Aging: Harmful Drug Abuse, Eating Disorders And Plastic Surgery In Middle Age

When I think of Demi Moore, I envision her almost naked -- and very pregnant-- body on the cover of Vanity Fair. I recall her feminine, sexy figure in the film "Striptease" and her powerful, muscular one in "GI Jane." Moore was, for many of us, the epitome of fearless sensuality, flexibility and strength.

Seeing current photos of the 49-year-old's frail, sickly body saddens me. As does hearing her described in the media as requiring "reassurance all the time that she was hot and sexy," or feeling desperate "to stay young and skinny to remain attractive to her husband." Her collapse follows that of another beautiful actress, the recently-turned-50 Heather Locklear, who was also reportedly hospitalized for prescription drug and alcohol abuse.

What is happening to these women? Are the challenges of midlife throwing them into a tailspin? Is it their reliance on youth and beauty -- and measures to maintain them -- that run them into trouble, as aging brings losses too difficult to bear?

Surely, most women have never been in the kind of spotlight -- or physical shape -- that these actresses are in. We know from older celebs (think 73-year-old Jane Fonda) about the unrelenting focus Hollywood places on youthful looks. But all women face complicated feelings as they watch their bodies change with age. And according to experts, many are falling victim to the kind of self-destructive measures that allegedly left Moore and Locklear unable to cope.

Dr. Margo Maine, psychologist and co-author of "The Body Myth," writes, "The degree of despair we are seeing among adult women about their bodies is unrivaled," as the bar is set for many at physical perfection. In "Face It," a book about the psychology of an aging appearance, I write about the emotional havoc created by equating youth with beauty and the dangers when our culture reinforces that equation.

Dr. Cynthia Bulik, director of the UNC Eating Disorders Program at The University of North Carolina, told The New York Times that women age 50 and beyond are not only using Botox and plastic surgery to look younger, but are engaging in extreme weight- and shape-control behaviors as well. Her clinic is treating an increasing number of midlifers who routinely binge and vomit, abuse laxatives, starve themselves and engage in compulsive, self-destructive activities as they deal with midlife issues.

Statistics show that substance abuse by midlifers is also on the rise. While often used socially and in moderation to start, these substances become increasingly relied upon to deal with emotional issues about aging. These activities become secretive, the substances serve to self-medicate and then the behavior patterns are difficult to stop. Similarly, the use of cosmetic procedures may become addictive as well. For many, they start as a reasonable way to deal with the desire to "anti-age," but as we all know -- and can see -- the use of these procedures has skyrocketed among midlifers, and for some, turns into an obsession they cannot stop.

So what are some healthier alternatives? Some nips and tucks at our attitudes perhaps? Maybe if we change how we view our aging selves, we could avoid heading down these destructive paths? Instead of becoming out of control -- or obsessively controlling -- about the external changes that come with age, try using some of these internal guidelines to keep you on course.

  • Change is the only constant in our ever-aging bodies: From the minute we are born, we are instruments of transformation. Midlife and beyond is another stage of life and an important turning point. Like moving from childhood to adolescence into adulthood, it is one where we will witness change on our faces and bodies. Rather than try to "anti-age," perhaps it's better to recognize that we must constantly adjust to the changes we see. Constant change is one thing we can count on.

  • Controlling our bodies doesn't stop time: Of course, maintaining healthy habits is a good thing. Eating well, drinking in moderation and staying strong and flexible is especially important as we age. But when control becomes an obsession -- taking precedence over common sense and reason -- then we have equated it with "anti-aging." We will enjoy the fruits of our healthy efforts if we accept that there is no way to turn back the clock. Change is inevitable and must be managed -- not controlled -- from within.
  • Alcohol and drugs numb our feelings, not resolve them: If you find you are increasingly relying on substances as you age, remember they are not solutions to conflicts, anxieties or fears. They can temporarily allay them, but their use can become addicting. We need to deal directly with the complicated feelings that aging brings, and numbing ourselves makes that process more difficult. Keep in mind, you will find many other midlifers today at 12-step programs who are facing the same feelings. You are not alone.
  • Letting go is the only way to go: Mourning losses is a necessary part of aging. You ask almost any man or woman who has managed to negotiate the aging process with grace and style, and you will hear them talk about letting go. They know that it is not possible to hold on to who they once were or to a self-image that they can no longer maintain. To them, the behaviors used to avoid and deny that fact seem unproductive and fruitless. Instead, they focus their energy on reshaping and redefining themselves. Mourning is part of that process -- letting go to make room for new meaning and new self-definition.
  • All of this is to say that we can do a lot to prolong our health and wellbeing as we age. We can protect our skin, stay fit and work hard to remain vital and active at midlife. But, a certain amount of change occurs no matter what we do and we all have to learn to deal with that fact.

    I recently heard some hopeful words from Grammy award winner Adele, who was talking to British Vogue about her appearance. She said, "I've seen people where it rules their lives, who want to be thinner or have bigger boobs, and how it wears down on them ... I don't want that in my life. I have insecurities, of course, but I don't hang out with anyone who points them out to me."

    Adele is in her 20s now, and as a singer may feel less "on-camera" pressure than actresses do. But If she continues to hold onto that attitude and uses the advice suggested above as she ages, hopefully she'll avoid the downward spiral that others -- like Demi and Heather, allegedly, as well as plenty of everyday women -- have taken, as they barrel through midlife.

    Do you know people who have spiraled out of control as they headed toward midlife? Any words of wisdom for them?

    Vivian Diller, Ph.D. is a psychologist in private practice in New York City. She serves as a media expert on various psychological topics and as a consultant to companies promoting health, beauty and cosmetic products. Her book, "Face It: What Women Really Feel As Their Looks Change" (2010), edited by Michele Willens, is a psychological guide to help women deal with the emotions brought on by their changing appearances.

    For more information, please visit my website at, friend me on Facebook (at or continue the conversation on Twitter.

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