There is little awareness of disordered exercise as an issue in menopause, whereas discussion and training around disordered eating in menopause is more visible.
Is there a connection between disordered eating and exercise in menopause?
Disordered exercise often goes hand in hand with disordered eating, and for some women, they are inseparable. Is there a connection between disordered exercise and menopause, as well as disordered eating?
Menopause Movement member, coach Cathy Houghton shared her specialist knowledge at a recent Menopause Movement webinar, Disordered Exercise Too Much & Too Little! Disordered eating, exercise and weight control.
We’re sharing some of what she had to say about disordered exercise (although she prefers the less judgemental ‘distressed’ over ‘disordered’), as there is so little awareness on this as an issue into menopause, whereas discussion and training around disordered eating in menopause is much more visible.
What is disordered exercise?
Disordered exercise refers to a problematic relationship with physical activity that can lead to harmful physical, emotional, and psychological responses. It is often associated with the eating disorders anorexia nervosa, bulimia nervosa, or orthorexia, where exercise becomes a means of compensating for, or controlling, food intake. This disordered behaviour that can be triggered by menopause is typically driven by a distorted body image, societal pressures, perfectionism, low self-esteem, and/or the redistribution of weight and weight gain in menopause.
One common manifestation of disordered exercise in women is excessive and compulsive exercising. Women may engage in intense workouts for long durations, disregarding the body's need for rest and recovery. This can result in overuse injuries, hormonal imbalances, fatigue, and compromised immune function. Despite the known risks of disordered exercise for women in menopause (or at any point in their life), there is little or no training for the personal trainers who work with these women, and little awareness for the women themselves.
What are some of the drivers for disordered exercise in menopause?
Perimenopause and the changes that come with, it can be risky time, increasing the possibility of disordered exercising for a minority of women, due to a number of different factors, including:
- Menopausal weight gain, or seeing a redistribution of body fat, typically around the stomach & midriff.
- Seeking external validation through the amount of exercise done, rather than validation from their looks, or a more youthful body (we’re not saying that this is right, we’re acknowledging this is what some women experience).
- A fear of ageing and life changes - the empty nest, the grey divorce, grief etc. Exercise can be like a lifeboat to hold onto, something familiar and perhaps something they can try to excel at.
- The midlife juggling that goes on in the menopause sandwich years can trigger levels of stress not previously experienced - women may now be busier than they’ve ever been before, looking after multiple generations, managing the pressures of work and the demands of a frenetic world.
- The body can feel stressed by the impact of the physical menopause symptoms, raising cortisol levels – so women try to manage stress in new ways.
- Midlife and menopause can bring feelings of the body and life being out of control - exercise is one thing a menopausal woman can control!
The wellbeing and medical worlds pressure us to do more, more, more…to be healthy in menopause – what is not recognised is that this can be taken too far. Obsession with exercise can affect health, disrupt normal functioning, leading to isolation, strained relationships, and a diminished quality of life.
What are the red flags for recognising disordered exercise in menopause?
There’s a spectrum of behaviour when healthy exercise regimes tip over into more problematic territory. Being aware of these behaviours can be helpful for any health or pro who treat or train women into menopause (and at all other stages), and for women to recognise in themselves, including:
- Having rigid exercise rules and rituals.
- Not being able to rest days without feeling guilty or anxious.
- Feeling distressed when unable to exercise due to injury or illness.
- An increase in the number of injuries.
- Having a ‘no-pain, no-gain’ approach.
- When exercise regimes interfere with relationships with partners, family & friends.
- Feeling too fatigued to do anything after exercise.
- Neglecting aspects of life outside of exercise.
- Losing the joy of exercise when it becomes something to be endured.
Compulsive or disordered exercise can cause:
- Injuries, including overuse injuries, muscle tears and stress fractures.
- Bone density loss – osteopenia/osteoporosis.
- Persistent muscle soreness.
- Chronic pain in joints & muscles.
- Fatigue and sluggishness.
- Change in resting heart rate.
- Increased frequency of illness & upper respiratory infections.
Disordered exercise perpetuates a negative body image. Women may engage in exercise as a means of achieving an idealized body shape or size, driven by societal pressures and media influences. However, the relentless pursuit of an unrealistic body image can fuel dissatisfaction, self-criticism, and a cycle of disordered behaviours as results are never enough, perpetuating the cycle.
Addressing disordered exercise in women requires a comprehensive approach involving medical professionals, therapists, and support networks. Treatment may include cognitive-behavioural therapy, nutritional counselling, and gradual reintegration of balanced exercise routines. It is essential to promote body positivity, self-acceptance, and a healthy relationship with exercise that focuses on enjoyment, well-being, and overall health rather than external appearance.
Recognizing and addressing disordered exercise in women, we can foster a culture that emphasizes holistic well-being, self-compassion, and a balanced approach to physical activity. Encouraging open conversations and providing support can help individuals develop healthier relationships with their bodies and exercise, promoting long-term health and happiness and as Cathy says, we need to build a better relationship between food, movement and our bodies.
Cynthia Bulik – Midlife Eating Disorders
Margo Maine & Joe Kelly – Pursuing Perfection (Eating Disorders, Body Myths, and Women at Midlife & Beyond)
Bø, K. and Nygaard, I. (2019). Is Physical Activity Good or Bad for the Female Pelvic Floor? A Narrative Review. Sports Medicine, 50(3), pp.471-484.
The Eating Disorder Therapist Podcast – Finding your Freedom with Food (not menopause-specific but a number of episodes on over-exercising)
A recording is available to members in the Member’s Circle, for non-members here