Elsevier

Maturitas

Volume 124, June 2019, Pages 25-31
Maturitas

Evaluating attitudes about aging and body comparison as moderators of the relationship between menopausal status and disordered eating and body image concerns among middle-aged women

https://doi.org/10.1016/j.maturitas.2019.03.014Get rights and content

Highlights

Abstract

Objective

Evidence suggests the menopausal period may be a unique window of vulnerability for the development or exacerbation of eating disorder symptoms among middle-aged women; however, it is unclear who is most at risk during this period. The goal of this study was to evaluate whether appearance-related aging concerns and body comparison, two sociocultural factors, moderated the association between menopausal status and disordered eating behaviors and body image concerns among middle-aged women.

Method

Participants (N = 310) completed an online survey about their menopausal status, aging concerns, body comparison, disordered eating, and body image concerns.

Results

Tests of moderator models revealed that at low levels of aging concerns, peri-menopausal women reported greater dietary restraint than pre-menopausal or post-menopausal women. Additionally, among women with high scores for body comparison, post-menopausal women reported significantly more dietary restraint than either pre- or peri-menopausal women.

Discussion

These findings suggest that the effects of menopause on dietary restraint may be stronger for some women than others.

Introduction

Although prior research on body image and eating disorders symptoms has focused mainly on adolescent girls and young adult women, middle-aged women are not immune from eating disorders. One risk factor for body dissatisfaction that is unique to middle-aged women is menopause. Menopause is the permanent absence of a menstrual period for at least 12 months [1]. The peri-menopausal period, characterized by hormonal fluctuations that cause irregularities in the menstrual cycle and physiological changes to a woman’s weight and shape [1], may be a potential window of vulnerability for disordered eating attitudes and behaviors considering the physiological changes to women’s bodies – gains in weight and fat mass [2], and changes in skin tone/texture [3,4], are in contrast to the young and thin sociocultural standards of beauty.

Despite the body changes associated with menopause, research on the effects of menopausal status on body image concerns and disordered eating behaviors is mixed. Some data indicate that postmenopausal women reported greater dietary restraint and eating disinhibition compared to pre-menopausal women [5,6], yet others found no group differences [7,8]. Mangweth-Matzek et al. [9] found peri-menopausal women reported a significantly greater prevalence of eating disorders, higher rates of feeling fat, and greater body shape and weight preoccupation compared to pre-menopausal women. Given these inconsistent findings, it is difficult to understand who might be most at-risk for disordered eating or body image concerns during the menopausal period. These discrepant results could indicate that there are important moderators not being considered in these models; however, no research to date has examined moderators of the relationship between menopausal status and eating disordered attitudes and behaviors. Therefore, in order to better identify which women may be most at-risk, the aim of the current study is to examine potential moderators of the association between menopausal status and disordered eating behaviors and body image concerns, with a focus on sociocultural factors as moderators.

One potentially relevant moderator is attitudes about aging. In Western societies, female aging has been strongly associated with a decline in physical attractiveness [10]. Given that middle-aged women experience physiological changes (including weight gain, wrinkles, and loss of skin elasticity) that direct them away from the thin beauty ideal, aging anxiety is a well-studied risk factor for body shame, body dissatisfaction, and excessive concerns about dieting in this age group [[11], [12], [13], [14]]. Thus, negative attitudes about aging may be a sociocultural risk factor that interacts with menopausal stage in identifying level of body dissatisfaction among middle-aged women.

Another potential moderator for middle-aged women is body comparison, which refers to comparing perceptions about one’s body and physical appearance to others’ [15], and stems from Festinger’s Social Comparison Theory [16]. Body comparison is associated with thin-ideal internalization, body dissatisfaction, and eating disorder symptoms among middle-aged women [17]. Although body comparison has not been evaluated in the context of menopause, given the dramatic body shape and weight changes that can occur, it is possible that body comparison may act as a moderator of the relationship between menopause and disordered eating/body image concerns.

The goal of the current study was to examine potential sociocultural moderators (attitudes about aging and body comparison) that could help explain who might be most at risk for an association between menopausal status and disordered eating and body image concerns. We hypothesized that being in the transitional period of menopause (i.e., peri-menopause) would be most strongly related to body image concerns and disordered eating among those with high levels of negative attitudes about aging or high levels of body comparison because of the physical changes that are characteristic of the peri-menopausal period.

Section snippets

Participants

We recruited participants to take part in a study of body dissatisfaction and disordered eating among three generations of women (young adult women, their mothers/middle-aged women, and their maternal grandmothers/older women). Young adult women were recruited from introductory psychology classes at a large, public, southeastern university, and their mothers, the focus of this study, were recruited using contact information provided by their daughters.

A total of 365 mothers between the ages of

Results

In order to identify potential covariates, demographic variables and use of interventions for menopause were investigated for both menopausal group differences and correlations with dependent variables. Age was the only variable that both significantly differed by group (as expected, pre-menopausal women were the youngest, followed by peri-menopausal women, and post-menopausal women being the oldest) and was associated with an outcome (body image concerns; r = −.11, p <  .05). Thus, for all

Discussion

The goal of this study was to identify which women might be most at risk for an association between menopausal status and disordered eating and body image concerns by evaluating the sociocultural factors of attitudes about aging and body comparison as potential moderators of this relationship.

Results indicated that it is among women with low levels of negative attitudes about aging for which the peri-menopausal period was associated with greater dietary restraint compared to women in the

Contributors

Katherine A. Thompson conducted literature searches, provided summaries of previous research studies, and wrote the first draft of the manuscript.

Anna M. Bardone-Cone designed the study and wrote the protocol.

Both authors contributed to and approved the final manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

Funding for this study was provided by the UNC Department of Psychology and Neuroscience.

Ethical approval

This research was conducted using human subjects and in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki). The study was approved by the Institutional Review Board of the University of North Carolina at Chapel Hill, and informed consent was obtained from all participants.

Provenance and peer review

This article has undergone peer review.

Research data (data sharing and collaboration)

There are no linked research data sets for this paper. Due to the sensitive nature of the questions asked in this study, participants were informed during the consent process that data would remain confidential and not shared.

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