CHARLOTTE, N.C. — Kelly had an epiphany in her car two years ago on a lunch break.

She thought about the lifestyles of other people in their early 30s, her age. They went out. They had kids. They led full lives. When she thought about her own life, she burst into tears. Her life revolved around her bingeing schedule.

Kelly's plan that day: Go home after work at 2:30, binge and purge until her husband got home. Dinner with him. Binge and purge again.

Kelly, then 30, reached two conclusions in her car that day:

The eating disorder she had since she was 15 years old could kill her.

She was the only one who could stop it.

Eating disorders among women age 30 and older in the United States are increasing. Some women, like Kelly of Charlotte, N.C., have suffered from an eating disorder most of their lives. For others, there's a trigger, like a divorce or a parent's death. Many feel overwhelmed by aging and the pressure to look young.

The medical complications of eating disorders tend to worsen as women age, says Angela Redlak, a clinical psychologist at the Renfrew Center Foundation in Charlotte, where Kelly is treated. They are more prone to develop osteoporosis, dental erosion, heart disease and arthritis.

The chronic pain of these conditions causes many middle-aged women — unlike teenagers and women in their 20s — to acknowledge they have an eating disorder and seek help.

Tormented adolescence

Growing up in upstate New York, Kelly says she was always about 40 pounds overweight. Her mom told her she would buy her clothes if she lost weight.

When Kelly started to like boys, she noticed they weren't attracted to overweight girls. She was 15 when she read a magazine article about anorexia and bulimia and decided that would be the easiest way to get thin.

As soon as school let out for summer break after Kelly's sophomore year, she started dieting. When she went back to school in the fall, she'd lost 35 pounds. She weighed 123 pounds, a normal weight for her 5-foot, 5-inch, small-boned frame. In six months later, her weight had dropped to 95 pounds.

During treatment for anorexia, she met some girls with bulimia, so she started binging and purging, too.

When people told her she looked too skinny, she felt emboldened to get even skinnier. Then Kelly's two best girlfriends walked away from her. Boys made vomiting noises when she passed by in the school hall.

Eventually the message got through and she gained weight. When her longtime boyfriend died in an ATV accident, Kelly turned to drugs, then alcohol. She stopped eating.

In a new relationship she tried hiding her disorder, but every once in a while he suspected something. She would tell him to mind his own business.

"I was sick of that life," she said. "It was having no life."

Still, they married and moved to Charlotte three years ago. But Kelly's eating disorder moved with her.

A while after Kelly's lunch-break epiphany, she contacted the Renfrew Center in south Charlotte.

"Eating disorders are very deceptive by nature," says Redlak, Renfrew's clinical supervisor. To help pull women out of their disorder, Renfrew uses traditional talk therapy, group therapy, couples and family therapy.

When Kelly started going to group therapy, she was with younger girls.

"I was like, 'Look at what happens. Do you want it to follow you?' " she said. "It held me back from doing many things."

When Kelly was in her 20s, she wanted to be a state trooper. Looking back, she thinks she would have pursued a career had she not suffered from an eating disorder. Now she works at a delivery company.

Affecting more women

After a year of therapy, Kelly says she is finally discovering who she is.

"I realize I'm worth more than what I was doing to myself," she said.

It is common for women age 30 and older to take responsibility for their disorder, says Redlak. Between 20 and 30 percent of Redlak's patients are over 30, and the number is growing.

The trend seems to be true across the country, says Cynthia Bulik, director of the eating disorders program at University of North Carolina-Chapel Hill. Fifty percent of her patients are older than 30, and that number is rising, she says.

Bulik says societal pressure for lifelong thinness is prompting many women to develop the disorders later in life. It usually has a devastating effect on their families.

Women who are 30 and older are often more motivated than adolescents to get help, Redlak says.

But they don't necessarily have better outcomes, especially if they've had an eating disorder for many years.

When Kelly was 15, she was dismissed by her dietitian and heard her doctor blame her mother for her eating disorder.

Kelly doesn't blame anyone anymore. She focuses on getting better.