Before she reached her late thirties, Yogi had never struggled with her weight. “I always used to wonder why my friends complained so much about their weight fluctuating, and having to buy new clothes after holidays,” she says. Then perimenopause hit and, at just 37, Yogi found herself riding a hormonal rollercoaster of symptoms – including significant changes to her eating habits.

“Up until that point in my life I’d never really lost or gained weight, and I’d never struggled with disordered eating, so I didn’t realise it was anything serious until I lost a lot of weight,” she explains. She found she was skipping meals regularly and lying to her partner about having already eaten. “I had a lot of anxiety and low moods, no appetite and no motivation to eat. I wasn’t eating enough food for the whole day, and people were starting to notice that my clothes were hanging off me,” she recalls.

At the same time, Yogi says, other changes were raging around her body – her periods became lighter and further apart, her libido plummeted, and she struggled with vaginal dryness, insomnia, and later, hot flushes. “I don’t think I understood what was happening. I wasn’t waiting for the menopause to happen, I didn’t know the symptoms, so I had no clue that this was what it can feel like,” she says.

Then, after months of rapid weight loss, suddenly it all changed again. “I started bingeing on sugary foods because it helped with the feeling of fatigue. The list of sweet items I craved just kept growing, and I eat things now that I’d never have dreamed of before, like finishing an entire cake on my own,” Yogi tells me. “I didn’t really like sugary stuff growing up, so my partner was really surprised by these new cravings.”

Now 44, Yogi sought help for her perimenopause symptoms around three years ago – although she had to go private for blood tests and a diagnosis before her GP would agree to prescribe hormone replacement therapy (HRT). “It was a struggle to get the help I needed from my GP, but going on HRT has been great for my physical symptoms and, to some extent, has helped with my eating behaviours.

“It’s helped with mood balance, night sweats and insomnia, which has made me feel more able to exercise and meet people again. That’s helped with my appetite, and I’m a lot better than I was before, but I still struggle with food and weight,” she says.

Martha Williams, senior clinical advice coordinator at the charity Beat, says eating disorders affect women in the forties, fifties and sixties
Martha Williams, senior clinical advice co-ordinator at the charity Beat, says eating disorders affect women in the forties, fifties and sixties (Photo: Supplied)

Yogi now believes she suffers from an eating disorder, and she isn’t alone in this. Research published in the journal Menopause in January suggests body dissatisfaction around the menopause may increase the risk of midlife eating disorders.

Research in this area is still very limited, so it’s important not to overstate the link. “In my clinical experience, if women develop an issue with food around that age, it tends to be that they’ve previously been affected,” says Dr Paula Briggs, chair of the British Menopause Society.

For patients with a history of restrictive eating disorders, such as anorexia, bone density can be a particular concern around menopause because both carry an increased risk of osteoporosis and osteopenia. That said, she adds, “it’s not something we commonly see in clinic”.

Prevalence data suggests that, by midlife, 15 per cent of women meet the threshold for having experienced an eating disorder in their lifetime, and 3.6 per cent have done so in the previous 12 months, with binge eating disorder the most common during this period. However, harmful stereotypes about eating disorders mean older women may be overlooked.

“There’s still a stereotype that eating disorders only affect young women and actually that’s not the case at all. We definitely do see women in their forties, fifties and sixties being affected,” says Martha Williams, senior clinical advice co-ordinator at eating disorder charity Beat.

“One of the most damaging stereotypes is that eating disorders have a certain look, but you can’t tell how unwell someone is just by looking at them or by the size of their body. Someone with an eating disorder may actually be gaining weight – they could be struggling with binge eating disorder rather than anorexia – but that’s still just as serious and deserving of specialist treatment and support,” she says.

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As for why some women develop disordered eating behaviours in midlife, it’s likely to be due to a complex combination of different factors. Hormonal changes around perimenopause are associated with weight gain and weight that’s harder to shift – as well as carrying more weight around your middle. This, in combination with increased anxiety and low mood, can contribute to women feeling more self-conscious about their changing bodies or, like Yogi, looking for coping mechanisms to manage symptoms like fatigue.

“It’s difficult to pinpoint exactly [what the link is] because the research is so limited around eating disorders with an onset later in life. But what we do know about menopause is that, for a lot of women, your body changes, you might not be sleeping well, your hormone levels are changing. All of these things can contribute to anxiety or feeling tired, so women may end up eating more sugar to try and feel more alert,” Williams explains.

Another important factor, she points out, is that menopause often coincides with other big life events, like children leaving home or the death of a parent. “For a lot of people, eating disorders are very much about control. When everything else in their life feels out of control, the one thing they feel they can have control over is what they put into their body and the things they eat. That can give you a false sense of security, where you feel like you’re in control, but actually it’s the eating disorder that’s controlling you,” she says.

This certainly rings true for 59-year-old Rachael, who became fixated with the idea that her perimenopause symptoms were caused by gluten and dairy intolerances, and ended up cutting both out of her diet. “I wouldn’t say I had an eating disorder, but I definitely had some disordered habits, which came about as a result of loss of cognition, not being able to reason about anything, and just being so desperate to feel better,” she explains. “It’s not normal to restrict your diet like that, but food was the one thing I could control. It started out of sheer desperation, but then it very easily became a habit, even though it wasn’t working for me. It was a coping mechanism.”

In the end it was HRT, not changing her diet, that provided a solution to Rachael’s symptoms. But she says perimenopause also heightened her lifelong self-consciousness about her body, leading to a habit of weighing herself twice a day – which, she adds, “I’m still finding difficult to break even now, more than seven years post-menopause”.

So, what are the warning signs to look out for? “It starts with that preoccupation – being overly concerned or overly focused on what you’re eating to a point where it becomes obsessive. It might be that you’re skipping meals, or it might be that you’re starting to binge and feeling out of control – anything that’s not normal for you,” Williams explains. If you have any concerns, she adds, “get in touch with your GP at the earliest opportunity”.

More information and support, including phone and online helpline services, at beateatingdisorders.org.uk

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