Eating Disorders – A Growing Problem Among Women in Midlife
The drop in estrogen lowers resting metabolism, burns fewer calories, increases muscle loss and fat storage.
Eating disorders are slowly but steadily gaining ground among women in middle and older age.
Doctors and experts notice a significant increase in problems among women aged between 40 and 70 who seek help. Since they don’t fit the stereotype of someone with an eating disorder – that is, they’re not teenage girls – their diagnosis is often missed or treatment is delayed, reports net.hr.
“There’s nothing worse than being told by a doctor you’re too old for an eating disorder,” says Cynthia Bulik, founder of the University of North Carolina’s Center of Excellence for Eating Disorders.
“Yet countless women in menopause report exactly that.”
The most common types: binge eating, bulimia, and laxative abuse
Research shows that between two and 13 percent of women over 40 have an eating disorder, and experts think up to 30 percent of middle-aged women may have symptoms, with a noticeable rise, according to Elizabeth Wassenaar, certified eating disorder specialist and regional medical director at the Eating Recovery Center in Colorado.
Binge eating is the most common disorder in mature women, followed by bulimia, and Jason Nagata, a physician specializing in eating disorders at UCSF Benioff Children's Hospital in San Francisco, also notes an increase in laxative abuse in this age group.
Middle-aged women may also experience anorexia and orthorexia – a disorder involving obsessive exercise and “healthy” eating, often tied to perimenopause, which can lead to malnutrition.
Symptoms of perimenopause and menopause are key in the development of eating disorders due to complex physiological and psychological changes.
Ways these conditions increase a woman's risk of developing eating disorders include:
Hormones that change body composition
Menopause can trigger eating disorders much like puberty affects teenage girls.
During puberty and menopause, estrogen fluctuates, affecting serotonin production, mood, happiness, confidence, and physical health.
“During perimenopause and menopause, women often experience an increase in overall body fat, especially around the abdomen,” explains Nagata.
As he points out, this mostly happens due to the drop in estrogen, which affects fat storage and regulates appetite and mood.
The drop in estrogen lowers resting metabolism, burns fewer calories, increases muscle loss and fat storage, lowers energy, activity, and increases body dissatisfaction.
Regaining lost sense of control
Besides hormonal changes, menopause often comes alongside major life shifts like children leaving home, marital issues or divorce, job changes, and aging parents needing care – all of which strongly impact eating habits.
Additionally, “middle-aged women carry much of the family burden,” says Robyn Kievit, registered nurse and certified eating disorder specialist from Massachusetts.
Under such pressures, eating disorders may develop as a way to “regain a lost sense of control,” says Wassenaar.
“The desire for control is a powerful psychological driver of eating disorders at any age, but especially in midlife,” Nagata emphasizes.
One patient in 2009 said that controlling food was the way she managed her life.
Pressure to stay slim
Women in midlife face pressure to remain slim and youthful as their bodies naturally change, leading to weight dissatisfaction in 73 percent of them – a situation worsened by trendy weight-loss drugs like Ozempic and harmful #SkinniTok trends.
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“Asking a woman aged 45 to 55 to look like she did at 15, 20, or even 30 is unfair,” says Kievit.
Bulik notes that women in perimenopause and menopause experience body changes that often cause feelings of disconnection from themselves, which worsen eating disorders as a coping strategy.
History of eating disorders, anxiety, and depression
Women who developed eating disorders in youth are at the highest risk of relapse during menopause.
“Research shows many women with midlife eating disorders didn’t experience these issues for the first time,” says Nagata.
Jennifer Wildes, director of the Eating Disorders Program at the University of Chicago Medical Center, says she’s seen this in her patients.
“Some were never treated or had symptoms fade only to return with menopause,” she says.
How to recognize and recover from eating disorders
The main challenge in treating women in perimenopause and menopause is helping them recognize their eating disorder, which is often masked by diets, health trends, or aging itself.
Signs weight loss is out of control include preoccupation with food or weight, frequent detoxing, severe restrictions, social food avoidance, and compensatory behaviors like excessive exercise, laxative use, reducing or skipping meals.
Recognizing signs is key because “eating disorders treated in the first six months have the best chance for full recovery,” says Kievit.
The good news is that when recognized and diagnosed, evidence-based treatments – including proven psychotherapy – can be highly effective.
Women struggling with eating disorders in midlife can seek help from trained therapists, nutritionists, doctors, and organizations.
No matter where they turn for help, Wassenaar stresses the importance of doing so before it’s too late, writes National Geographic.
“It’s never too late to seek help for an eating disorder and build a peaceful relationship with your body,” she says, adding, “Whether you’ve developed eating disorders for the first time or lived with them for decades, now is the time to seek and receive help.”
