Perimenopause and Your Relationship With Food: Understanding the Changes in Appetite and Hunger
Perimenopause changes how your body responds to food. Understand why appetite and cravings shift and how to build a healthier relationship with eating.
Why Perimenopause Changes How You Eat
Many women notice that their relationship with food shifts noticeably during perimenopause, and often in ways that feel confusing or frustrating. Foods that never caused weight gain now seem to. Hunger feels less reliable as a guide to when and how much to eat. Cravings become more intense, particularly for sugar and carbohydrates, at specific points in the hormonal cycle. These are not signs of weakened willpower or personal failure. They are predictable physiological responses to the hormonal changes occurring during this transition. Estrogen and progesterone both influence appetite regulation, blood sugar sensitivity, gut motility, and the brain's reward responses to food. When their levels become erratic, so does the experience of eating.
The Hunger Signals Are Changing
Estrogen influences leptin, the hormone that signals satiety to the brain. As estrogen levels fluctuate and decline, leptin signalling becomes less reliable. This can mean that the usual hunger and fullness cues you have relied on for years become less clear. Some women eat more than they intended because they did not receive the normal stop signal. Others find that they feel hungry more frequently despite having eaten adequately. Disrupted sleep, which is very common in perimenopause, amplifies this by elevating ghrelin, the hunger hormone, and suppressing leptin further, creating a biological drive to eat more, particularly of high-calorie foods, regardless of actual nutritional need. Understanding this mechanism helps remove the moralising from what can otherwise feel like a personal failing.
Sugar and Carbohydrate Cravings
The specific craving for sweet and starchy foods during perimenopause has several hormonal drivers. Fluctuating estrogen affects serotonin production, and carbohydrates temporarily increase serotonin, which explains why many women reach for them when mood is low. Cortisol, which rises under stress and tends to be elevated in perimenopausal women because of sleep disruption and the body's stress response to hormonal flux, directly increases appetite for energy-dense food. Insulin sensitivity also changes during this period, meaning the body processes sugar differently and may experience sharper blood sugar swings. The practical response is not to eliminate these foods through restriction, which often backfires, but to eat them in contexts where blood sugar impact is moderated: alongside protein and fat, earlier in the day, and in smaller quantities.
Weight Changes and Body Composition
One of the most common food-related concerns during perimenopause is the perception that eating habits that previously maintained weight are no longer working. This reflects real metabolic changes. Declining estrogen promotes fat redistribution toward the abdomen. Muscle mass begins to decline in the late forties and early fifties unless actively preserved through resistance exercise, and since muscle burns more calories at rest than fat, this reduces overall metabolic rate. The response that is most likely to produce the best outcomes is not eating less, which often reduces muscle further and increases cortisol, but eating more strategically. Prioritising protein at each meal preserves muscle mass and increases satiety. Reducing highly processed foods reduces the blood sugar volatility that drives overeating.
Disordered Eating Patterns and Emotional Eating
Perimenopause can reactivate or intensify difficult patterns around food, particularly in women who have a history of disordered eating. The combination of body changes, reduced control over appetite signals, and the emotional challenges of the transition can lead to cycles of restriction and overeating, increased food-related anxiety, or using food as a primary emotional regulator. If you notice that your relationship with food during perimenopause is causing significant distress, contributing to guilt and shame, or interfering with your social life, speaking to a GP or therapist with eating disorder awareness is worth doing. This is not a niche concern. Many clinicians are now aware that perimenopause is a time of vulnerability for food-related psychological difficulties.
Practical Ways to Support a Better Relationship With Food
Building a positive relationship with food during perimenopause is less about following a strict eating plan and more about creating conditions where eating is satisfying, regulated, and enjoyable. Eating at consistent times each day reduces blood sugar volatility and helps re-establish clearer hunger signals. Including substantial protein at breakfast, at least 20 to 30 grams, substantially reduces mid-morning and afternoon cravings. Slowing down during meals and eating without screens allows the brain time to register fullness before overeating occurs. Reducing alcohol not only supports better sleep but also removes a significant driver of the calorie-dense late-night eating that many perimenopausal women describe. These changes are not diets. They are structural supports for a body going through a genuinely demanding transition.
Nourishment Over Numbers
The most useful reframe for many women during perimenopause is shifting from a calorie-focused or weight-focused approach to food toward a nourishment-focused one. The question is not how little you can eat but how well your body is being supported. Are you getting enough protein for muscle maintenance? Enough calcium and vitamin D for bone density? Enough omega-3s for brain and joint health? Enough fibre for gut motility, which slows during perimenopause? When food becomes primarily about meeting these functional needs rather than managing weight, the relationship with eating often becomes significantly more peaceful and the practical outcomes, including body composition, tend to improve as a welcome side effect.
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