I have had an influx of middle-aged women visit my office recently. They are not seeking weight management strategies; instead they are requesting help with eating disorder or disordered eating behaviors. What is the link between these women? It seems to be perimenopause and menopause. Any major life change can spur on eating disorder behaviors; however, what is it about this time period specifically that is causing this reaction is so many women?
Menopause officially starts when a woman hasn’t had a menstrual cycle in 12 consecutive months. It can be very difficult to lose weigh during this time. In fact, a woman may find herself gaining weight during perimenopause, which can begin a decade before menopause. Many factors, which are often uncontrollable, cause weight gain during menopause.
- Hormone fluctuations – decreased estrogen during menopause has been linked to weight gain; although, the reason is not entirely clear. Some researchers argue that estrogen deficiency may be an important obesity-triggering factor.
- Decreasing muscle mass – as we age, we naturally lose lean muscle tissue. Hormone changes also contribute to decreasing lean tissue and increasing fat mass. Lean tissue is highly metabolic, meaning having more muscle increases your metabolic rate or metabolism. As we age and we’re losing lean tissue, our metabolism slows down.
- Sleep issues – many women experience sleep disturbances during menopause and the research clearly shows that lack of sleep is linked to increased calorie intake and weight gain.
Fluctuations in estrogen levels in combination with social pressures to conform to female ideals at a time of bodily change seems to create the perfect scenario for eating disorders to develop. Eating disorder behaviors in middle aged women range from restricting food intake, over exercise, laxative abuse, and binge eating. Different from younger women who tend to suffer more from restrictive type eating disorders, older women tend to gravitate more towards binge eating disorder or nighttime eating syndrome. In addition, eating disorders later in life are associated with greater rates of medical problems than in younger women.
What should you do if you know someone or you yourself are approaching menopause?
- Avoid low calorie diets. Cutting calories too much increases the loss of lean muscle, which accelerates the drop in metabolic rate that occurs with age.
- Try the Mediterranean diet or a more plant-based diet. Increase the healthy fats in your diet to cut down on inflammation and eat foods as close to their natural state as possible.
- Add in weight resistance exercise. The goal should be to maintain as much lean tissue as possible, so increase the weight training instead of doing only cardio.
- Practice good sleep hygiene. Turn off screens at least one hour before bedtime, use the bedroom for sleep and sex only, go to bed around the same time every night, and practice relaxation techniques before bed to quiet your mind.
- Incorporate stress relieving techniques like meditation, yoga, walking in nature, reading, and positive self-care.
- Try an alternative method like acupuncture or herbal supplementation. A review of several studies found that acupuncture may increase estrogen levels, which can reduce menopausal symptoms and promote better sleep. Also, supplementing with pine bark extract has been shown to reduce stress and relieve menopausal symptoms.
Losing weight during menopause should not be the primary goal. Instead focus on overall health by eating a balanced diet, moving more, and relieving stress. However, if you are finding yourself or a loved one slipping into a disordered eating pattern, help is available.
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Kohama, Takafumi, and Masako Negami. “Effect of low-dose French maritime pine bark extract on climacteric syndrome in 170 perimenopausal women.” J Reprod Med 58.1-2 (2013): 39-46.
Lizcano, Fernando, and Guillermo Guzmán. “Estrogen Deficiency and the Origin of Obesity during Menopause.” BioMed research international vol. 2014 (2014): 757461. doi:10.1155/2014/757461
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