Menopause and eating disorders – what’s the link?

We typically think of eating disorders affecting teenagers and young adults. However, a limited but growing body of research is increasingly showing that eating disorders and menopause may also be linked.

“The evidence can be conflicting at times,” says Dr Sarah Ball, a GP with a special interest in the menopause at Newson Health. “But some studies do show that there is a higher risk of eating disorders around perimenopause. My gut instinct, as a GP, is that it is more common during this phase of a woman’s life.”

Menopause and eating disorders

What does the science say?

While the data is still in its infancy, researchers are beginning to look into the relationship between menopause and eating disorders.

A study in 2013 found that perimenopausal women were significantly more likely to report symptoms of an eating disorder compared with premenopausal women. Further research in 2016 also concluded that perimenopause is a high-risk period for eating disorders to develop or return.

A surprising 13% of women aged 50 and over were reported to have symptoms of an eating disorder in a 2012 study. The same study also found that 71.2% of women were actively trying to lose weight, with diet pills and excessive exercise the most common methods of controlling weight.

Researchers believe that menopause – like puberty – represents a window of vulnerability for women. It’s thought that hormonal fluctuations, changes in our body and conflicting thoughts around womanhood all contribute to the likelihood of developing an eating disorder.

Menopause may be a time when a pre-existing eating disorder becomes problematic again or it may be when an eating disorder develops for the first time.

How might menopause trigger an eating disorder?

Perimenopause – the years leading up to menopause – can bring with it a rollercoaster of symptoms. A number of these symptoms are due to falling levels of estrogen. We have estrogen receptors all over our body. As estrogen falls throughout perimenopause and menopause, there isn’t as much estrogen to latch onto all of these receptors.

These receptors play important roles in systems all over our body. This includes the production of other hormones, such as serotonin, the so-called ‘happy hormone’. As Sarah explains, this can have significant consequences in our ability to regulate our mood.

“We’re at the mercy of our hormones,” she says. “When they’re fluctuating – such as during puberty and perimenopause – we’re at our most vulnerable.

“As we lose estrogen, our mood often becomes more dysfunctional. During perimenopause, we’ll have lower levels of progesterone too. This is a calming hormone and as this starts to diminish, it can also contribute to feelings of anxiety.”

The final straw

Adding to the pressure is external stresses in a woman’s life. Around the typical age of menopause, many of us are looking after children, caring for parents and other relatives, as well as managing work. Add in the stress of a changing body and it’s no surprise that many women end up feeling out of control.

“During the menopause transition not only will our mood be at risk of declining, but so will our metabolism,” explains Sarah. “We might notice that we’re developing a ‘spare tyre’ around our middle and this may well add to poor self-esteem.

“For perimenopausal women, the second half of their cycle can prove challenging. They might experience cravings, feel increasing PMS-type symptoms and bloated. We’re more likely to reach for a packet of biscuits and eat them all, thereby triggering feelings of regret and self-loathing, leading to a vicious cycle being set up between mood and food.”

With all these changes going on, it’s no surprise that many women want to retain a sense of control. Becoming obsessive over food can be one way of trying to overcome a feeling of powerlessness.

Why is it a problem?

As teens, we were far more likely to have our eating habits monitored by the adults around us – whether it be family at home or teachers at school. The same can’t be said as we age. As Sarah explains, eating disorders may go unnoticed for a much longer period of time in perimenopausal and menopausal women.

“Older women are typically much better able to hide their eating disorders than teenagers,” says Sarah. “We’re now the ones feeding the family and deciding what we eat and when. It’s much easier to hide food avoidance or binging and purging from others.”

While an eating disorder can have devastating effects for our health at any age, our resilience decreases as we get older.

Eating disorders can put pressure on various systems of our body, including our cardiovascular and nervous system. Added to this is the fact that levels of estrogen are falling naturally during perimenopause – a key regulator of bone density. Women who are undereating or bulimic are putting themselves at an additional risk of osteoporosis.

And it’s not just undereating that’s a problem. Binge eating can lead to problems of weight gain and obesity, bringing with it higher risks of serious health conditions including cancer and coronary heart disease.

What you can do

The good news is that there is help out there. Understanding the symptoms of menopause can help you to determine the support you need. Download our free menopause symptom tracker and watch Liz’s video below on the symptoms of menopause to find out more.

“It’s important to remember that the first line treatment shouldn’t be antidepressants,” says Sarah. “You need to stabilise your hormones and this will help to reduce the symptoms of the menopause and metabolic changes. This is where HRT [Hormone Replacement Therapy] can be helpful.

“There’s the age-old myth that HRT makes us gain weight, but this isn’t true. When we have low estrogen levels, our body goes into survival mode. The only thing our body can do to counteract this is to make fat cells, as fat creates a weak type of estrogen.

“If we can help our body by replacing hormones, we can counteract these metabolic changes and menopausal symptoms.”

Find more support for eating disorders

Watch Liz dicuss symptoms of menopause

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Also included in the bundle is The Truth about HRT. This guide aims to give all women affected by menopause symptoms, as well as their medical advisors, the most up-to-date, relevant and helpful information on HRT to inform choices that significantly improve long-term health and wellbeing.

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