Eating disorders and menopause: The hormonal connection
The Big Change. The Transition. Reverse Puberty. Internal Summer.
There are many monikers for the time when a woman moves beyond periods and birth control and the monthly annoyances she has dealt with since teenagehood. Most women fear the commonly known side effects that can occur during this time, like mood swings, brain fog, hot flashes, and irregular periods. In addition to these symptoms, possible changes to a woman’s appearance, appetite, and energy levels might contribute to unexpected behaviors, like disordered eating.
Eating disorders at midlife transcend the myth that they only affect young people. While it’s true that the hormonal fluctuations and physical changes brought on by puberty can fuel negative body image, it can be foolish to think this also can’t happen at the other end of menstruation—menopause.
Unfortunately, there isn’t as much research—and therefore not as many solutions—for women who develop eating disorders later in life.
Below, I’ll dive into how the changes women experience during perimenopause and menopause can precipitate disordered eating behaviors, and what women should look out for as they approach one of life’s greatest pivots.
What are perimenopause and menopause?
According to the Mayo Clinic, perimenopause refers to the time during which the female body is transitioning to menopause. Perimenopause usually begins in your 40s but women might notice symptoms developing in their mid- or late 30s.
What’s happening in the body during menopause?
During perimenopause and menopause, the female body starts producing less estrogen and progesterone, two hormones that play starring roles in a woman’s menstrual cycle. But when these two hormones aren’t as readily produced, women can experience symptoms such as:
sleep changes and increased fatigue
mood swings
appetite changes
night sweats, hot flashes
brain fog, poor concentration
…and lots more.
Emotional changes during menopause
Symptoms of menopause can extend beyond physical discomforts. This point in a woman’s life can be considered a “midlife” milestone. Culture commonly ascribes midlife crises to men, but women can experience them, as well. Reaching this age may offer more opportunities for introspection and reflection, which can bring about all sorts of feelings and emotions.
At the same time, the physical and emotional manifestations of menopause may cause women to feel detached from their bodies. They may feel they can no longer control or trust their bodies to operate the way they used to. This can bring on feelings of insecurity and fear.
Cultural views on aging and women
When a woman reaches a certain age, Western society—which values youth and very specific standards of beauty—tends to ignore her.
The connection between menopausal changes and eating disorders
If you haven’t caught on by now, these unstable and uncertain life events are the perfect breeding ground for eating disorders.
As hormones fluctuate, their body shape changes, and the world around them unravels in unexpected ways, women may feel the need to cling to something stable. And without even realizing it, they might turn to their diet and body to control what they can in their world.
According to a 2023 literature review published in Current Opinion in Psychiatry:
What puberty is for eating disorders in adolescence and young age is menopausal transition for midlife women.
Changes in appetite and energy levels may affect what women eat and how much energy they have to exercise. Plus, age-related metabolic adjustments can result in a loss of muscle mass and an increase in body fat, which, depending on the individual’s feelings about weight and body image, might shatter her self-esteem.
Signs and symptoms of disordered eating during menopause
If you’re a woman on the cusp of this transitional period, here are a few signs to look out for that may signal the early stages of an eating disorder.
an increased (and borderline obsessive) interest in and focus on:
weight
physical appearance
numbers (weighing, calories, etc.)
cutting out food groups after deeming them “bad” or “unhealthy”; feeling more restrictive about the types of foods you allow yourself to eat
feeling guilty after eating certain foods
feel compelled to exercise and/or exercise excessively in an effort to burn calories
engaging in secretive behaviors around food
It’s important to note that those women with a history of disordered eating may be more likely to develop symptoms even after they’ve recovered.
How to address disordered eating during menopause
There are also virtual groups that can help individuals build community and find support:
On a national level, the Eating Disorders Coalition has introduced the Nutrition CARE Act. If passed, the act would fix the gap in Medicare Part B coverage. This gap currently excludes individuals with eating disorders from receiving nutritional therapy, which is a vital component of recovery.
There is a lot of uncertainty that comes with menopause. A lot of change, a lot of fear. And possibly, a realization that life is fleeting. While this can be a frightening and confusing time for many women, it’s also an opportunity to connect with others and find support in community.
If there’s one thing I learned in recovery, it’s that I couldn’t have done it alone. When you have a group of people you can share with and where you feel seen and valued, recovery (and life) becomes a little less lonely.