Eating Disorders and Perimenopause: A Silent Struggle for Many Women
Let's Discuss the Link Between Perimenopause and Eating Disorders
ств項Stereotypes surrounding eating disorders have persisted, primarily portraying them as afflicting only young, white, female individuals. However, this image does not represent the reality, as people of all ages, races, and genders can develop these conditions. A surprising revelation is the upward trend in eating disorders reports among women during perimenopause, a transitional period typically beginning in middle age and lasting years.
According to recent studies, an estimated 2% to 7.7% of women aged 40 and above may meet the criteria for an eating disorder diagnosis. This includes conditions such as anorexia, bulimia, and binge-eating disorder. Furthermore, up to 13% of women aged 50 and older may experience at least one symptom of an eating disorder. Many more contend with poor body image and disordered eating practices, resorting to measures like skipping meals, excessive exercise, or misusing laxatives.
"Menopause and perimenopause are periods when people experience their bodies differently and grapple with the stress of midlife," explains Doreen Marshall, PhD, CEO of the National Eating Disorders Association (NEDA). "This may increase vulnerability to eating disorders."
In the paragraphs below, we delve into the reasons behind the occurrence of eating disorders during perimenopause and offer guidance for navigating this challenging phase.
A resurgence or a fresh start?
When people develop eating disorders during perimenopause, it is often a reappearance of a previous condition or an entirely new struggle. In some cases, it is a resurgence of symptoms that have smoldered for years, with perimenopause being the tipping point. For others, this marks their first encounter with serious body image issues and food-related concerns. In short, anyone can be affected.
It is worth noting that a person's body does not need to conform to a certain image for them to develop an eating disorder. According to Dr. Marshall, only about 6% of eating disorder sufferers are actually underweight.
The emotional turmoil of perimenopause fuels disordered eating
The hormonal changes and mental health struggles that accompany perimenopause provide fertile ground for disordered eating. This period, which typically begins in a woman's mid-40s and lasts between four and eight years, may coincide with a host of personal and professional demands (such as career responsibilities, childrearing, caring for aging parents, the empty nest, divorce, or the loss of a parent) and/or significant life changes. The ensuing stressors can trigger or worsen body image issues or eating disorder symptoms.
At the same time, the hormonal upheaval of perimenopause can have a substantial impact on mental health, with mood swings being common during this phase. Eating disorders often coexist with other mental health conditions, such as depression. Consequently, an episode of depression might contribute to the development (or recurrence) of an eating disorder.
Researchers also speculate that the drop in estrogen levels during perimenopause could contribute to eating disorders specifically. This hypothesis stems from the known connection between eating disorder risk after puberty and changes in estrogen levels.
Body shape changes exacerbate body image concerns
Dr. Bulik suggests that many women are taken aback by one common shift during perimenopause: their bodies begin to store more fat around the waist. This change, at least partly due to falling estrogen levels, may happen even with consistent eating and exercise habits. Such body alterations can be disheartening for women and may intensify disordered eating behaviors, especially when they are unprepared for such shifts. Research indicates that being dissatisfied with one's weight is a significant risk factor for developing an eating disorder.
Other perimenopause symptoms, such as hot flashes, night sweats, poor sleep, vaginal dryness, and/or joint and muscle pain, further compound physical and mental distress. Chronic fatigue can trap some individuals in a cycle of increasing body dissatisfaction, further negative feelings, and, in some instances, eating disorders. Studies suggest a link between the severity of perimenopause symptoms and the risk of negative body image or at least some eating disorder symptoms.
The 'anti-aging' pressure society places on women fuels disordered eating
Dr. Marshall emphasizes that "our bodies change throughout our lives." However, women, particularly, are inundated with messages that physical change is undesirable. There is an excessive amount of pressure on women to remain youthful and avoid becoming 'invisible' or replaced—in their careers, relationships, or other aspects of life. The fear of being overlooked can fan the flames of eating disorders.
Some research suggests that social media can be a dangerous environment for individuals prone to self-criticism. In one study of women aged 40 to 63, those who excessively compared themselves to others while scrolling were more likely to report disordered eating symptoms.
Steps to redress the situation
Eating disorders are complex, multifaceted issues, and it is impossible to avoid them altogether. However, there are several steps that might help women maintain a positive outlook regarding their changing bodies and weather the emotional and physical challenges of this transitional period.
- Talk about perimenopause. Part of the problem is that we do not engage in sufficient discussions about perimenopause, including the normal body changes that may occur. Open up about your experiences to friends, family, or your primary care physician or obstetrician-gynecologist. Dr. Rosser advocates for providing patients with “anticipatory guidance” regarding typical changes as they progress through this transition.
- Focus on health, not weight loss. Perimenopause is a good opportunity to reassess your lifestyle habits and prioritize overall health. Instead of concentrating on shedding pounds or conforming to a specific body type, aim for adding healthy years to your life.
- Eat to fuel your body. Numerous diet fads litter the landscape, but eschewing the term “diet” can help you cultivate a healthier relationship with food. Professionals such as the American Heart Association encourage a balanced approach to meals, emphasizing nutrient-rich selections like lean proteins, calcium- and vitamin D-rich foods, fruits and vegetables, whole grains, and unsaturated fats. Restrictive dieting can lead to unsustainable and unhealthy habits.
- Exercise to boost your strength. Consistent aerobic exercise can help maintain cardiovascular fitness, but strengthening exercises are essential for maintaining (or building) muscle and bone mass after age 40. Strength training plays a critical role in preserving your overall health and alleviating the psychological and physical effects of perimenopause.
- Curate your social media feed. The way you utilize social media plays a role in your well-being. Opt for following individuals who inspire and uplift you, and shift your attention away from content that makes you feel diminished.
- Establish a good sleep routine. The importance of sleep for physical and mental well-being cannot be overstated. If night sweats make it challenging to sleep soundly, try utilizing cooling techniques like a bed fan, temperature-regulating bedding, or cool pillows.
If perimenopause symptoms or any of the aforementioned issues persist, do not hesitate to reach out to your doctor. There are treatments available to manage symptoms and alleviate associated struggles.
Lastly, if you or someone you know is struggling with an eating disorder, help is available. Contact the Alliance for Eating Disorders' helpline at 1-866-662-1235 or visit their website for additional support.
- Eating disorders, such as anorexia, bulimia, and binge-eating disorder, can affect people of all ages, races, and genders, with a higher prevalence shown in women during perimenopause.
- The emotional turmoil and mental health struggles that accompany perimenopause can trigger or worsen body image issues and eating disorder symptoms.
- Body alterations during perimenopause, such as increased storage of fat around the waist, can be disheartening and may intensify disordered eating behaviors.
- The pressure society places on women to remain youthful and avoid becoming 'invisible' or replaced can fan the flames of eating disorders.
- Steps to maintain a positive outlook during perimenopause include talking about the experience, focusing on health rather than weight loss, eating for energy, engaging in strength-building exercises, curating social media feeds, establishing a good sleep routine, and seeking professional help when necessary.
- It is essential to remember that anyone can develop an eating disorder, regardless of their body type, and help is available for those who need it.
- In addition to the National Eating Disorders Association helpline, there are various health-and-wellness, mental-health, and women's health resources that offer support and guidance for navigating eating disorders during perimenopause.
- Science continues to explore the connection between hormonal changes, mental health conditions, and eating disorders, providing insights into the complexities of this silent struggle for many women.
