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Candice Bergen boldly goes where few Hollywood actresses have gone in her forthcoming memoir, openly discussing her weight gain and the body image issues older women face.

"Let me just come right out and say it: I am fat," the 68-year-old icon writes in A Fine Romance. "I live to eat. None of this ‘eat to live’ stuff for me. I am a champion eater. No carb is safe—no fat, either."

The Murphy Brown star elaborates to say that women over fifty have a choice: they can preserve their face or their butt, but not both. She proudly says she chose the former, and has gained 30 pounds in the last 15 years—and couldn't be happier.

Her friends who chose the latter? "They maintain their weight by routinely vomiting after major meals consisting of a slice of steak or a filet of fish.”

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The comment was seemingly made in jest, but it conjures a sad image—one of women well past middle age struggling with the kind of disordered eating we typically associate with teens and sorority girls. The kind of behavior many young women write off as "temporary," vowing they'll get help down the road.

Of course, the reality is that women of all ages struggle with disordered eating and eating disorders. Bergen’s remark reveals a secret many older women hide—and in some cases, have kept hidden their entire lives.

Seventy-one percent of women over the age of 50 are actively trying to lose weight, and 13 percent exhibit eating disorder symptoms, according to a study from 2012 conducted by Cynthia Bulik, a distinguished professor of eating disorders at UNC-Chapel Hill's School of Medicine. The most common disorders among this group include binge eating disorder (B.E.D.) and purging after eating, in the way Bergen describes.

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Bulik, who went on to write a book about eating disorders in midlife, stressed to Fusion that these conditions represent a serious medical issue. "We must not conflate vanity with illness,” she said. “Vomiting after meals is a sign of bulimia nervosa or purging disorder—not a choice between ‘face and butts,’ as Ms. Bergen suggests.”

They also represent a cautionary tale for younger women who put off seeking treatment. “Patterns of disordered eating can persist for a lifetime if they go unaddressed and untreated,” says Claire Mysko director of programs for the National Eating Disorder Association (NEDA). “And tragically, they often do. That's why early intervention is such a critical piece of confronting this epidemic."

Mysko points out that young people should get help as soon as symptoms emerge, but understands doing so may be easier said than done. "The problem is that some of the early warning signs, including dieting and poor self-image, are normalized and even expected in our culture. We need to do a better job at screening for eating disorders and we need to take negative body talk seriously.”

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Taryn Hillin is Fusion's love and sex writer, with a large focus on the science of relationships. She also loves dogs, Bourbon barrel-aged beers and popcorn — not necessarily in that order.