Menopause and Disordered Eating: What You Should Know

Media portrayals of disordered eating and eating disorders tend to focus on younger people, especially teenagers and young adults. However, these disorders do not discriminate based on gender, race, or sexuality—and certainly not age. Many adults in later life experience these issues as health and hormonal changes occur, impacting mental health and eating behaviors (Monteleone et al 2018). During times such as these, older adults may develop disordered eating or an eating disorder.

Understanding Eating Disorders vs. Disordered Eating

Eating disorders are patterns of behaviors that significantly disrupt a person's life and go beyond dieting (American Psychiatric Association, 2023). Those with eating disorders often experience preoccupation or anxiety concerning food, eating, body weight, or body shape. People who struggle with these disorders often have distressing thoughts that lead to maybe behaviors such as avoidance of food, excessive overeating, and purging through purposeful vomiting, laxative misuse, or excessive exercise. It's estimated that they affect up to 5% of the U.S. population (American Psychiatric Association, 2023).

Disordered eating, however, involves specific attitudes regarding food and behaviors that might center around restriction or disinhibition. This may appear in the form of using diet pills, skipping meals, engaging in cleanses, excessive focus on one's appearance, overeating, and supplement misuse (The Emily Program, 2019).

Types of disordered eating include:

• Restrictive eating, which involves extreme limitation of food intake of certain with an intense need to control one's body appearance and health (Vincent et al., 2024). This struggle goes beyond the ordinary concern about overindulging occasionally. Those who engage in restriction may go long periods without eating (e.g., fasting), overcompensate with excessive exercise, or set strict limits on what and how much they eat (Vincent et al., 2024).
• Disinhibited eating is the opposite of restriction and involves consuming large, excessive amounts of food, often accompanied by feeling a sense of loss of control (Vincent et al., 2024). Those engaging in these behaviors might binge-eat, emotionally eat, or get up to eat in the middle of the night. It's also common for those engaging in disinhibited eating to feel guilt or shame after these behaviors.

Hormonal Changes and Disordered Eating

Just like puberty and pregnancy, menopause causes significant biological, physical, and psychological shifts (Vincent et al., 2024). During this time, those undergoing menopause may experience sleep disturbances, changes in appetite, increased body image concerns, anxiety, and depression—in addition to changes in physical appearance such as increased body fat and decreased muscle mass. Societal expectations that women be thin and youthful further increase the risk of developing disordered eating patterns well into later life (Vincent et al., 2024).

It can be tricky to tell the difference between disordered eating and an eating disorder, especially when both may involve complex patterns of behaviors, impairment of daily life, and fixation on food and body image. The Emily Program (2019) suggests that individuals reflect on their eating behaviors, making note of any shifts. If you feel there has been a change from occasional to regular episodes of binge eating or fasting, unrelated to cultural or religious practices, it may be time to seek support. If you are still unsure, the National Eating Disorder Association offers a screening quiz to aid in assessing your relationship with food.

What Now?

If you or someone close to you are struggling with disordered eating or an eating disorder, take the time to learn more about eating disorders. The National Eating Disorder Association Resource Center offers information to take important steps to get help for yourself or others. It’s important to reach out for support for yourself or to someone who might be struggling as soon as possible. Being aware of changes in your eating and exercise habits, especially during significant hormonal fluctuations such as menopause, can help protect your well-being and encourage a healthier relationship with yourself and food.

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