Is intuitive eating harder after menopause? | Nutrition By Carrie

While intuitive eating isn’t right for everyone, it has helped a lot of people. I’ve seen up close and personal how intuitive eating has helped many of my clients develop a peaceful, balanced relationship with food and cultivate an approach to health that honors their body’s wisdom.

I’ve also seen how the path to adopting intuitive eating can be quite different in young adult women than it is for women in midlife or older. Looking specifically at women in the menopausal years, in some ways it’s easier to embrace intuitive eating, but in other ways it’s harder.

You may have noticed that there’s a lot more open discussion about menopause today than there ever was before. Menopause is less likely to be viewed as something shameful and secretive, and rightly so, because it’s something that all females go through. It’s a natural life transition (even when it doesn’t feel like it).

It’s also a period of life when women are at increased risk of developing an eating disorder for the first time or seeing a resurgence of former eating disorder symptoms. That’s partly many women experience other life transitions around the time of menopause (career changes, kids leaving the nest, divorce, caring for elderly parents). Unfortunately, the new “conversation” about menopause includes new pressure to control the body’s changes during this time, which I fear is further amplifying eating disorders risk.

So intuitive eating may be more important than ever in midlife. What smooths the way to this path, and what might throw a wrench in the works?

Hitting diet rock bottom

One small study I looked at on the adoption of intuitive eating among post-menopausal women noted that one benefit of age is life experience, and for some women, the accumulation of the negative effects of dieting — weight regain-loss-regain, the deprivation-rebound eating pendulum, etc. — can lead to skepticism of weight loss diets, a strengthened desire to move away from dieting, and an openness to exploring intuitive eating.

This is in line with previous research that found becoming skeptical about dieting after experiencing weight regain was part of what prompted adults in larger bodies to shift to a non-dieting approach to food and health. They realized weight loss diets were sources of deprivation that lead to frustration and food compensation — and a strong sense of guilt.

(Not surprisingly, the first IE principle is “Reject the diet mentality,” because the hope of finding a new-and-improved weight loss diet may inadvertently cause you to try to control your diet, getting in the way of listening to your body’s cues about what foods are satisfying and make you feel good.)

Another key to successfully adopting intuitive eating is learning body acceptance and actively resisting the dominant diet culture by challenging weight stigma and the sociocultural norms of beauty and thinness. Body and weight acceptance is a critical step because if someone continues to struggle with this, it’s difficult to fully develop a peaceful relationship with food. That’s why I integrated body image and embodiment counseling in my work.

Other factors that smooth the way to becoming an intuitive eater, according to this small study, were:

• Allowing flexibility in the daily eating rhythm and anticipating needs.
• Learning to identify and accept emotions (for those who struggle with emotional eating).
• Developing food satisfaction for nutritious foods.

The lure of the thin ideal

The practice of intuitive eating — whether learned or “naturally occurring” — is associated with lower BMI. However, association does not prove cause and effect, and certainly people who have struggled with their weight may find that they gain weight, lose weight or stay around the same weight after adopting intuitive eating. (This depends on which part of the weight loss-weight regain cycle someone was in when starting intuitive eating.)

One reason for this association is that those who naturally have a BMI in the “normal” range may feel they’re “allowed” to stop trying to make their bodies even thinner and embrace intuitive eating, whereas those with BMIs in higher ranges may feel more pressure to keep trying to make their bodies smaller.

Indeed, research has found that even when someone wants to move away from weight loss diets, having significant concerns about weight can lead to ambivalence about actually giving up dieting (or other means of weight loss), putting an obstacle in the path of practicing intuitive eating.

The study on post-menopausal women found that even if a woman had experienced the undesirable consequences of weight loss diets, if they had internalized unrealistic ideals of thinness — and compared themselves to those ideals — the resulting body dissatisfaction prompted her to still tried to restrict her diet in order to lose weight. And unfortunately, research has found that body dissatisfaction persists with age. I’ve had clients in their 70’s who still yearn for their teenage body.

(In my experience as a nutrition therapist who also lives in this world and is on social media, I see a heightened pressure to lose weight that’s a combination of the availability of GLP-1 medications and increased messaging about the “perils” of midlife weight gain.)

Another obstacle is that while women in the study agreed that respecting internal cues related to hunger, fullness and satisfaction, integrating this into everyday life felt difficult when they were confronted with family obligations, schedules, or the influence of others.

More food for thought

Body changes that accompany the menopause transition can lead to feeling of panic and a need to control the body — which is one reason that eating disorder risk increases during this window of time.

Women may also be concerned about the increased risk of age-related chronic health conditions such as heart disease, diabetes or cancer, and feel that losing weight or at least preventing weight gain will lower that risk. However, the reality is that many factors affect health, and eating nutritious food and being physically active — along with not smoking, moderating alcohol intake, nurturing positive relationships, having a purpose in life, and keeping up with preventive health screenings — plays a much bigger role in health.

And, let’s call a spade a spade, not only does our society praise thinness, it also celebrates youth. Many women are motivated to try to look younger (not for nothing does beauty and youth culture run on a parallel track to diet culture) — or at least try to not be both “old” and “fat.”

The pressure is real. Maybe you feel it yourself, maybe you’ve witnessed it second hand among female friends or family members — or those horrid “this 90’s actress used to be hot but now she looks like a frumpy housewife” articles that juxtapose old movie stills or formal marketing photos with grainy photos captured by a paparazzo in a grocery store parking lot.

That’s why I agree with the elements of research findings that highlight the importance of body image work and what might be termed as social justice (pushing back against unreasonable societal ideas about how we should look) when moving away from diets and towards intuitive eating. This can be hard work, but it’s meaningful, fulfilling work. And I love being a guide for it!

Hi, I’m Carrie Dennett, MPH, RDN, a weight-inclusive registered dietitian, nutrition therapist and body image counselor. I help adults of all ages, shapes, sizes and genders who want to break free from disordered eating or chronic dieting, learn how to manage IBS symptoms with food, or improve their nutrition and lifestyle habits to help manage a current health concern or simply support their overall health and well-being. This post is for informational purposes only and does not constitute individualized nutrition or medical advice.

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