Credit: Laura Lewis on Flickr, under Creative Commons (CC BY 2.0).

(WOMENSENEWS)– When someone says “eating disorder,” what image do you conjure up? Chances are if you are like most people, you imagine a thin white upper- middle class teenage girl. Surprisingly, you couldn’t be more wrong.

Whatever preconceived notions you may have about who suffers from eating disorders, it’s time to erase them and start over. Granted, anorexia nervosa is more visible than other eating disorders; those afflicted are strikingly underweight, may look pale and may have other signs of the disorder such as dry skin and brittle hair. Pictures of someone with anorexia are shocking and attention-grabbing. The media love anything with a provoking visual hook. That’s why we are much more likely to read stories about anorexia in newspapers and magazines than stories about the less visual eating disorders such as bulimia nervosa or binge eating disorder.

Plus, people are more aware of the lethality of anorexia nervosa, and the media are always hot on the trail of any story about a celeb who dies, be it from anorexia nervosa, drug or alcohol abuse or suicide. Most people are less aware that other eating disorders also carry a death toll. The landscape of eating disorders has changed and we have to update our understanding of what they are and who they afflict.

If we look at the numbers, the most common profile of someone with an eating disorder is a woman in her 30s or 40s who struggles with weight control and suffers from binge eating disorder. But countless women and men in midlife and beyond–from all racial, ethnic and socioeconomic backgrounds–wake up each morning to an ongoing battle with eating and body image, with many suffering from anorexia nervosa, bulimia nervosa, purging disorder, binge eating disorder and night eating syndrome.

Under the Radar

Millions more lurk below the diagnostic radar with enough disordered eating to disrupt their lives, but not to receive an official diagnosis.

On the surface, eating disorders play out similarly in adults and teens, but the context and the impact on their own and their families’ lives differs enormously. Some adults with eating and body-image-related disorders live productive lives and carry their illness around with them like a hidden secret. For others, eating disorders remove them from the playing field of life, impairing their ability to work, reproduce and love.

In the medical field, typecasting eating disorders as teen disorders poses dangerous challenges for adult women and men seeking compassionate care. Primary care physicians, obstetricians and gynecologists and other health care providers may overlook these disorders in adults or, even worse, demean women for not having “grown out” of these adolescent problems or ridicule men for having a “girls’ disorder.”

Partners and children suffer when adult women and men are afflicted. The cost of treatment renders families destitute and destroys relationships. Intimacy is crushed by body image concerns. Trust in relationships is shattered as women and men desperately try to hide their illness from others.

The treatments that we currently use were developed primarily for adolescent girls. We are only now starting to tailor treatments to deal with the specific challenges faced by adult women and men: how to recover when you have to work, engaging partners in recovery, developing parenting skills and protecting the next generation.

It feels as if the landscape has changed abruptly, and our understanding and compassion have lagged dangerously behind.

Reprinted from “Midlife Eating Disorders: Your Journey to Recovery” by . Copyright 2013 by Cynthia Bulik. Used by permission of Walker and Company, a division of Bloomsbury USA.

Find her on Twitter @cbulik.

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Eating Disorders Actually Most Common in Midlife