The menopausal transition--a possible window of vulnerability for eating pathology

Int J Eat Disord. 2013 Sep;46(6):609-16. doi: 10.1002/eat.22157. Epub 2013 Jul 11.

Abstract

Objective: No published studies, to our knowledge, have examined the association of menopausal status with eating disorders and body image in women. We assessed these associations in a large sample of middle-aged women.

Method: We administered an anonymous questionnaire to a randomly selected nonclinical sample of women aged 40-60 in Innsbruck, Austria. The questionnaire covered demographic items, menopausal status, weight history, measures of body image, and current eating disorders as diagnosed by DSM-IV criteria. Using modified WHO criteria, we classified the respondents' current stage of menopausal transition as premenopausal (N = 192), perimenopausal (N = 110), or naturally postmenopausal (N = 134). In a separate analysis, we also examined the small group of women with surgically induced menopause (N = 12).

Results: The three groups were similar in all demographic features except age, and did not differ significantly on current body mass index (BMI), weight-control behaviors, or dieting history after age adjustment. However, perimenopausal women reported a significantly greater prevalence of eating disorders as compared to premenopausal women. Perimenopausal women also reported significantly higher self-ratings of "feeling fat" and higher Body Shape Questionnaire scores than premenopausal women. Women with surgically induced menopause also showed an elevated prevalence of eating and body image pathology.

Discussion: Our data suggest that the menopausal transition is associated with an increased prevalence of eating disorders and negative body image. Menopause, like puberty, may perhaps represent a window of vulnerability to these conditions, likely because of changes in hormonal function, body composition, and conceptions of womanhood.

Keywords: body image; eating disorders; menopausal transition.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Composition
  • Body Image*
  • Body Mass Index
  • Body Weight
  • Feeding and Eating Disorders / epidemiology*
  • Female
  • Humans
  • Middle Aged
  • Perimenopause / physiology
  • Perimenopause / psychology*
  • Premenopause / psychology
  • Prevalence
  • Surveys and Questionnaires