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Menarche and Peri-menopause: Times of Increased Risk for Eating Disorders


Sunday, March 26, 2017: 10:00 AM-12:30 PM

Background: This presentation presents recent research regarding risk factors of menarche and menopause, explores how lack of information and acknowledgement regarding these transitional stages has contributed to body shame and eating disorders, and discusses how to address them in the treatment setting in order to optimize recovery.

Objectives: Following this presentation, participants will be able to: 1.) Name one central question that must be addressed at menarche and at menopause. 2.) Give an example of a metaphor from the feminine cycle as it relates to eating disorders that can be used in a treatment setting. 3.) Name one requirement of a healthy transition into menarche and menopause.

  1. Describe the window of vulnerability with regard to
  2. The onset of menarche
  3. modern Western culture versus traditional cultures
    1. inter-relationship of bio/psycho/social issues
    2. body image
    3. eating disorders

B. peri-menopause

1. modern Western culture versus traditional cultures

2. inter-relationship of bio/psych/social issues

3. body image

4. eating disorders

II. Discussion of the latest research regarding eating disorders and the risk factors:

  1. Menarche
  2. Peri-menopause
  3. Gender differences
  4. Eating Disorder treatment approaches using:

A. Identification of strength and resiliency factors found in the menstrual cycle

  1.  Application of “menstrual Metaphors” to eating disorder symptomology
  2. Psychoeducation regarding research information not readily available
  3. Using menstrual stages in establishing identity and boundaries
  4. Use of ritual to assist in transitions

IV. Q&A

It has been well known that the onset of eating disorders often coincides with puberty, however, research now indicates the transition into menopause is also associated with increased risk of eating disorders and negative body image. Recent studies point to two phases in a woman’s life where she is most vulnerable to the development of an eating disorder: puberty and peri-menopause, the bookends of the female reproductive cycle.

While one of the diagnostic criteria of anorexia is amenorrhea, the role of the feminine menstrual cycle, as a whole, has been largely ignored in the treatment of eating disorders. Most attention has been given to the absence or presence of menstruation with regard to diagnostic or medical concerns, but with little regard to the naturally occurring physical and psychological changes that arise at the onset or cessation of the female reproductive cycle.

Trauma and attachment theories tell us that it is not simply what happened and shouldn’t have happened to an individual that can lead to trauma – but also what should have happened and didn’t. In this vein, this presentation will explore how the lack of information, acknowledgement, and honor within our modern culture regarding menarche and menopause has contributed to body shame in girls and women, and also to the development of eating disorders.

In order to improve the odds of obtaining recovery, the issues relevant to these critical transitions that occur within the female life cycle need to be recognized and addressed. This didactic and interactive presentation will explore the ways in which menarche and peri-menopause are related to the development of negative body image and to eating disorder symptomology. Approaches to addressing them within the treatment setting will be presented

Primary Presenter:
Anita Johnston, PhD, CEDS

Anita Johnston, PhD, CEDS is the Clinical Director of Ai Pono IOP in Honolulu, Ai Pono Maui Residential Program in Maui, and Consultant to EATFED Eating Disorders Programs in Sydney, Australia. She is the author of Eating in the Light of the Moon, which has been published in six languages, book chapters in Bridging the Research Treatment Gap and the Psychospiritual Clinician’s Handbook, and co-creator of the Light of the Moon Café e-course.



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