Disorders of eating and body image during the menopausal transition: associations with menopausal stage and with menopausal symptomatology.

OBJECTIVE: Recent reports from our laboratory and others suggest that the menopausal transition may represent a window of vulnerability for eating disorders in women. Here, we present new findings regarding this issue. METHODS: We surveyed 230 women aged 40-60 years using an anonymous questionnaire focused on eating-disorder and body-image symptomatology. We then compared groups of respondents based on (a) menopausal stage as assessed by World Health Organization (WHO) criteria and (b) menopausal symptomatology as assessed by the Menopause Rating Scale (MRS). RESULTS: WHO-defined menopausal stage (premenopausal, perimenopausal, and postmenopausal) showed no significant associations with eating and body-image measures. However, MRS scores showed strong associations with most measures of the Eating Disorder Examination Questionnaire, as well as with questions regarding satisfaction with body image. These associations remained little changed even when removing the four psychological items from the MRS score and examining only the association of the MRS somato-vegetative and urogenital items with these outcome variables. DISCUSSION: Our data augment existing evidence that the menopausal transition may be associated with eating and body-image disturbances. However, reported menopausal stage, which is difficult to define reliably, may be less informative than menopausal symptoms as a predictor of disordered eating and associated symptoms. LEVEL OF EVIDENCE: V-descriptive survey study.

The impact of face masks on emotion recognition performance and perception of threat.

Facial emotion recognition is crucial for social interaction. However, in times of a global pandemic, where wearing a face mask covering mouth and nose is widely encouraged to prevent the spread of disease, successful emotion recognition may be challenging. In the current study, we investigated whether emotion recognition, assessed by a validated emotion recognition task, is impaired for faces wearing a mask compared to uncovered faces, in a sample of 790 participants between 18 and 89 years (condition mask vs. original). In two more samples of 395 and 388 participants between 18 and 70 years, we assessed emotion recognition performance for faces that are occluded by something other than a mask, i.e., a bubble as well as only showing the upper part of the faces (condition half vs. bubble). Additionally, perception of threat for faces with and without occlusion was assessed. We found impaired emotion recognition for faces wearing a mask compared to faces without mask, for all emotions tested (anger, fear, happiness, sadness, disgust, neutral). Further, we observed that perception of threat was altered for faces wearing a mask. Upon comparison of the different types of occlusion, we found that, for most emotions and especially for disgust, there seems to be an effect that can be ascribed to the face mask specifically, both for emotion recognition performance and perception of threat. Methodological constraints as well as the importance of wearing a mask despite temporarily compromised social interaction are discussed.

Menarche, puberty, and first sexual activities in eating-disordered patients as compared with a psychiatric and a nonpsychiatric control group.

OBJECTIVE: To examine chronology and experience of menarche, puberty, and first sexual activities in eating-disordered patients as compared with a psychiatric and a nonpsychiatric control group. METHOD: We interviewed 150 females, namely 50 patients with anorexia or bulimia nervosa (ED), 50 patients with polysubstance dependence (PSD-CO), and 50 healthy controls (HE-CO) (defined by DSM-IV) on chronology and their experience of menarche, puberty, and first sexual activities adjusted for childhood sexual abuse. RESULTS: ED women were similar to HE-CO in age at menarche and most sexual milestones, but differed significantly from PSD-CO women, who were "early starters." Regarding their experience of menarche, pubertal body changes, and first sexual activities, however, ED women rated these variables significantly more negatively than did either of the comparison groups. These significant differences remained after adjusting for sexual abuse. CONCLUSION: These findings suggest a negative body attitude in ED patients already at pubertal age, namely years before onset of the disorder. Prospective data are needed.

Never too old for eating disorders or body dissatisfaction: a community study of elderly women.

OBJECTIVE: The aim of the study is to examine eating behavior and body attitude in elderly women. METHOD: A randomly selected nonclinical sample of 1,000 women, aged 60-70 years, was contacted for our questionnaire survey covering current eating behavior, weight history, weight control, body attitude, and disordered eating (DSM-IV). RESULTS: The 475 (48%) women included in our analyses had a mean BMI of 25.1 but desired a mean BMI of 23.3. More than 80% controlled their weight and over 60% stated body dissatisfaction. Eighteen women (3.8%; 95% confidence interval: 2.3-5.9%) met criteria for eating disorders (ED; N = 1 anorexia nervosa, N = 2 bulimia nervosa, and N = 15 EDNOS) and 21 (4.4%) reported single symptoms of an ED. CONCLUSION: Although EDs and body dissatisfaction are typical for young women, they do occur in female elderly and therefore should be included in the differential diagnosis of elderly presenting with weight loss, weight phobia, and/or vomiting.