Eating Disorders Among Menopausal Women Are on the Rise

Menopause is a time of change, between the cessation of menstruation, hormone fluctuations and various physical and emotional symptoms including hot flashes, sleep difficulties and mood changes. Also, stubborn weight gain, which some experts and studies have seen lead to an increase in eating disorders among perimenopausal and menopausal women. According to a study published in the International Journal of Eating Disorders, an eating disorder diagnosis may be more prevalent in midlife aged women during the menopause transition (9 percent during perimenopause) compared with midlife aged women at pre-menopause (2 percent). The same study found that women in perimenopause may also have the highest rates of dysregulated eating behaviors (e.g., counting calories, consuming diet foods) of any reproductive stage at midlife, and are significantly different from women at pre-menopause on assessments of body dissatisfaction. To learn more about the link between eating disorders and menopause, I reached out to Amy Goldsmith, RDN, LDN.

Amy Goldsmith, RDN, LDN, is the founder of Kindred Nutrition & Kinetics, a private practice that provides evidence-based medical nutrition therapy in sports nutrition and eating disorders/disordered eating. With more than 25 years of experience, Goldsmith is an expert in understanding the human body's biochemistry and works collaboratively with each client's performance and clinical care team to help them reach their health and wellness goals. In the space of eating disorders, she creates a nonjudgmental, safe space, meeting patients where they are and advocating or modeling how to advocate for their needs.

According to Goldsmith, perimenopause and menopause cause changes to sleep, body composition and mood, all at a potentially hectic part of life. “[They happen at] a time of life when women are at the height of their careers, working through empty nesting and potentially caring for their own parents,” she tells me. When everything feels out of control and a woman feels exhausted or not happy with her body, Goldsmith says they sometimes use nutrition and exercise intake as a maladaptive coping mechanism that can lead to disordered eating. As for whether this is a new phenomenon or one that’s always existed, Goldsmith posits that the link has probably always existed, but is exacerbated with misinformation, fad diets and comparison through social media.

Since we often most closely link eating disorders to adolescent or young adult women, I was curious whether women who have struggled previously with disordered eating are at a higher risk for slipping back into those habits during menopause. That’s not necessarily the case. Per Goldsmith, “If someone has had an eating disorder in the past and does not have a relapse prevention plan or support, menopause can trigger a recurrence. It also can trigger things for the first time as eating disorders do not discriminate with age, sex or race.”

I was also curious whether the spike in popularity of Ozempic and other GLP-1s for weight loss is playing a role in this menopause-eating disorder connection, since it feels like we’re placing more value on thinness, as a society, than we have in years past. Goldsmith says it’s a possibility, explaining that some practices that help treat menopause symptoms advertise GLP-1 services as a way to combat this weight gain. Additionally, she points to celebrities who have been open about taking GLP-1s and celebrated for their weight loss. Still, while these medications are right for some people, they’re not for everyone.  “When someone is suffering from body dysmorphia or a negative body image, a pill becomes very attractive. However, this medication is not for everyone and doesn't necessarily work for everyone, so it's very important to work with a physician who understands your body and how GLP-1's work,” she stresses.

If you do feel yourself slipping into disordered eating habits during this phase of your life, the first step is to accept that you need help. “You can search for eating disorder experts in your area or make an appointment with your primary care physician to ask for a referral,” Goldsmith says. “It is also important to share your concerns with a loved one who you trust so that you can be held accountable to ensure you get help.”