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The Connection Between Binge Eating and Menopause
Aug. 26, 2022
An eating disorder in midlife can be triggered by perimenopausal hormone shifts, but that’s just part of the story. Here’s what you need to know, and how you can begin to get your eating, and your life, under control.
It may seem like a random connection, but there is a very real link between perimenopause and eating disorders such as anorexia nervosa, bulimia or binge eating, and (surprise!) hormones play a role.
“Part of estrogen’s function appears to be regulating eating behaviors,” says Jessica H. Baker, Ph.D., Associate Professor, University of North Carolina at Chapel Hill Department of Psychiatry, who has researched and reviewed the subject of eating disorder behaviors in mid-life. “Based on my research, hormone shifts, especially changes in estrogen levels, play a part in increasing the risk for disordered eating during the menopause transition. Eating disorder symptoms appear to be directly impacted by these fluctuating hormones.”
These kinds of hormone shifts happen in puberty, PMS and perimenopause. But hormones are just part of the picture.
What exactly is binge eating?
“The medical term, ‘binge eating disorder’ (BED) is a form of eating disorder that is often characterized by episodes of eating large quantities of food very quickly, or past the point of fullness,” explains Boston-based Registered Dietitian Chloe Davis Giraldi, MS, RD, LDN. “It may be accompanied by a feeling of loss of control, shame, or guilt after an episode, and binge eating is sometimes done in secret.”
We often think of binge eating as a disease suffered by teens or young adults, but research has shown a prevalence of eating disorders in perimenopausal women, aged 40 to 60. One 2012 study showed that 13% of women 50 and older have an eating disorder diagnosis.
“Perimenopause may be a period of risk for the onset, worsening, or relapse of an eating disorder due to the many biological, emotional, and social changes that occur during this time,” says Baker.
Besides hormones, what else can put you at risk?
Mid-life is an obstacle course of challenges, changes and stressors. Combined with crazy hormone ups and downs, they can trigger anything from depression to an eating disorder.
“There’s also a domino effect involved: Other menopause symptoms present a confluence of triggers that could create a vicious cycle,” says Giraldi. "For example, inadequate sleep has been shown to be associated with binge eating behaviors.”
Two other common menopause symptoms that act as dominos are anxiety and depression. “Both are common in people with an eating disorder, and research indicates anxiety often predates the development of an eating disorder, such as binge eating,” says Baker.
Where can you seek help?
Start by asking yourself three questions:
How am I coping with my emotions?
How much am I eating, and is it more than normal?
How am I using eating as a coping strategy?
“These ‘Three Hows’ help you see how you’re coping on an emotional eating/binge eating continuum,” says Giraldi, who suggests getting more information from Multi-Service Eating Disorders Association (MEDA). “MEDA has tons of good information and a directory of treatment providers for therapy, nutrition and beyond.” Another excellent resource is the National Eating Disorders Association (NEDA), where you can find treatment, support, and education.
What can you do to regain control?
“A dietitian’s role in binge eating treatment is to help a person understand their relationship with food through counseling and education,” says Giraldi. “Specific treatment varies, depending on the type and severity of the eating disorder, and you often need a multidisciplinary team, including a trained doctor, therapist and dietitian.”
One strategy that Giraldi employs is a “ditch dieting” mindset. “Binge eating can be a vicious cycle of restricting 'desired' foods, which ultimately leads to cravings, binges and feelings of guilt.” An ‘intuitive eating’ approach allows you to make peace with food, including commonly "forbidden" items like pasta, cookies or ice cream, normalizing them, and beginning to eat more mindfully. It’s important to consistently check in with your emotions and your thoughts about food: What am I feeling right now as I eat this? How does it taste? Am I feeling full?
One very effective treatment is Cognitive Behavioral Therapy (CBT), which takes that awareness of food and emotional eating a big step further. CBT is a psychological behavioral treatment that’s delivered by a trained mental health professional. It’s a talk therapy that is problem-specific (treating sleep problems, anxiety, depression, or emotional eating, for example) and goal-oriented, and it’s very interactive.
“This is a short-term therapy, typically 12 to 16 weekly sessions, and there is homework,” says Phenology Scientific Advisor Sheryl Green, Ph. D., an assistant professor at McMaster University in Hamilton, Ontario, a clinical health psychologist at the affiliated Women’s Health Concerns Clinic and a coauthor of "The Cognitive-Behavioral Workbook for Menopause."
“Awareness is a beginning step—examining the negative thoughts, beliefs, and thinking patterns that co-exist with something like an eating disorder—because these patterns of thinking influence behavior. Then, you identify specific behaviors. What are your triggers and warning signs? What time of day did you have this thought? Who were you with? All of these details are key to deconstructing your thinking patterns in order to retrain your brain,” says Green.
The process continues with manageable, methodical steps called ‘cognitive restructuring,’ and the key to all of it is your participation. “We use ‘cognitive therapy worksheets,’ to get patients to write these thoughts down and make them laser focused on their feelings and behaviors. All of these tools provide a map to guide you through the process, and to create the change that you want and need,” she says. To learn more about CBT and where to find a licensed practitioner, Green recommends the Association For Behavior and Cognitive Therapy (ABCT).
Taking proactive steps toward making healthy changes and controlling this binge eating cycle is a challenging process, but one that you can achieve. Says Giraldi, “This is a journey that you will work through and learn from, with help from trusted professionals like trained dietitians, doctors and psychologists. No one is going to be perfect. It’s important to give yourself some grace, and patience and understanding.”
Want to talk to a Registered Dietitian?
If you have some questions, you can talk to a Registered Dietitian for free. Just download the Phenology App to connect with an RD specially trained in menopause-related topics via text-based, 1-on-1 chat. Click here to get the app.
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