When we talk about eating disorders, teenagers and young people are the first ones to come to our mind. But surprisingly, midlife, especially the perimenopausal phase, can also be a vulnerable period for women. During this time, a woman's body goes through several changes, including hormonal shifts and psychological stress, which in turn can contribute to an increased risk of disordered eating patterns.
In an interaction with the OnlyMyHealth team, Dr Mahua Bhattacharya, Consultant Obstetrics and Gynaecology, Fortis Hospital, Anandpura, discusses how perimenopause may affect a woman’s relationship with food and body image and what can be done to support those going through it.
Also Read: Feeling Dismissed During Menopause? Here’s What A Doctor Says About Menopause Gaslighting
Why Perimenopause Can Trigger Eating Disorders
To answer this question, it is important to understand the link between perimenopause and disordered eating. Although the connection is not widely recognised, research and clinical observations suggest that perimenopause can trigger or worsen disordered eating behaviours in some individuals, says Dr Bhattacharya.
A 2016 study published in the journal Maturitas suggests that the years leading up to menopause can be more emotionally and physically challenging than many realise. Just like during puberty, the hormonal ups and downs of perimenopause, especially changes in oestrogen, can deeply impact how a woman feels about her body and her relationship with food. For some, this can lead to the return of an old eating disorder or even the start of a new one.
Dr Bhattacharya explains that hormonal fluctuations during perimenopause, especially in oestrogen and progesterone, can significantly impact a woman’s relationship with food and body image in several ways:
- Increased cravings or appetite changes, especially for comfort foods
- Mood swings or anxiety, which can lead to emotional eating
- Slower metabolism and weight gain, fuelling body dissatisfaction
- Poor sleep and stress, both of which are linked to changes in hunger hormones
Common Eating Disorders During Perimenopause
Certain eating disorders or patterns are more likely to emerge or worsen during perimenopause. The most commonly affected or triggered include:
- Binge Eating Disorder (BED): Frequent episodes of uncontrolled eating
- Atypical Anorexia Nervosa: Restrictive eating without extreme weight loss
- Bulimia Nervosa: A cycle of bingeing followed by purging
- Orthorexia or Obsessive Healthy Eating: An unhealthy obsession with “clean” or “healthy” foods
How To Spot The Signs In Perimenopausal Women
Because eating disorders during perimenopause may not look obvious, it’s important for family, friends, and healthcare providers to watch for subtle red flags:
- Rigid food rules or new “clean eating” obsessions.
- Skipping meals, avoiding social meals, or claiming to be “too full”.
- Sudden adoption of extreme diets, intermittent fasting, or detoxes.
- Secretive eating or food hoarding.
- Frequent weighing, body checking, or obsession with body parts.
- Compulsive or excessive exercise routines, even when unwell
If these patterns persist, it’s time for a deeper conversation and possibly professional help.
Also Read: From Skin Itching To Burning Mouth: Unusual Symptoms Of Perimenopause You Shouldn’t Ignore
Treatment And Management Options
According to Dr Bhattacharya, eating disorder treatment includes various approaches depending on the disorder's type and severity. Common therapies include:
- Enhanced Cognitive Behavioural Therapy (CBT-e)
- Family-based treatment
- Dialectical Behavioural Therapy (DBT)
- Nutrition education by trained professionals
- Antidepressants to aid those with bulimia or binge-eating disorder
- Hospitalisation in severe cases to stabilise urgent medical issues
Additionally, long-term care often involves managing physical health issues caused by the disorder. Successful treatment typically combines therapy, medical monitoring, and nutrition planning for lasting recovery and health stabilisation.
Conclusion
Eating disorders are said to affect up to 5% of the population. Anyone can develop it, including women in their perimenopausal phase. During this stage of life, with so many changes happening in the body and mind, it’s normal to feel overwhelmed, and sometimes that shows up in how women eat or feel about their bodies. These signs are often subtle and misunderstood. But with the right support from loved ones, doctors, or therapists, women can get the help they need. Hence, focus on creating a safe space where you can have honest conversations about your symptoms and the challenges you face during this phase.