Eating disorders, disordered eating and body dissatisfaction in midlife

When we think about eating disorders and poor body image, what often comes to mind? Perhaps a teenage girl or a young woman in her 20's. We don't necessarily link eating disorders and midlife women. But picture this: a woman in her 40's or 50's, who may be at the peak of her career while juggling work, family and other life responsibilities who is experiencing an eating disorder for the first time, or is experiencing a relapse from her younger years.

The thing is, disordered eating, eating disorders and body dissatisfaction don't have an age limit.

While adolescence and early adulthood are recognized as vulnerable periods for the development of eating disorders, these difficulties can also emerge or resurface later in life. Research suggests that eating disorders affect approximately 3.5% of midlife women, with some eating disorder symptoms reported at considerably higher rates (Finch et al., 2023). A review by Samuels et al. (2019) also highlights that women may experience chronic, recurrent or late-onset eating disorders during midlife and beyond.

Body dissatisfaction is also common during this stage of life. Research suggests that eating disorders affect approximately 3.5% of midlife women (Finch et al., 2023), while 1 in 4 women experiencing menopause also report body image issues (Liptember Foundation, 2024).

So, what is actually happening?

Midlife can bring several physical, hormonal, mental and emotional changes that may influence a woman's relationship with food, her body and herself. Body image changes and her relationship with food during perimenopause can look like:

1. Changes in her body

Research has identified differences in lean mass, muscle mass and fat distribution across menopausal stages, although these changes are also influenced by the natural ageing process (Szeliga et al., 2026). Shifts in body composition, fat distribution and muscle mass can change how a woman experiences and feels about her body. These changes may bring increased body dissatisfaction or a sense of not feeling quite at home in herself.

2. Changes in appetite

Research following women through the menopausal transition found changes in appetite, including increased feelings of hunger and desire to eat, alongside changes in dietary intake (Duval et al., 2014). For women with a history of restrictive eating or disordered eating, navigating these changes can sometimes feel particularly challenging. Changes in hunger, fullness and appetite can feel unfamiliar, particularly for women who have spent years dieting, following rigid food rules or overriding their body's natural hunger cues.

3. Changes in mental and emotional wellbeing

Sleep disturbances, anxiety, low mood, irritability and brain fog can affect emotional wellbeing, resilience and the way a woman copes with the changes happening around her.

Body dissatisfaction can also have a broader impact on wellbeing. Research involving midlife and older women found that greater body dissatisfaction was associated with more negative emotions, greater psychosocial difficulties and poorer quality of life over time (Smith Kilpela et al., 2023).

4. Changes in her relationship with food

The menopausal transition can coincide with significant changes in how a woman experiences her body, her sense of identity and her stage of life. For women with a history of eating difficulties, these changes may bring old thoughts, behaviours or fears back to the surface. For others, longstanding concerns may become harder to manage. Previous struggles with food, dieting, body image or disordered eating may resurface during midlife. Disordered eating in midlife can be a recurrence. For some women, new difficulties may emerge for the first time.

5. Increased pressure to control her body

With changes in body shape and composition often comes increased exposure to messages about weight loss, anti-ageing, menopause diets and body transformation. These messages can reinforce the idea that her changing body is something that needs to be fixed.

Research involving midlife women found that pressure from the media and people around us can contribute to appearance comparisons and greater internalization of "the thin ideal". These factors were associated with body dissatisfaction, which was in turn associated with restrictive eating behaviours and bulimic symptoms (Hockey et al., 2021).

Over time, these messages can make it harder for women to accept their changing bodies and feel comfortable in themselves.

It's never too late to make peace with food and your body

Yes, eating disorders and menopause is something need to talk more about. Midlife can be a challenging transition, but it can also offer an opportunity to reconsider some of the messages we've carried around about food, weight and what it means to be healthy.

Perhaps it's time to question the diet rules, expectations and ideals that no longer serve us. To recognize that our bodies are allowed to change, and that our worth has never been determined by our shape or size.

Your relationship with food and your body has no expiry date.

You are not too old, too far gone or too set in your ways to begin again. You deserve to nourish yourself, feel more comfortable (or more accepting) in your own skin and receive support along the way. ❤️

Further reading and support

If you're navigating perimenopause or menopause and finding that your relationship with food, eating or your body is becoming more difficult, you're not alone.

The Butterfly Foundation has developed a helpful resource exploring the connection between perimenopause, menopause, eating disorders and body image.

Perimenopause, menopause, eating disorders and body image – Butterfly Foundation (PDF) 

It includes information about recognizing changes in eating and body image, seeking support and looking after your wellbeing during this transition.

References

1. Butterfly Foundation. (2025). Periods, pregnancy and hormones: New research reveals the major life moments that contribute to women's body dissatisfaction. Online article.

2. Duval, K., Prud'homme, D., Rabasa-Lhoret, R., Strychar, I., Brochu, M., Lavoie, J.-M., & Doucet, E. (2014). Effects of the menopausal transition on dietary intake and appetite: A MONET Group Study. European Journal of Clinical Nutrition, 68(2), 271–276. https://doi.org/10.1038/ejcn.2013.171

3. Finch, J. E., Xu, Z., Girdler, S., & Baker, J. H. (2023). Network analysis of eating disorder symptoms in women in perimenopause and early postmenopause. Menopause, 30(3), 275–282. https://doi.org/10.1097/GME.0000000000002141

4. Hockey, A., Barlow, F. K., Shiels, A. L., & Donovan, C. L. (2021). Body dissatisfaction in midlife women: The applicability of the tripartite influence model. Body Image, 39, 202–212. https://doi.org/10.1016/j.bodyim.2021.08.006

5. Samuels, K. L., Maine, M. M., & Tantillo, M. (2019). Disordered eating, eating disorders, and body image in midlife and older women. Current Psychiatry Reports, 21(8), 70. https://doi.org/10.1007/s11920-019-1057-5

6. Smith Kilpela, L., Hooper, S. C., Straud, C. L., Marshall, V. B., Verzijl, C. L., Stewart, T. M., Loera, T. T., & Becker, C. B. (2023). The longitudinal associations of body dissatisfaction with health and wellness behaviors in midlife and older women. International Journal of Environmental Research and Public Health, 20(24), 7143. https://doi.org/10.3390/ijerph20247143

7. Szeliga, A., Chedraui, P., & Meczekalski, B. (2026). The impact of the menopausal transition on body composition and abdominal fat redistribution. Journal of Clinical Medicine, 15(2), 740. https://doi.org/10.3390/jcm15020740