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Body dissatisfaction can lead to eating disorders at any age

Eating disorders are stereotypically associated with adolescents and young adults. Growing evidence, however, suggests that these conditions can occur at any time during a woman’s lifespan, including at midlife. A new study finds that body dissatisfaction is a primary cause of eating disorders, especially during perimenopause.

Eating disorders are serious mental health conditions characterized by disturbances in eating behaviour and body image that occur in approximately 13.1% of women across the lifespan. The prevalence of any eating disorder specifically for women aged older than 40 years is roughly 3.5%, with specific symptoms such as dissatisfaction with eating patterns being documented as high as 29.3%. Serious complications such as high mortality and morbidity are associated with eating disorders. These adverse health events are likely to be magnified when present at older ages. However, few studies on eating disorders have included participants at midlife, including premenopause, perimenopause, and postmenopause.

Some evidence that supports the idea that perimenopausal women have the highest rates of dysregulated eating behaviours (eg, weight-control behaviours such as regular counting of calories or consumption of diet foods) of any reproductive stage at midlife and are significantly different from premenopausal women with regard to body dissatisfaction and feelings of fatness. Although findings such as these remain scant, the association between eating disorders and symptoms of perimenopause (eg, negative mood, depression, and fatigue) confirm that perimenopause may be a particularly risky time for eating pathology.

In this new small study, which sought to investigate the structure of eating disorder symptoms specifically during perimenopause and early postmenopause, the researchers used network analysis statistical models to compare the structure and importance of specific eating disorder symptoms across reproductive stages. Although they admit that larger studies are necessary with this underrepresented female population, the researchers believe that the study confirms that dissatisfaction with body image is a key risk factor for eating disorders across the lifespan, especially at midlife.

Abstract

Objective: Eating disorders (EDs) are often stereotyped as disorders of adolescence and young adulthood; however, they can occur at any age. Prevalence of EDs at midlife are approximately 3.5% and specific symptoms at midlife can have prevalences as high as 29.3%. Studies also inconsistently suggest that EDs and related symptoms may be more prevalent in midlife aged women during perimenopause compared with midlife aged women at pre-menopause. To date few studies have examined the structure of and associations between ED symptoms in women specifically during perimenopause and early postmenopause. Thus, the purpose of the current study is to investigate the structure of ED symptoms specifically during perimenopause and early postmenopause.

Methods: Participants included 36 participants (45-61 y old) in a larger clinical trial who completed the Eating Disorder Examination Questionnaire (EDE-Q) at a baseline study visit. Network analysis statistical models were used to examine the structure of and associations between ED symptoms assessed via the EDE-Q.

Results: Shape dissatisfaction and weight dissatisfaction were the top 2 central symptoms in the network.

Conclusions: Results corroborate previous studies and indicate that, similar to young adult samples, dissatisfaction with body image is a core feature of ED pathology across the lifespan.

Reference

 Jody E Finch, Ziqian Xu, Susan Girdler, Jessica H Baker. Network analysis of eating disorder symptoms in women in perimenopause and early postmenopause. Menopause . 2023 Mar 1;30(3):275-282. doi: 10.1097/GME.0000000000002141. Epub 2023 Jan 17.

Content created February 2023

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