Letting Go of an Eating Disorder During Midlife

For more than two decades, Sue Harootunian, 47, waged a losing battle against anorexia. Slowly starving herself to death, she avoided eating in front of her family and began jogging obsessively.

Eventually, her 5-foot 4-inch frame wasted away to a mere 80 pounds -- so fragile that death was a real possibility.

"If you look at her physical condition, you're amazed that she can function as well as she does right now, because it's just devastated her physically," said her husband, Lee.

Literally at her breaking point, Harootunian finally sought help at the Renfrew Center, an elite treatment facility in Philadelphia.

She also allowed "20/20" to chronicle her desperate fight to overcome her disease to serve as an example for other women struggling with eating disorders.

"The whole idea of gaining weight is scary, but it's not. I have mixed emotions about it," Harootunian, a mother of three, said on the morning she checked in at Renfrew.

The image of a grown woman struggling with an eating disorder may seem incongruous, but in recent years, experts have detected a hidden epidemic raging in homes all across America, with mothers struggling to save the lives -- not of their daughters -- but of themselves.

Ordinary Beginnings

Harootunian's anorexia was born out of years of suffering in silence and isolation, and many adult women may find her story unsettling for its ordinary beginnings.

Harootunian's husband, Lee, was an executive at a Fortune 500 company. Because he spent long hours on the road, Harootunian often found herself raising their kids alone, becoming lost in her loneliness.

"I had a difficult relationship with my husband, and I just internalized a lot of things, and I didn't feel pretty. I didn't feel good about myself," she said.

"I probably did neglect some of her needs at the time," her husband said. "If that contributed to this, certainly I'll take responsibility for it."

Feeling that her life was spinning out of control, Harootunian asserted control over the one thing she could -- her body. At times, she ate only popcorn during her meals. She also began drinking heavily and abusing laxatives.

Eventually, Harootunian was so debilitated by her anorexia that she became withdrawn and emotionally unavailable to her family.

"She used to sleep in bed all the time," said her daughter, Kristen, 10. "She'd get too skinny and it would freak me out."

"At least once or twice a day we would notice that mom was sick," said her oldest child, Corbin, 13. "But I had known that it was an eating disorder that we have to take care of so we can get her better."

Adjusting to Renfrew

When Harootunian first arrived at Renfrew, the staff spent several days just trying to stabilize her health.

"She was 67 percent of her ideal body weight. Her heart rate was low. She was dehydrated. She needed to be placed on bed rest," said Dr. Susan Ice, the medical director at Renfrew, where more than 20 percent of patients are women over 35 years old.

"Being very selective about the types of food that one eats; being very preoccupied with weight, leaving the dinner table early -- all those things would sort of signal that there's a problem," Ice said.

Many adults afflicted by eating disorders first developed their illnesses when they were teenagers. Harootunian's case is rare in that hers developed during adulthood.

And for adult women, the triggers are often common midlife anxieties like divorce, empty nest syndrome or the loss of a parent.

For this reason, the treatment program at Renfrew involves not just developing healthy eating habits under the supervision of medical staff and a nutritionist but also therapy -- one-on-one sessions with professionals, couples therapy with spouses, or dealing with body issues through art.

The Breakthrough

Harootunian's breakthrough occurred in a group session called "Psycho Drama" in which a therapist asked other women to play various characters in Harootunian's life. During this session, Harootunian revealed that her relationship to her father was also rocky.

Like her husband, Harootunian's father, a traveling salesman, was often absent from her life. That she didn't have a closer relationship with her dad was deeply hurtful to her as a child.

"I just don't know why Daddy doesn't talk to me. I try so hard in school. And I just don't know why I am not good enough for him," she said during therapy.

Harootunian didn't have the opportunity to fully reconcile with him before his death.

"When my father died, a part of me died," Harootunian told the therapist. "But I know that he's sending me messages to keep doing this, to stay strong, for one reason or another. I feel like I'm on a mission to do this for me, and for him."

The therapist showed Harootunian how she had been using her eating disorder to numb all those years of pain. Confronting her eating disorder through role playing, Harootunian declared, "I want you out of my life!"

It was a cathartic experience for her. When asked by ABC News medical editor Dr. Tim Johnson what she learned during that session, Harootunian said, "That I was at a point where I really wanted to take care of myself. That I was evolving. That I meant something."

Following this revelation, Harootunian approached her treatment program with renewed vigor. Back at home, her husband also made changes -- cutting back on his work hours and caring for the kids while Harootunian was at Renfrew.

Finally, 58 days after she was admitted, at a cost of about $1,000 a day, Harootunian was well enough to go home.

Coming Home

"She ultimately left eating over 4,000 calories, and we started her out at about 1,200," Ice said. "She gained about 25 pounds in the program, and left at almost 90 percent [of her ideal body weight]."

For several weeks after her release, Harootunian continued to check in daily with the Renfrew staff at its outpatient facility, where she took part in therapy sessions. Slowly, her life regained a sense of normalcy.

"I don't get stressed out about a lot of things. I am not as much of a perfectionist," Harootunian said.

Still, she worries about any possible effects her anorexia might have had on her young children.

"I hope that seeing me as a different person will give them insight to stay healthy and stay well," she said.

"Just to see her back, feeling good about herself -- it's energizing and it's positive, and it's extremely attractive in every way to me," her husband said.

Last June, nearly a year after her release, "20/20" caught up with Harootunian again on the Jersey shore. Sporting a new turquoise swimsuit, she reveled in the surf with her kids and proudly showed off her new figure.

She had gained 40 pounds, and weighed a very healthy 120. Although people can never be completely cured of anorexia, Harootunian has not had any relapses and no longer needs the Renfrew support groups.

"It's just letting go of that eating disorder, that's the hardest step," she said. "And you know, a journey of a thousand miles takes one small step."