Researchers also theorize that the drop-off in estrogen during perimenopause, and the body’s response to it, can help spur eating disorders specifically. That’s partly based on the knowledge that eating disorder risk soars after puberty, and estrogen changes have long been suspected as one explanation (of many).
Your shifting body shape may contribute to body image issues.
Dr. Bulik says many women are blindsided by one super-common change during perimenopause: Your body will start to store more fat around your middle. That, too, is at least partly thanks to plummeting estrogen levels—and it can happen even if you’re eating and exercising just like you always have, Mary Rosser, MD, PhD, an assistant professor of women’s health at Columbia University Irving Medical Center, in New York City, tells SELF.
Many women feel disheartened by this particular fact. “It’s one of the things I hear all the time,” Dr. Bulik says. “‘I had no idea my waist was going to change so much. Now I have to throw all my pants out and get new stuff.’” That can be “triggering” for some people, she adds, especially when they’re not prepared. In fact, according to research, as many as 73% of women experience dissatisfaction with their weight in midlife—and it’s a significant risk factor for an eating disorder.
Dr. Rosser agrees, noting that she’s had many patients come to her distressed by this new belly shape. “It can really knock into people’s self-confidence,” she says.
Then there’s the hot flashes and sleep loss…
As you move through perimenopause, you may be hit with a slew of symptoms, like hot flashes, night sweats, poor sleep, vaginal dryness, and/or joint and muscle pain. In short, you might be feeling pretty lousy, physically and mentally—and drained of the energy you need to exercise, Dr. Rosser points out. That can trap some people in a cycle of fatigue, additional body shape changes, and increasingly negative feelings toward themselves.
Studies do suggest there’s a link between the severity of perimenopause/menopause symptoms and eating disorder risk: Women with more (or worse) symptoms are more prone to having a negative body image or at least some symptoms of an eating disorder.
To make matters worse, society is telling you not to age.
As Dr. Marshall puts it, “The reality is, our bodies change throughout our lives.” Yet women, especially, are bombarded with messages telling them physical change is not OK. There’s “inordinate pressure,” Dr. Marshall says, for women to remain frozen as their 20- or 30-something selves. There can be a real fear, the experts say, of becoming “invisible” or even replaced—whether at work or by a partner—and that can add fuel to the eating disorder fire.
Some research suggests that social media can be a danger zone for people who are prone to judging themselves against others. In one study of women age 40 to 63, those who tended to compare and despair while scrolling were more likely to report disordered eating symptoms.
Take steps to buffer yourself—and get help when you need it.
Eating disorders are tricky things, with multiple contributing factors. So while there’s not necessarily one thing you can do to avoid developing one entirely, there are some things you can try to stay positive about your changing body and mitigate the mental and emotional toll of this difficult transition.
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