Eating Disorders in Midlife

We don’t typically think of perimenopausal women when we talk about eating disorders, but middle age can be a high-risk time for developing one. More than one in ten women over the age of 50 engage in eating disorder behaviors, according to ANAD (The National Association of Anorexia Nervosa and Associated Disorders).

There are a few similarities between adolescence and perimenopause that make it easier to understand why women in midlife may be susceptible. Both are stressful times of transition to a new stage of life that we may feel ambivalent about or afraid of.  In addition, a characteristic of both is that our bodies seem to have minds of their own and change in ways we may not like. That is related to a third and particularly interesting (to me) similarity: fluctuating hormones, especially estrogen.

Research shows that reproductive hormones play a role in the development of eating disorders in adolescence, and evidence suggests that the same may be true for women in perimenopause. The time around menopause is a unique “window of vulnerability” for getting an eating disorder.

How much time do you spend thinking about food and calories?

Eating orders are complicated things and there is not one thing that causes them. I’ve often heard that genetics load the gun and the environment pulls the trigger. If you or other people in your family have had eating disorders in the past, you’re more susceptible. In midlife, things like the loss of  a spouse or feeling lonely or powerless, or poor self-esteem may trigger an eating disorder.

According to ANAD, the biggest sign to look for is a preoccupation with food, calories, and exercise. How much time do you spend thinking about food and calories? How much time do you spend exercising? Does it interfere with other activities?

If you think you might have an eating disorder, talk to your doctor or another health care professional. Eating disorders have the highest mortality rate of any mental illness. They can affect bone density, the kidneys and the heart—and middle age bodies are less resilient than young ones. As with other illnesses, the earlier you catch it and address it, the easier it is to treat.


Dr. Barb DePree MD
Dr. Barb DePree MD

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