Body dissatisfaction can trigger eating disorders at any age (March 2024)

As I embark on midlife, more and more female clients disclose to me how dissatisfied they are with their bodies. Many of these clients have been chronic dieters, and many have struggled with body image during much of their lifetime, while many others have not thought twice about their body until now.

Typically, eating disorders are thought of as being something that adolescents or young adults struggle with, not “mature” adults. I know how false that perception is, and I feel fortunate that in 2019 I had the opportunity to lobby on Capitol Hill with the EDC (Eating Disorders Coalition) in support of adding nutrition counseling coverage for outpatient eating disorder treatment under Medicare.

Eating disorders are very serious—every 62 minutes at least one person dies as a direct result from an eating disorder—having the second highest mortality rate of all mental illnesses, after opiate addiction. A study published last November in Menopause, the journal of the North American Menopause Society, found that body dissatisfaction is a major component of eating disorders in women during midlife.

The authors of the study said about 3.5% of women age 40 years or older have an eating disorder, and as many as 29.3% of women in this age group experience specific disordered eating symptoms, such as dissatisfaction with eating patterns.

Perimenopausal women—who have entered the stage of life when their ovaries begin producing less hormones—may have the highest rates of dysregulated eating patterns, such as counting calories or consumption of “diet foods,” when compared to women at other stages of midlife, and differ significantly from women who have not yet entered perimenopause in terms of body dissatisfaction (“feeling uncomfortable in their body”).

The study investigated eating disorder symptoms in 36 women ages 45-61, specifically focusing on perimenopause and early postmenopause. The result showed that body dissatisfaction is a key risk factor for eating disorders across the lifespan, especially at midlife, with the fear of gaining weight and fear of losing control of eating habits being particular features of midlife eating disorders.

I certainly see aspects of this in my own practice, such as when clients share with me that it bothers them when they develop different cravings and realize that their palates have changed. I can relate, as my own preferences and cravings have changed. I always like to say that “part of owning a body is that we will have different preferences, cravings, hunger levels, and fullness levels, and different foods will provide satisfaction” and “what has worked one day may not work the next and it’s constantly working to understand your body and your needs, instead of someone telling you what your wants and needs ought to be.”

Reference:

Finch, Jody et al. Network analysis of eating disorder symptoms in women in perimenopause and early postmenopause. Menopause, March 2023, Volume 30 Issue 3.