As women age, the often become aware of changes in their appetite, metabolism, and relationship with food. As perimenopause and menopause approach, women may feel like they are losing their identity, or experience fear or shame around eating and weight gain or loss. Sometimes, menopause triggers eating disorders in middle-aged women, or exaggerate disorders first diagnosed decades earlier. Knowing what to expect, and what to do, if that happens can help you have a healthy relationship with food throughout your adult life.

What is Perimenopause?

Perimenopause is the period of transition from a woman’s child-bearing years into full menopause – when the body no longer releases egg for reproduction. Perimenopause can begin as early as a woman’s late 30s or in her 40s and generally lasts about 2 years. During this period, women can still get pregnant, but they will also experience many of the same symptoms of menopause:

  • Reduced or erratic menstrual cycle
  • Hot flashes and night sweats
  • Vaginal dryness
  • Insomnia
  • Emotional changes and mood swings
  • Irritability
  • Depression

Some of the mental symptoms can carry on well into menopause, making middle-aged women feel like different people than they were in their younger years.

What Menopause Does to Women’s Stress and Appetites

The connection between menopause and eating disorders is often connected to questions of stress and identity. Perimenopause often overlaps with significant changes in a woman’s life:

  • Her children leaving home
  • Divorce
  • Taking on senior roles with additional responsibility at work
  • Becoming a caretaker for aging parents

Women may feel like their roles as mother or homemaker have been taken away from them. Or they may find the burdens of managing their college-aged children and aging parents at the same time overwhelming. These stressors can push women into an unhealthy relationship with food and their bodies.

Eating disorders are often the result of feelings of guilt and shame around food. “Stress eating” and dieting can both be coping mechanisms to deal with external stress. Women may eat to sooth their frayed nerves. They may also diet to exert control over some part of their chaotic lives. However, when these coping mechanisms are taken too far, they can trigger guilt and shame resulting in:

  • Anorexia Nervosa – severely restricted food intake
  • Bulimia Nervosa – binging on food and then purging it from the body
  • Binge Eating Disorder – eating large or uncontrolled amounts of food, often in secret

Middle-aged women may be especially vulnerable to this kind of shame and guilt because of American societal pressures to remain young and beautiful. The natural signs of aging can make women feel ashamed in ways they associate with food intake, exaggerating body image issues and making eating disorders even more severe.

Hormone Changes Create an Atmosphere for Eating Disorder Development

There is also a biological component to how menopause can trigger eating disorders in middle-aged women. Eating disorders are often considered a teenaged problem. It’s true that many people who develop eating disorders first experience symptoms during puberty. Researchers believe this is because of the hormonal changes happening in adolescent bodies. Menopause has these same kinds of hormonal changes. Middle-aged women in perimenopause and menopause experience a significant reduction of estrogen. This can trigger or exaggerate existing psychological illnesses including depression and – research now shows – eating disorders.

What to Do if Menopause Triggers an Eating Disorder

If you are experiencing changes in your relationship with food at any age, your first step should be to discuss those changes with your primary care physician. Loss of appetite, weight gain, and other food-related symptoms may be side-effects of medication or hormone supplements prescribed during menopause.

However, if you are experiencing shame or guilt about your eating, you should also consider speaking with an experienced psychotherapist, as well. By identifying and addressing the emotional impacts of hormonal and stress-related changes, you can avoid the dangerous physical issues that can come with an eating disorder. A coordinated treatment plan that includes physical health, mental health, and nutrition is the best way to help you regain a healthy relationship with food and your body.

David Stanislaw is a psychotherapist with over 30 years of experience. He helps children, teens and adults with eating disorders and other psychological issues. Contact David Stanislaw to get help today.