Why the Menopause Transition Can Lead to Eating Disorders and Body Dissatisfaction

Research shows a link between the menopausal transition and the way we feel about our bodies. In this blog, endocrinologist and menopause expert Dr Yvonne Chow from Jean Hailes for Women’s Health discusses this link.

Women and girls are disproportionately impacted by eating disorders and body dissatisfaction – and there are a number of life stages and health conditions that can impact this.  

One such area is the menopausal transition, with new research and lived experience insights from Butterfly’s The Changing Room campaign shedding a light on how perimenopause and menopause can impact eating disorders and body dissatisfaction.  

“Menopause especially and getting older has made me feel dissatisfied with my body. One day you look in the mirror and see your body shape changing before your very eyes” – Woman with lived experience 

We spoke to endocrinologist and menopause expert Dr Yvonne Chow from Jean Hailes for Women’s Health on why this occurs, the role society plays in how we perceive ageing and our bodies, and what people can do to support their mental health, body image and wellbeing during perimenopause, menopause and beyond.  

Why perimenopause or menopause can be a time when people might struggle with their body image 

Menopause refers to a woman’s final menstrual period, which usually occurs between 45-55 years. Perimenopause is the time leading up to menopause, and common symptoms include irregular periods, hot flushes, sleep problems, headaches, aches and pains, dry vagina, sore breasts, mood changes, forgetfulness, brain fog, and anxiety or depression.  

All of these changes and symptoms can leave people feeling dissatisfied with their bodies, says Dr Chow.  

“The menopause transition – when a woman enters the end of her ‘reproductive career’ – is a time of hormonal changes,” says Dr Chow. “Similar to pregnancy and puberty, when hormonal changes occur, it often results in changes to the body. And as we age, weight gain and changes to how body fat is distributed is common, and a lot of women might feel like they don’t have control over their bodies. This can be triggering for many women, but particularly those who have struggled with body image throughout their lives.” 

The menopausal transition can lead to changes in eating habits, increased stress and anxiety, body dissatisfaction and feelings of loss of control, which are common factors in the development of eating disorders. Experiences of shame, stigma and misconceptions that eating disorders only impact young women can also cause distress.   

How symptoms of menopause can broadly impact relationships with food, exercise and the body 

While some may experience an eating disorder for the first time during menopause, others may experience a relapse or worsening of pre-existing eating disorder symptoms.  

Dr Chow says that she often meets women in her clinic who have experienced body image issues or disordered eating in the past. 

“[These concerns] often come back again when they start experiencing the anxiety or low mood from menopause. Eating disorders can re-emerge during times of increased stress – it’s often a way of trying to control uncertainty or manage stress. So when they’re going through the stress of the menopause transition, they may go back to these patterns of disordered eating.” 

“Menopause coupled with my long-term marriage breaking down have had the most significant impact on my thoughts about my body.” – Woman with lived experience 

The role society plays 

Not only are hormonal and body changes common during menopause, but this stage of life can also bring a host of social pressures and change, from children moving away, divorce, loss of loved ones, the natural ageing process and moving away from the ‘young, thin’ ideal. 

Dr Chow agrees that this social pressure can lead older women to feel ‘invisible’. 

“In our society, all around us, there is this societal ideal that a desirable woman is one who is thin, young and doesn’t carry fat in the middle. So, when women experience changes that are against this ideal, they can start to feel unattractive. ”

Many women tell me during consults that they start to feel sad and invisible to society and they feel like they’ve been ‘put back on the shelf’. So, women are already going through quite a challenging time but to also have those thoughts of “is this what people are thinking about me?” or “is this what society is thinking about me now?” can be really distressing. 

The way society views and exacerbates beauty ideals does negatively experience how women view their own body changes throughout their life.” 

“The older, and by default further, I get from what is considered attractive for a woman the worse I feel about my body.” – Woman with lived experience 

“Aging has been a negative experience – everything seems to be focused on the younger age group, and we are forgotten” -Woman with lived experience 

How to seek help 

If you’re experiencing perimenopause or menopause and are finding your relationship to your body, food or exercise has changed for the worse, seeking help from professionals who understand is important. 

Dr Chow recommends starting with your GP and ensuring you go into the appointment prepared to discuss your concerns.  

“Particularly if you’re also struggling with mental health, book a long consultation or appointment and let the reception know. I think a good way to start is to write down your agenda, your concerns, or what you want addressed, on paper, and bring this into the consultation.” 

“As a clinician, I find it really helpful if women come into the appointment with a list of questions, so I can make sure to address all of their concerns. This is particularly helpful for topics that are a bit uncomfortable to discuss.”  

It can also help to speak to professionals that understand eating disorders – search Butterfly’s Referral Database to find quality eating disorder professionals and services nearest to you. 

To help you advocate for yourself in the doctor’s office or other healthcare settings, Butterfly has created a ‘Kindly Do, Kindly Don’t Support Script’. You can input your concerns, medical history, goals for the appointment and advise health professionals of language and actions that may be helpful or harmful to your recovery. 

Relationships with our bodies change over time, but talking helps 

Dr Chow agrees that these conversations are essential in breaking down stigma and helping people feel less alone in what they’re experiencing.  

“I see this increased movement towards talking about menopause symptoms rather than trying to hide them, which I think is a great thing. We should reduce the shame and stigma around menopause symptoms in wider society. I’d like to see women and their friends and their family talk more openly about this – it can take away some of that shame and reduce anxiety around the menopause transition for these women.” 

“We should also be letting women know that this is a natural ageing process. I speak to them about the biology, what’s happening to their body. I often find that knowing may not stop things from happening, but it can give them that little bit of control, that knowledge of what’s happening.” 

“It’s never too late to work on the strategies for managing those thoughts, particularly disordered eating thoughts. If you feel like your health is being compromised by the weight gain from menopause and ageing, we can do things about that. It’s about seeking help and not accepting that it’s your fate [to feel dissatisfied with your body.]” 

Get support

For support with eating disorders and body dissatisfaction call the Butterfly National Helpline on 1800 ED HOPE (1800 33 4673) or visit www.butterfly.org.au to chat online or email, 7 days a week, 8am-midnight (AEST/AEDT).  

To learn more about Perimenopause and Menopause, visit Jean Hailes for Women’s Health 

Access more resources and lived experience insights into women’s health, eating disorders and body image concerns in Butterfly’s campaign The Changing Room.  

Access the Butterfly and Jean Hailes for Women’s Health ‘Perimenopause, menopause, eating disorders and body image’ tipsheet for further information and tips to support your wellbeing.