Fear of aging: A precipitating factor in late onset anorexia nervosa

Two women with first onset of anorexia nervosa at ages 37 and 41 years presented with certain common clinical features. Both had presented a facade of social adjustment during their adult life, while mainta ning a very dependent and enmeshed relation with their parents. The development of some visible physical stigmata of aging, such as wrinkling and sagging skin, in association with a decline in their parents' health with aging caused their parents to encourage the patients to assume a more independent existence, as they realized that the patients would not remain “their little girls” forever. The patients, who had essentially postponed the adolescent task of separation-individuation for over 20 years, had a great deal of difficulty coping and developed intractable anorexia nervosa. They eventually transferred their dependency upon their spouse and/or grown-up children. Consideration of this factor could be very important in the management of some older eating-disordered patients.