Eating disorders are often thought of as something that affects adolescents and young adults. However, a growing number of adults are being treated for conditions like anorexia, bulimia, and binge eating disorder. While some may have had eating disorders earlier in life, what this New York Times article calls “a significant minority” develop symptoms for the first time in middle age.

For example, Cynthia M. Bulik, director of the Eating Disorders Program at the University of North Carolina, Chapel Hill, says that, since 2003 half of its patients have been adults, despite the fact the program was initially geared towards adolescents.

Like younger people, a stressful event may trigger destructive behaviors such as restricted eating, laxative abuse, binging, purging, or excessive exercise. However, as women get older, they may become more adept at concealing the disorder. Doctors may not also notice red flags such as changes in the menstrual cycle because they’re not trained to look for them. If a teenage girl stops getting her period, questions related to diet and exercise are more likely to come up than if a woman in her early ’50s stops menstruating, as menopause tends to begin in that age group.

Dr. Bulik said programs like the one at Chapel Hill are working to raise physicians’ awareness of the rise of eating disorders in older patients. “Often they don’t ask the question because they have in their mind this stereotypical picture of eating disorders as a problem of white, middle-class teenagers.” Clearly this is a growing problem that needs to continue to be addressed.

I’ve definitely known people who didn’t fit the stereotypical profile of someone with an eating disorder but clearly needed help. It’s heartbreaking to see, and sometimes, especially if it’s someone who’s only a casual acquaintance, there’s really not much you can do but hope they get treatment. Though broaching the topic with a friend or family member can be scary, sometimes even something as simple as, “Hey, I’m a little worried about you” can help get the conversation going.

For more information on eating disorders and where to find help, visit the National Eating Disorders Association.