There are many factors that affect our eating behavior throughout our lives. Women, in particular, experience such influences during periods of major change such as puberty, pregnancy or postpartum. The transition to menopause, with its significant physical, hormonal, psychological and social changes, is also a – usually long – period that affects the way each woman thinks and acts in relation to her diet.
If you are a woman at this stage of your life, it is important to understand what the transition to menopause brings, how menopause changes affect eating behavior, how your relationship with food changes and, most importantly, what you can do to maintain a healthy eating behavior.
What exactly is “eating behavior”?
Before we dive into how eating behavior is affected, let’s explain exactly what we mean by this term.
“Eating behavior” is defined as the set of our habits and choices related to food consumption. It includes characteristics such as:
- What we eat: What foods we choose, by what criteria and how these foods affect our health
- How much we eat: In what quantity we consume each food and how this quantity may be related to our physical or psychological state (e.g., emotional eating, overeating, restrictive eating)
- How we eat: our eating habits (e.g., mindful or mindless eating, snacking in front of screens, etc.)
- Why we eat: Do we always eat because we are hungry or for other reasons? (e.g., emotional needs, social events, social pressure, etc.)
All of these characteristics are significantly influenced by the changes that occur at all stages of menopause. Yes, there are stages in the menopausal transition.
The stages of menopause
Menopause is a completely normal physiological process that marks the end of the reproductive age for the female body. The term “menopause” does not actually refer to a stage in a woman’s life but to a point in time, specifically the point at which 12 months have passed since your last period. Therefore, when we talk about menopause, we refer to the menopausal transition. This usually occurs between the ages of 40-65, although sometimes it starts earlier, and is divided into the following stages:
- Pre-menopause: the stage before the onset of changes in the frequency of menstruation. At this stage, symptoms are usually not noticed as the changes are negligible.
- Perimenopause: this stage is characterized by period changes that last more than 3 months. They are usually accompanied by the first symptoms, such as hot flashes or mood disorders.
- Post-menopause: the period after the absence of a period for 12 consecutive months. This stage is also referred to as simply “menopause”.
It is important to emphasize that each stage is different for each woman, not only in duration but also in what symptoms she will experience and how much her daily life will be affected.
Changes during menopause
The vast majority of women – an estimated 85% – will experience at least one of the symptoms of menopause, which last an average of 7.4 years. The most common of these are:
- Hot flashes
- Night sweats
- Headaches/Migraines
- Muscle and joint pains
- Fatigue
- Vaginal dryness
- Urinary symptoms
- Difficulty in concentration (brain fog)
- Mood disorders
- Irritability
- Insomnia or sleep disorders
At the same time, the physiological changes that occur in the body affect women in various ways that are related to both their relationship with food and their body image.
- Decrease in reproductive hormones, especially estrogen
- Possible increase in ghrelin, the hormone that regulates appetite
- Increase in fat storage, especially visceral fat, and consequent changes in body composition
- Decline of muscle mass and bone density
- Decrease in skin elasticity
Women usually experience all of the above in an unfriendly environment towards women in adulthood. Beauty standards and social pressures to defeat aging put a great psychological pressure on many women and become the cause of body image dissatisfaction.
Furthermore, the burdens that women carry from other social obligations (adolescent children, elderly parents, increased responsibilities at work and at home) add to their already burdened psychology. The result is an increased likelihood of depressive symptoms and anxiety disorders.
Effects on eating behavior – what we know from studies
It is important to emphasize that research on women in menopause is unfortunately limited. A systematic review published in 2024 in the scientific journal Applied Physiology, Nutrition, and Metabolism included only 10 studies with a publication date after 2010. The study found alarming levels of disordered eating behavior and intense dissatisfaction with body image in women in perimenopause and menopause. More specifically:
- An increase in binge eating was observed, which is likely associated with an increase in ghrelin during perimenopause.
- Higher levels of orthorexia nervosa – disordered behavior related to an obsession with healthy eating. In this case, the researchers assume that significant changes in body composition lead women to seek drastic ways to manage their weight and change their body image.
- For the same reason, there were increased cases of women who significantly reduced their energy intake and their nutrition lacked the necessary macronutrients – proteins, fats and carbohydrates – to cover their daily needs.
- On the other hand, an increase in cases of obesity was also observed after menopause, which is likely related to the drop in estrogen levels and the inevitable increase in appetite.
- Finally, the chances of emotional overeating also seemed to increase, which is likely related to the intense symptoms of menopause, anxiety and symptoms of depression, as well as dissatisfaction with body image.
Eating disorders in perimenopause and menopause
We could divide the possible disorders into two categories: those characterized by restrictive behaviors (eating less) and those in which there is disinhibited and impulsive behavior in relation to food (eating more).
Restrictive behaviors
- Reducing food consumption and energy intake in order to lose weight
- Excessive preoccupation with food and repetitive restrictive thoughts and behaviors
- Intense concern about weight and body image
- Ignoring hunger cues
- Removing entire food groups from the diet (e.g. carbohydrates)
- Abstaining from food for long periods of time
- Using laxatives, diuretics or excessive exercise in order to control weight
- Orthorexia nervosa
- Anorexia nervosa
Disinhibited eating behaviors
- Overeating episodes that may be accompanied by a feeling of loss of control
- Emotional binge eating
- Eating not due to hunger but due to external stimuli (social events, social pressure, etc.)
- Feelings of guilt and intense concern about body image, especially after binge eating episodes
- Night overeating episodes
- Bulimia nervosa
Treatment and prevention
You may experience any of the above behaviors at any stage of the menopausal transition, individually, in combination or not at all.
If you have difficulty managing any of the above, you should ask for help. Contact a mental health specialist, who is the only one who can diagnose a possible eating disorder. If you need to, you can also seek help from a nutritionist, who will properly guide you on how to nutritionally support the changes in your body. If you are facing any other health issue, seek out doctors and health professionals who will listen to you and address your health in relation to the challenges of menopause.
There are ways to prevent disordered eating behaviors like the above ones during the menopausal transition:
- Build healthy eating habits that promote health and will help your body stay strong and adapt more easily to the changes that come with menopause.
- Make exercise a part of your life, especially strength training. It will help you preserve your valuable muscle mass that begins to decline during menopause, help you maintain a healthy weight, maintain your bone health, and help you with mood swings.
- Learn about intuitive and mindful eating that can become a shield against disordered eating behaviors and teach you to trust your body’s hunger and satiety cues again.
- Try to be kind to yourself during this transitional stage. The changes of menopause, as difficult and discouraging as they can be, are a natural development stage of the female human body over time.
- Find support and understanding through communication with other women who are at the same stage of life. Everything becomes a little easier when we belong to a group that understands us.
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Scientific resources
https://cdnsciencepub.com/doi/10.1139/apnm-2023-0623
