The Hidden Crisis: Eating Disorders During Menopause

For Menopause Awareness Month

When we think about eating disorders, we often picture young women in their teens and twenties. But there's a growing crisis that deserves our attention: the rise of eating disorders during menopause and midlife. As we observe Menopause Awareness Month, it's crucial to shine a light on this overlooked intersection of mental health and women's ageing.

The Perfect Storm

Menopause brings a cascade of physical and emotional changes that can create the perfect storm for disordered eating. The hormonal shifts that begin in perimenopause, which can start as early as the mid-30s, don't just cause hot flashes and mood swings. They fundamentally alter how our bodies process food, store fat, and regulate hunger.

Weight gain during menopause is common, with many women experiencing an average increase of 5-10 pounds, particularly around the abdomen. This redistribution of body fat, combined with a slowing metabolism, can trigger intense anxiety and distress, especially in a culture that prizes thinness and youth.

More Than Just Dieting

What starts as an attempt to "get back to my old weight" can spiral into something much more serious. Women in midlife may develop or relapse into various eating disorders, including:

• Anorexia nervosa: Severe restriction of food intake

• Bulimia nervosa: Binge eating followed by purging behaviours

• Binge eating disorder: Episodes of consuming large amounts of food with feelings of loss of control

• Orthorexia: An unhealthy obsession with "clean" or "healthy" eating

• Atypical eating disorders: Disordered eating patterns that don't fit neat diagnostic categories but are equally harmful

The psychological factors are complex. Many women at midlife are grappling with identity shifts as children leave home, careers evolve, and relationships change. The feeling of losing control over one's body during menopause can lead some women to exert rigid control over food and exercise.

The Unique Challenges

Eating disorders in midlife women often go undiagnosed and untreated for several reasons:

Medical oversight: Healthcare providers may attribute symptoms like fatigue, irregular periods, or bone density loss to menopause alone, missing the signs of an eating disorder.

Normalisation of dieting: Society expects and even encourages women to fight ageing and weight gain, making dangerous behaviours seem like normal "self-care."

Lack of research: Most eating disorder research focuses on younger populations, leaving midlife women without adequate treatment protocols.

Shame and stigma: Women may feel embarrassed about having what they perceive as a "teenage problem" or may hide their struggles to maintain an image of having it all together.

The Health Consequences

The stakes are particularly high for menopausal women with eating disorders. At this life stage, the body is already vulnerable to:

• Accelerated bone density loss, increasing osteoporosis risk

• Cardiovascular complications

• Cognitive changes

• Weakened immune function

• Hormonal imbalances that can worsen menopausal symptoms
  

Malnutrition and extreme dieting can intensify hot flashes, disrupt sleep, worsen mood swings, and accelerate the very ageing processes women may be trying to prevent.

Breaking the Silence

The first step toward addressing this crisis is acknowledging it exists. If you're struggling with disordered eating during menopause, know that you're not alone and help is available. Consider these steps:

Talk to your healthcare provider: Be honest about your eating patterns, exercise habits, and relationship with food. Ask about specialists in eating disorders who work with midlife women.

Seek specialised support: Look for therapists trained in both eating disorders and midlife issues. Support groups specifically for women over 40 can provide understanding and connection.

Challenge diet culture: Recognise that the pressure to look a certain way at any age is a cultural problem, not a personal failing. Your worth isn't determined by your weight or appearance.

Focus on health, not size: Shift your attention to how you feel—your energy levels, strength, sleep quality, and overall wellbeing—rather than the number on the scale.

A Call for Awareness

This Menopause Awareness Month, let's expand the conversation beyond hot flashes and hormone therapy. Let's talk about the mental health challenges that accompany this transition, including the very real risk of eating disorders. Let's advocate for better screening, more research, and treatment programs designed for women at midlife.

Menopause isn't a disease—it's a natural life transition. And women deserve to navigate it with support, compassion, and access to appropriate care for both their physical and mental health.

If you or someone you love is struggling with disordered eating, reach out for help. Organisations like Beat Eating Disorders provide Helplines for people of all ages, offering support and information about eating disorders no matter where you are in your journey. These Helplines are free to call from all phones.

Recovery is possible, and you deserve to thrive at every stage of life.