Study links perimenopause and eating disorder risk

Perimenopause can be a challenging time of life for many women, with body and mood changes common accompaniments to the profound hormonal changes taking place.
 
According to new research from the Butterfly Foundation, more than half of all women experience some degree of body dissatisfaction during this time.
 
Combine that with females being twice as likely as males to experience an eating disorder in their lifetime, and researchers say the potential intersection of perimenopause and disordered eating becomes clear.
 
While eating disorders are more often thought of as a disease of adolescence and young adulthood, other stressful times, such as perimenopause, can also trigger eating disorders.
 
The research shows 55.8% of women say perimenopause or menopause leaves them dissatisfied with their bodies.
 
The research adds weight to previous evidence, including a 2016 study that also suggested perimenopausal women may be more vulnerable to disordered eating, and a 2023 study that found eating disorders affected around 3.5% of menopausal-aged women.
 
Dr Karen Spielman, a Sydney GP with a special interest in eating disorders, says perimenopause and menopause are often times when women will present to their GPs seeking advice on weight gains.
 
This provides an ideal opportunity for GPs to screen for eating disorders, Dr Spielman says.
 
‘Often our patients do present with concerns around weight gain, so we need to be screening for eating disorders, particularly at that time,’ she told newsGP.
 
Dr Spielman said it is also important for GPs to screen patients at a higher weight, or those seeking weight loss advice, which can become an issue for many women around menopause.
 
‘People’s moods and cycles and eating appetite, all sorts of things fluctuate with hormones, and so it would make sense that there would be increased vulnerability at times of hormonal fluctuation,’ she said.
 
She said as perimenopause and eating disorders both affected menstruation, they could also share some common symptoms.
 
‘Our patients, whose cycles have switched off because of malnutrition, are putting themselves into a similar state,’ Dr Spielman said.
 
‘They don’t get hot flashes, those same physiological changes, but the risk of osteoporosis and some of the other changes in the body, certainly there’s an overlap.
 
‘It’s definitely something that we are aware of and need to be thinking about.’
 
The GP Hub point-of-care tool, produced by the Inside Out Institute for Eating Disorders, is a screening tool for GPs to support patients who may be experiencing, or at risk of, an eating disorder.
 
Launched last year and endorsed by the RACGP, it offers what Dr Spielman describes as a ‘non-confrontational tool’ for GPs to use with patients.
 
‘We just start by asking, “how is your relationship with food?” It’s a beautiful, gentle, easy, non-confrontational way to start the conversation about eating disorders,’ she said.
 
‘GPs are really well placed to pick that up at any stage, right from vulnerability through to severe illness. We see our patients all the way across the spectrum, and we are skilled at picking it up all the way along the spectrum as well.
 
‘If we can raise the awareness and be screening for eating disorders, we can really save lives with early intervention, because we know evidence-based treatments offered early really can hugely impact morbidity and mortality.’
 
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