Every day, Helen Engel-Gray makes sure she consumes less than 1,500 calories.
She calculates the fat, protein and carbohydrate content of each morsel that passes through her lips, and if she eats something unhealthy, she tells herself angrily that she deserves to be overweight.
The 31-year-old became anorexic as a teenager, when she ate so little that her hair fell out and her menstrual cycle stopped. "I do not consider myself recovered," the Edmonton teacher said via e-mail. "I don't know if it is possible to completely revamp the way I look at food."
Ms. Engel-Gray is one of a rising number of women past their teens and 20s who have a dysfunctional relationship with food. Some, like her, suffer relapses of eating disorders they faced as teens, while others develop a problem for the first time in their 30s, 40s, 50s or even 60s.
In the public eye, eating disorders have been traditionally viewed as falling into two categories - anorexia and bulimia - that affect a population of girls and women too young to know better. The issue brings to mind visions of body-image obsessed teens and gaunt fashion models, who most people assume suffer, get treatment, grow up and move on.
But health professionals say eating disorders are not just the domain of the young, and that more adult women are now displaying symptoms. This fall, Sheena's Place - an eating-disorder support centre based in Toronto - plans to create a new group for professionals over the age of 25, responding to an increase in calls from adult women.
"We're seeing a trend of older women coming in the last couple of years," said Anne Elliott, the centre's programming director. "The age range is quite phenomenal in our groups. It could be somebody who's 16 or somebody who's 60."
According to science journalist Trisha Gura, whose book Lying in Weight: The Hidden Epidemic of Eating Disorders in Adult Women was released in May, the number of women older than 30 seeking treatment for eating disorders has tripled in North America over the past 15 years.
A study by the Harvard Eating Disorders Center in Boston followed 240 women for 15 years, from the age of 25 to 40, and found more than two-thirds did not recover from their disorder.
"Older women, those past their 20s, need to know that they are indeed vulnerable to eating disorders and that their illnesses, over time, present a very different challenge than the eating disorders of adolescence," writes Ms. Gura, who realized in her 40s that her own battle with body image was far from over.
Part of the problem, she says, is that most adult women do not display typical symptoms of anorexia or bulimia. They do not starve themselves completely or make themselves throw up, but instead exercise compulsively and diet constantly.
Ms. Gura realized she had a major problem after having her first child. She gained only 10 pounds before giving birth to a 6-pound, 9-ounce daughter.
As is often the case with their younger counterparts, older women's disordered eating habits are triggered by a life transition.
With adults, this could be the loss of a parent, a child moving away, a pregnancy or a divorce.
The aging process alone can also set off a problem with food, Ms. Elliott said.
"Being an older woman is yet another life transition, so with all of us baby boomers going into this, we may be more at risk and the older body is harder to recover," she said.
The dangers of eating disorders are serious at any age, but older women can suffer major complications from the bone loss and cardiovascular stress that arises from malnutrition.
Merryl Bear, director of the National Eating Disorder Information Centre, said adult eating disorders are a relatively new phenomenon, but are easy to understand.
"Self-control, willpower, taking control of one's body: The behaviours that get exhibited by an individual with an eating disorder are strongly admired and sanctioned in our society," Ms. Bear said. "People say, 'You look so young for your age, you're in such good condition, gosh, I admire that you can say no to the slice of cake.' "
Shirley Leon, a clinical counsellor based in Vancouver, has treated many adult women with self-diagnosed eating disorders.
Most focus on their weight as a way of coping with stress, she said, as the responsibilities of adult life pile up. "They have to be family people and career people," she said.
Many of her clients seek help because they are pregnant, or are trying to get pregnant, she said, and realize they can no longer be purging and excessively exercising.
But Ms. Engel-Gray knows plenty of women who have not sought help for their obvious issues with food.
She describes friends who regularly binge eat to the point of pain, "and then work out like demons to try to burn off the calories that they have consumed."
She has seen colleagues obsess over Weight Watchers points or nibble at salad during lunch after skipping breakfast altogether.
"A teenage girl would be accused of having an eating disorder," she said. "I think that perhaps there is an underlying admiration for older women who can maintain their figures ... even if it's not in a healthy way."
Trisha Gura, author of Lying
in Weight, shares her story
of living with anorexia
in an audio slideshow.