the hospital after failing to thrive following a bout with pneumonia. Upon running a series of medical tests, physicians were unable to find an organic reason for her dehydration and malnutrition. Through a psychiatric interview, however, it was determined that the woman had an eating disorder—although she had never had one previously.

Feeling Fat

The woman complained that eating even small amounts of food made her feel fat, and she sneaked prunes as a laxative to help return her stomach to its "correct shape." She also excessively exercised with a running routine of laps around the hospital floor. She said that she had never been preoccupied with food or had an eating disorder, except some concern about her body after her son's birth.

She confided to the doctors that she was worried that this same son, who was recently divorced, was going to move back into her home and that she would have to cook and clean for him. She wanted to go back to her daughter's house, where she was when she had the pneumonia. Her anorexia, however, would have to be dealt with before that would be possbile. Cognitive therapy focused on her body image, food, and weight concerns, her running laps were restricted, and bathroom visits were monitored. It took her three months to gain and maintain her weight, at which time she was discharged to a minimally assisted living facility. At a six-month follow up, she was well.

Like a Teenager

In their case report of this woman's story, Drs. Hindi Mermelstein and Ranita Basu made a fascinating comparison between the 92-year-old woman and a 16-year-old patient. Both met all of the clinical criteria for anorexia nervosa, with the obvious exception of amenorrhea (lack of periods) in the older woman. Both had the same kinds of irrational thoughts of being grossly overweight while actually being too thin. Neither had previous evidence of depression, suicidal thinking, or other psychiatric problems. The teenager's trigger was a fear of going away to college—because she thought her parents, who had a history of marital violence, might kill each other once she was out of the house. Similarly, the girl responded well to therapeutic intervention and treatment.

In their article, which was published in the International Journal of Eating Disorders, the authors point out that caregivers need to be sensitive to the fact that eating disorders can appear in someone's life at any age. In our retelling of this unique case, we also wish to emphasize that recovery is also possible at any age.