An estimated 28.8 million people in the United States will be diagnosed with an eating disorder at some point in their lives, with women facing the highest risk. While anorexia, bulimia, and binge-eating disorder are often associated with adolescent women, midlife women are also susceptible to developing these conditions or experiencing relapses. According to a 2019 study from the University of California, San Francisco, approximately 50% of individuals relapse after eating disorder treatment.
Online, the term 'menorexia' has emerged to describe the tendency for menopausal or perimenopausal women to develop eating disorders, blending the words menopause and anorexia. However, adults who develop such disorders are underrepresented in research and treatment settings, creating a critical gap in understanding the problem's true scope, said Samantha DeCaro, a psychologist and director of clinical outreach and education at the Renfrew Center, a national eating disorder treatment center.
'Midlife adults meet the same diagnostic criteria as younger patients, struggling with symptoms such as restricting, bingeing, or purging,' said DeCaro, who also co-hosts the podcast 'All Bodies. All Foods.' 'What sets them apart, however, are the unique life transitions that can trigger or exacerbate body dissatisfaction and disordered eating: menopause, divorce, an empty nest, chronic illness, physical changes, and the challenges of aging in an ageist society.'
Midlife Eating Disorders Often Go Undetected
Many people with eating disorders in midlife can trace their struggles back decades, DeCaro noted. 'Some report issues with food or body image since adolescence, only crossing into a clinical eating disorder later in life,' she said. For others who have been relatively satisfied with their bodies until their 40s or 50s, it becomes a new, unsettling fixation.
Erin Parks, co-founder and chief clinical officer at Equip, a virtual eating disorder treatment platform, said that 25% of the site's adult patients fall into the midlife age category (ages 40-65). A survey of over 1,000 adults aged 40 and older found that 35% of women reported developing disordered eating behaviors for the first time in midlife, indicating a new onset.
'I actually think many midlife eating disorders go undetected because they don't look like what we typically think an eating disorder should look like,' Parks told HuffPost. 'Because diet culture — the belief system that equates thinness with health — is so normalized, behaviors often masquerade as wellness, like meal skipping, excessive exercise routines, or restrictive dieting, including the intermittent fasting trend, which makes them easy to overlook.'
While women are disproportionately affected, men are not immune. 'Thirty-nine percent of men felt worse about their bodies as they aged, yet eating disorder symptoms in midlife men are even more likely to be overlooked or attributed to other causes,' Parks said.
Hormonal Shifts Play a Key Role
The hormonal shifts that occur during menopause and andropause significantly contribute to triggering eating disorders later in life. For women, estrogen levels drop by about 60% during menopause, while progesterone production nearly stops. 'This creates a perfect storm of weight gain, mood swings, and feelings of losing control over their body,' Parks explained. Men also face challenges: testosterone decreases by about 1% annually starting at age 25, then more rapidly in middle age, leading to increased belly fat, muscle loss, and reduced energy.
Sometimes, eating disorders in midlife are spurred by offhand comments from medical doctors overly focused on weight loss as a solution to other conditions like hyperlipidemia, hypertension, or elevated blood sugar. Lauren Muhlheim, a psychologist and owner at Eating Disorder Therapy LA, noted that many midlife clients she sees are trying to solve or prevent a medical problem. 'But dieting and exercise can drive an eating disorder, and there are other ways to address medical conditions other than weight loss,' she said.
Our culture glorifies not only thinness but also youthfulness, creating a 'double bind for people in midlife,' DeCaro said. Eating disorders are not caused by a single factor. 'They develop through a perfect storm of risks that collide during vulnerable periods of life,' she said. 'For midlife adults, those stressors might include menopause, unwanted changes to appearance, chronic pain, grief and loss, or the sting of ageism.'
Advice for Those Concerned About Midlife Eating Disorders
If you are concerned you may be developing an eating disorder in midlife, experts offer the following advice:
- Recognize that it is normal for bodies to change. If you are hyperfixating on changes, try to focus on what your body has allowed you to experience rather than comparing it to your younger self or others, Muhlheim said. 'It is normal for our bodies to change with time, especially during hormonal transitions. What is not healthy is to be obsessed about your body or what you are eating or should not be eating. That takes up too much brain energy and keeps you from living your life.'
- Seek specialized care. Eating disorders are serious, potentially fatal conditions that often require specialized care, DeCaro said. Seek an assessment so a provider can recommend a level of care meeting both medical and emotional needs. Consider a weight-inclusive eating disorder therapist or dietitian. Virtual treatment is particularly effective for midlife adults needing flexible care that accommodates work and family responsibilities.
- Do not deal with it alone. Eating disorders thrive in isolation, but connection with others is a powerful recovery tool, DeCaro said. Join a virtual or in-person support group, listen to recovery stories on a podcast, or read memoirs by people who have navigated midlife eating disorders to remind yourself you are not alone.
- Avoid predatory diet culture messaging. Be cautious of messages targeting midlife adults with promises of 'reversing aging' or 'getting your body back,' Parks said. 'Unfortunately, in our society, it has become relatively standard. These messages can be particularly triggering during vulnerable life transitions. Culturally, we need to shift the conversation from managing aging bodies through the latest fad diet to supporting them with compassion through these natural life transitions.'
