We’ve all heard of the “almond mom.” A mother in her 40s or 50s who, after living through decades of extreme diet culture and body trends, is content to eat only a handful of almonds for lunch.
These women, typically at or approaching menopause, are made the butt of the joke, but we're ignoring a major issue — one that researchers are beginning to take more seriously.
Eating disorders: Not just a young person’s problem
Most people typically think of eating disorders as a teen or young adult problem — a troubled relationship with food and body image that some people develop during the transition from childhood to adulthood. And research has mainly focused on the first major stage of hormonal transition, but puberty is not the only time women experience reproductive hormonal upheaval.
Research shows menopause is another vulnerable time — and a much less talked about one — for some women to develop or redevelop eating disorders. One 2013 study found that 9% of perimenopausal women reported what the researchers defined as an eating disorder, while only 2% of premenopausal women reported the same. Troublingly, 15% of perimenopausal women surveyed reported at least some abnormalities in eating behavior.
“I often think about eating disorders as responses that occur at the confluence of biology, genetics, psychology, life transitions/challenges, and culture,” says Tori Cherry, licensed social worker, certified eating disorder specialist, and owner of Embodied Counseling. “Ageism and sexism seem to intersect during menopause, which can generate a lot of angst about one’s body and weight.”
Perimenopause can come with a lot of changes and unknowns, making it quite easy to fall into disordered eating. But as Cherry has seen firsthand in her practice, it is possible to find food freedom and peace, no matter your age.
Awareness is the first step, so let’s talk about how the menopausal transition can coincide with the development of an eating disorder, and how you might find relief.
What defines an eating disorder?
“Eating disorders are mental health conditions that involve a difficult and affected relationship to food,” Cherry says. “Often, individuals may also experience challenging relationships to their body image and exercise.”
The behaviors that present themselves can range from restriction, binge eating, purging, and more, but Cherry explains that these all generally manifest from a preoccupation with food and the anxiety it can cause.
Eating disorders can affect anyone of any age, gender, or size, although women are reportedly more likely to suffer from them, and they are typically a response to many contributing factors like culture, genetics, psychology, lived experiences, and more.
A “normal” relationship to food is subjective, and of course, we live in a culture that normalizes behavior many professionals might even define as disordered, but Cherry says that if you find yourself worried about food and eating on a regular basis, you might benefit from therapies that can help you give less thought to these things.
“Life without constantly feeling you should start another diet, checking your stomach in the mirror, avoiding being in photos at all costs, or comparing your body to others’ is possible,” Cherry says. “I believe people deserve a life free from frequent anxiety about food choices.”
How menopause and eating disorders collide
During menopause, which typically occurs between the ages of 45 and 55, women stop getting their period and lose the ability to get pregnant.
But according to a study published in Women’s Health, 60% of women say they do not feel informed about menopause, whether it be what is happening in their bodies, the symptoms they might begin to feel, or simply how to cope with all of it.
During perimenopause, you experience hormonal changes, specifically a decrease in estrogen and progesterone, as your body prepares to stop its menstrual cycle. There are physical changes that come with this, like weight gain, thinning hair, vaginal dryness, hot flashes, and more, that also coincide with new psychosocial stressors that come with aging as a woman.
“While there are more cultural conversations happening about menopause than ever before in recent history, there is still so much that is not well understood about these changes and how to best support women in navigating them,” Cherry explains.
All of these physical and social stressors, plus the simple fact that many women feel unprepared for this transition, increase the risk of psychiatric disorders, like depression, anxiety, and eating disorders.
Hormones and eating disorders
But this might not be the whole explanation. Knowing that eating disorders are associated with these times of reproductive hormonal change, researchers have also looked into the biological role hormones might play in the development and maintenance of eating disorders.
Estrogen has been shown to regulate food intake, potentially by making you feel fuller earlier, while progesterone can block this effect — but only in the presence of estrogen. We can see this pattern in our menstrual cycles: food intake decreases throughout the follicular phase when estrogen levels are rising, then increases in the luteal phase when progesterone levels rise following ovulation.
Not only this, another study found that reported levels of body dissatisfaction and a drive for thinness were associated with the luteal phase, and less associated with the follicular phase, suggesting that hormones play a role in the psychological stressors that can contribute to developing an eating disorder.
In a 2012 paper reviewing the literature on hormones and eating disorders, the authors conclude that estrogen and progesterone may actually play an active role in predisposing someone’s risk of developing an eating disorder. More research is needed to decipher exactly how, and how hormonal therapy might be an option for treating eating disorders in the future.
How therapy can help
Cherry says she’s seen many women in middle age experience “great liberation” with her talk therapy services. By identifying patterns, triggers, and behaviors, therapy can help people with eating disorders understand their relationships with food, exercise, and body image.
“Therapy can help individuals develop coping skills for living in a culture that is hostile to many bodies outside of the rigid and narrow beauty ideal, and heal shame and anxiety related to food and the body,” Cherry explains. “It’s not too late to get help or have a better, more peaceful relationship to food and your body.”
Eating disorders can be life-threatening, and they should be taken seriously at any age. So, even if you’ve lived your whole life under the harmful pressures of diet culture, you don’t have to live your life constantly worried about your body image and the amount of food you had for lunch. Recognizing that these thoughts shouldn’t be normalized, even in middle age, is the first step towards quieting them.
Eliza Mattson is a journalism student at Northwestern University and a Rescripted editorial intern. She is primarily interested in health and science writing, but she also studies history and economics. When she’s not writing or studying, you can find her rewatching Speed for the millionth time or baking cookies.