Perimenopause and Eating Disorder History: What You Need to Know

When Old Struggles Come Back During a New Transition

Perimenopause brings body changes, mood shifts, and cultural pressure around aging and body size. If you have a history with an eating disorder, this combination can feel uniquely destabilizing. Old thought patterns that had quieted may resurface. Restriction, bingeing, or other behaviors might feel more appealing as a way to cope or feel in control.

This does not mean you have failed your recovery. It means perimenopause is a genuinely demanding transition, and your past experiences with food and your body make it a particularly sensitive one. You are not alone in this, and recognizing the risk is the first step in navigating it carefully.

How Perimenopause Interacts With Eating Disorder History

Estrogen and serotonin are closely linked. Estrogen supports serotonin function, which affects mood, appetite regulation, and impulse control. When estrogen fluctuates and drops in perimenopause, serotonin signaling can become less stable. This may increase the pull toward disordered eating behaviors as a way to manage difficult emotions.

Hormone shifts also change how your body processes and stores fat, particularly around the abdomen. For someone with a history of body image struggles, these physical changes can feel deeply threatening. The fear or distress about body changes is understandable, but acting on it through restriction or other behaviors can destabilize health in ways that compound perimenopause symptoms.

Research also suggests that perimenopause itself is a period of elevated eating disorder relapse risk, even for people who have been in solid recovery for years. Knowing this is not cause for alarm. It is cause for extra support.

Symptoms That Overlap or Become Harder to Navigate

Appetite and hunger cues already become more variable during perimenopause for many people. If you have a history of disconnection from hunger and fullness signals, this variability can be harder to interpret and respond to in a nourishing way.

Mood swings and increased anxiety in perimenopause can heighten the emotional triggers that were historically linked to disordered eating. If anxiety and food restriction or other behaviors were linked for you, more anxiety may increase the pull toward those behaviors.

Fatigue is also significant. When you are deeply tired, self-care takes effort. Eating regularly, planning nourishing meals, and following through with treatment strategies all require more from you when your reserves are low.

What Helps: Approaches That Support Both Recovery and This Transition

Consistent, adequate nourishment is the foundation. Regular eating, including sufficient protein and carbohydrates, supports hormone stability, energy levels, and mood. This is not about any particular eating plan. It is about giving your body what it needs reliably, without long gaps between meals.

Connecting or reconnecting with an eating disorder-informed therapist or dietitian during perimenopause is genuinely valuable. This transition is a known high-risk period, and having support in place before a crisis is far easier than trying to access it during one.

Movement that feels connecting and enjoyable, rather than punishing or compensatory, can support both mental and physical health during perimenopause. Walking, dancing, gentle yoga, or swimming are worth exploring if they feel safe. The goal is nourishment, not burning.

Communicating with trusted people in your life about what you are navigating can reduce isolation. You do not need to share everything, but not carrying this alone matters.

Treatment Considerations and Cautions

Some providers may recommend dietary changes for perimenopause symptoms, including weight management strategies. If a provider uses language around restriction, calorie counting, or rapid loss, it is entirely appropriate to tell them about your history and ask for an approach that does not involve those frameworks. You have the right to care that does not put your recovery at risk.

Some medications used in perimenopause, including certain antidepressants, can affect appetite. Let your prescribing provider know about your history so they can factor it into treatment choices.

Supplements with stimulant properties that are sometimes marketed for perimenopause fatigue or metabolism should be approached with caution and discussed with your provider if you have a history of compensatory behaviors.

Hormone therapy may help stabilize mood, sleep, and some of the physical changes that feel most distressing. For people in eating disorder recovery, stabilizing these factors can actually support recovery. This is worth discussing specifically with both your eating disorder provider and your gynecologist or internist.

Working With Your Healthcare Team

If you have an eating disorder history, disclosing it to your perimenopause care provider is important. The way perimenopause is managed for you may need to look different, and your team cannot tailor care they do not know you need.

If your eating disorder team and your primary care or gynecology team are different people, ask for communication between them or keep both informed. Siloed care increases the risk of one treatment inadvertently affecting the other.

If you are not currently working with an eating disorder professional but your history feels active or at risk, this transition is a strong signal to reconnect with that support. It does not need to be a crisis to be worth attention.

Track Your Patterns

Tracking symptoms during perimenopause can help you see connections between hormone fluctuations and the moments when eating-related thoughts or behaviors feel harder to manage. Patterns that show up in the data are easier to bring to a provider than a vague sense of things feeling off.

PeriPlan lets you log symptoms and track how you feel over time. Use it in a way that feels useful to you, and share relevant patterns with your care team.

When to Seek More Support

Reach out to your eating disorder provider or a crisis line if you notice behaviors returning that you had moved away from. This includes restriction, purging, or other compensatory behaviors. Returning to support early makes recovery easier than waiting until things escalate.

Seek care if you are avoiding eating or eating in ways that feel out of control on most days. Your body needs consistent nourishment during this transition, and struggling to provide that is a medical concern, not a personal failing.

If you are in crisis related to eating, food, or your body, please reach out to the National Eating Disorders Association helpline or a local service. You do not have to wait until things are at their worst.

Recovery and Perimenopause Can Coexist

This transition is challenging. For those with an eating disorder history, it carries extra complexity. But it is also a time when many people deepen their commitment to caring for themselves, precisely because they can feel how much their body needs support.

Your recovery matters. Your health during this transition matters. You deserve care that holds both.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.