Diet Culture and Menopause
As pleased as I am that menopause health is finally getting the attention it deserves with research, evidence-based solutions, and workplace awareness, the negative impact of diet culture is just as great in this population as it is for the young folks.
Eating disorders are not just adolescent and young-people problems. We identify and treat eating disorders at all stages of life, and more research is emerging showing just how common they are in the 35+ age group. (Davies, 2024)
Interested in hearing more?
With increased celebrity influence, our 40/50/60-something patients and clients are feeling more pressure than ever to “do menopause right.” And for them, it isn’t just about meeting calcium and vitamin D needs, getting enough protein, and surviving the sleep disruptions.
It is somehow STILL steeped in the drive to be thin.
A new client of mine recently asked, “So how can I look like Demi Moore does now?”
My heart sank. Please tell me this rail thin frame is not what we are still chasing, I thought to myself….
I took a breath and replied gently, “You know, our bodies were not meant to look the same at all stages of our lives.” And my client’s eyes welled up, like she finally felt the heaviness of what she was asking me.
As I probed a bit into why this aesthetic was important to her, I realized we have a big problem on our hands. We know how dangerous diet culture is for our younger patients - from social media’s influence to dance/gymnastics/sports culture, to the own hateful language young people use when speaking about themselves and others:
“I’m such a big back!” heard in lunch lines with 12 and 13 year-olds shaming themselves about choosing a sandwich at lunch instead of a salad.
But eating disorders know no age limits; and the menopause industry is directly feeding into the diet culture chaos and noise - the peddling of elixirs and cure-alls, promises to reduce “menopause belly” and to get back to your more youthful body.
Because really, it’s still about being in a smaller body, shrinking and hiding.
I am asking everyone practicing medicine, therapy, and nutrition to please take a look at what the pressure to “not look menopausal” is costing our patients and clients. From over-prescribing GLP-1s purely to align with our thin-obsessed society, to the billions our patients are throwing at “menopause solutions” - some evidence-based, but most - not so much.
The confluence of hormonal changes in peri- and menopause combined with the amplifying pressure to work harder on our bodies, do more than we used to but somehow eat less (unless of course it’s lean protein!), creates the perfect storm for eating disorders to sneak in.
As health care providers in this space, here are some things we can do today to help support our patients as they navigate the hormonal, emotional, and physical changes that accompany menopause:
Focus on adequacy and food as both fuel AND as a necessary pleasure in life.
Educate yourself about a health-at-every-size (HAES) aligned treatment model. We should all learn more about BMI and fat-bias in the medical community and work to treat the whole person. Not everyone needs to lose weight. Yes, even those folks who don’t fit inside the BMI box of 19.9 - 24.9.
You don’t know what is going on with a person’s relationship with food unless you ask. BMI tells you almost nothing about a person’s relationship with food and their body. Even if a patient IS at increased health risk for having an elevated BMI, we have an obligation to Do No Harm. Actively encouraging weight loss in a person with disordered eating can be incredibly harmful - both medically and emotionally.
Ask your patients about their relationship with food. Refer them to a HAES-aligned dietitian who specializes in eating disorders if you suspect any type of restrict/binge cycling, purging, over-exercising, orthorexic beliefs, or any other adjacent behaviors. We must treat the eating disorder first.
Remind your patients to lead with compassion and gratitude for the incredible work their bodies have done thus far in life. Treat the whole patient, not just the number you see on the scale.
Please reach out and keep the conversation going.
Davies HO. Eating disorders of the perimenopause. Post Reprod Health. 2024 Dec;30(4):233-238. doi: 10.1177/20533691241293905. Epub 2024 Oct 21. PMID: 39434435.)
