Morley and Castle  have reported
atypical anorexia syndromes in the elderly. Anorexia
in the elderly was first described in 1890 in Guys
Hospital when it was termed "senile marasmus."
Patients were anorexic and died with no apparent cause
of death .
A spectrum of anorexia occurs in the
elderly. In bereavement appetite can be markedly diminished
and overt depression may not be apparent. A second anorexic
pattern occurs in the elderly where patients decide
to stop eating. Denying hunger and refraining from eating,
they may become emaciated and die. A distortion of body
image is present as they do not consider themselves
thin. They deny suicidal ideation and, if asked, wish
to be resuscitated in the event of cardiac arrest .
One atypical patient engaged in sham eating in that
he would chew and then spit out most ingested food.
In spite of weight loss, he felt his body size was "just
Morley  has not seen bulimia in
the elderly manifested by binging or purging. However,
he considers the almost universal laxative use in the
elderly a possible iatrogenic form of purging.
Diminished olfactory sensitivity, appetite
disorders and impaired taste sensation may contribute
to eating disorders in the elderly. Zinc deficiency,
sometimes present in the elderly, produces dysguesia
and may also have a role in decreasing enjoyment of