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Overeating disorders in menopause

Overeating disorders in menopause

As if menopause wasn’t difficult enough for many women, it could be the start, or return, of overeating patterns and disorders, that cause immense distress.  It seems there are unique symptoms and characteristics of the midlife transition, which can trigger women to develop a troubling relationship with food, eating, and the body.  In this blog, I am going to talk about what these are, and give some guidance about how to start to recover.

There are various different names for overeating disorders, such as Binge, Compulsive, and Emotional eating.  Then there are periods of overeating and restriction, such as in yo-yo dieting, or perhaps binging and purging in Bulimia Nervosa.   Some of these are officially recognized eating disorders, some are not.  Whatever the name, it can be incredibly difficult for a woman to admit that she is struggling with her eating, seek help, and then receive help.  

To be clear, this is not about overindulging occasionally such as in a social environment or on holiday.  This is about food and eating obsession, whether acting on the thoughts or not, with shame, guilt, and self-loathing following overeating episodes.  Thinking, buying, planning, eating or not eating – all ruling a women’s life and causing immense distress.  It is exhausting, all-consuming, and has a considerable impact on quality of life.

The following factors are common to all types of overeating disorders

  • A desire to be smaller, and very likely a history of dieting or restriction
  • Anxiety / low mood / increased stress / perhaps depression
  • A desire to be in control of food – and life
  • Low self- esteem/self-confidence
  • Overeating, (even with periods of restriction) is a coping mechanism for something else that is going on in life.

Let’s look at these again now in relation to menopause: -

  1. Menopause weight gain - Weight gain/fear of weight gain / low body esteem, are integral to the binging cycle. Often obsessively. Simultaneously, it is estimated that up to 90% of women gain weight between 45 and 55.[i] Rarely welcomed.  So, attempts to lose weight are happening, and it is harder to lose weight during menopause (as the body really fights to keep hold of fat reserves to boost oestrogen levels).  What is significant here it is incredibly rare for binging to start without food restriction first. Dieting is a precursor to many eating disorders. [ii]
  2. Stress, anxiety, depression – Between 2015 – 2018, 1 in 5 US midlife women were on anti-depressants.[iii]  In the UK, over half of perimenopausal women report an increase in depressive symptoms.[iv]  It seems that menopausal women are at risk of adverse mental health in disproportionate ways, both internally and externally. What strikes me is how much responsibility midlife women carry.  The juggling generation, the sandwich years – never-ending, exhaustive responsibility for family, home, career, and relationships…...  so hard to truly relax. I have yet to see a client who is not experiencing some sort of emotional angst.  This can be both a trigger and a maintaining factor for this disordered eating, inextricably connected to menopausal emotional lows.
  3. Control – A big word for many women – keeping all those plates spinning in life is done through control.  There is fear behind this, if 1 plate drops, then what - chaos? And perfectionism often here too – women do not just do a lot, they ‘should’ do it brilliantly.  So then immense frustration and dismay about why can’t they control their weight?  How can they be successful in every other area of life and yet not control the one thing they want so much – the perfect body?  It becomes just all too much, and it can spiral into self-sabotage through binging.
  4. The internal voice – in my experience the internal critical voice is at its strongest in midlife. And this is due to the pace of life, the multiple responsibilities, and also the physical and life changes.  At the same time, there is in contrast, a possibly yet unspoken voice, initially a whisper.  A voice that wants to say it is fed up with being taken for granted, or people-pleasing.  Or perhaps disappointment at how life is turning out? This is internal conflict and does nothing to help self-esteem, which can be compounded too by physical changes such as weight gain.  A women’s relationship with food can often be a mirror to the rest of her life.  If a woman consistently overeats, this is a comfort to meet a need that she may not have the confidence to see through.
  5. A coping mechanism – so many symptoms of menopause can be challenging – anxiety and low mood, messed up monthly cycles, insomnia, hot flashes, etc.  On top of everything else in midlife, as mentioned above, menopause symptoms can be the straw that breaks the camel’s back.  It is just sometimes too easy to self-medicate through food. Though it causes distress in the longer run, in the moment overeating can bring, temporarily, instant self-soothing effects. A fix, an escape, a refuge.  If food has been a women’s friend through life, it is needed more now than ever (and way too easy to get hold of)

If this is you, a few thoughts that might help you start to think about recovery -

  • Realize that you are not alone.  Overeating disorders are so prevalent that we don’t even have reliable statistics for them.  For example, it is estimated that 1 in 2 people with weight problems suffer from compulsive eating. [v]
  • If your overeating is prolonged, severe, or impacting your health or weight in any way, get to your GP, please. 
  • Whilst the NHS does offer some treatment for Binge Eating Disorders, resources are stretched.  However, you can start with some reading and self-help books.  There are also numerous counselors, coaches, and nutritional therapists, you can find a register of trained professionals here https://eating-disorders.org.uk/     There are also charities such as https://www.beateatingdisorders.org.uk/
  • Are you able to confide in a friend or relative?  Having someone to trust can be a great help.  
  • As hard as this may seem, try to leave thoughts of weight loss aside for the moment.  Try to focus now on a calmer, balanced relationship with food, with some professional help. 
  • Keep a journal, particularly noting what was going on each day before the compulsive eating starts.  What were you thinking or feeling?  This will help identify triggers and patterns.
  • Is there something else, in your life that does bring you pleasure/relaxation/comfort – other than food?  Welcome this, build on it, and do more of this kind of thing (if it is legal!).  Even if just for 5 minutes a day, do something to help you feel good.
  • Have you noticed that typical ‘bingey’ type foods make your menopause symptoms worse (e.g., sugar gives you hot flushes?)  Becoming aware of how certain foods makes us feel is helpful in making positive changes.  Try to think of food in a different way – as fuel and nourishment rather, rather than calories and fat.
  • As much as menopause will allow you, try to prioritise rest and sleep. Tiredness makes us hungrier, and lowers our mood.