2 - (SYM 18) Barriers and Facilitators to Binge-eating Disorder Treatment Among Older Women: Recommendations from Women with Lived Experience

Binge-eating disorder (BED) involves ≥1 objective binge episode (consuming an unusually large amount of food in one sitting, with loss of control) per week for ≥3 months. Older adult women experience high rates of BED yet are understudied in eating disorders research. In 58 eating disorders RCTs, only 3 even allowed participants age ≥65; none were designed for older adults. Thus, no guidelines exist for the treatment of BED in older women.

The current qualitative study explored the lived experience of older women with BED in later life. Participants (N = 30) were older women, aged 60+ (range = 60-76) with current BED who completed qualitative interviews and focus groups regarding myriad concepts (e.g., barriers and facilitators to BED treatment and diagnosis in later life, considerations for age-tailoring a BED treatment, and the impact of BED in their lives. We began with a conceptual framework to develop higher order codes. These deductive analyses formed 4 main themes (barriers, facilitators, considerations, and impact); inductive analyses formed subthemes. The research team individually coded quotes from all sessions and collated them into subthemes. The team compared thematic analyses, then refined and finalized subthemes based on shared observations.

Subthemes of barriers to treatment/diagnosis included 1) self-stigma especially in the context of older age (“I’m too old for this”); 2) messaging from medical providers focusing exclusively on weight, without considering eating disorders; 3) misperceptions that eating disorders affect older adults (by self, others, providers); 4) lifelong social context for women to put others first; and 5) logistics (e.g., cost) due to limited income. Facilitators included 1) remaining hope to change; 2) desire to understand the “why” (e.g., “why am I doing this?”); 3) strong drive to improve health and live longer (mostly related to messaging from medical providers on weight loss).

Recommendations included coping with social isolation with age, adapting to life transitions (e.g., empty nest, retirement), and loss/grief. Logistical considerations included 1) simple language/forms that are easy to digest, 2) small, female-only groups for social support, and 3) location accessibility. In depth information, significant BED impacts on life, and exemplar quotes will be presented. Ultimately, we aim to integrate feedback from women with lived experience to co-design an age-tailored BED intervention for older women that overcomes barriers, leverages facilitators, and is responsive to articulated needs.