Eating disorders impact more than 1.1 million people in Australia, representing 4.5% of the population. These disorders include binge eating disorder, bulimia nervosa, and anorexia nervosa.

Meanwhile, more than 4.1 million people (18.9%) are affected by body dissatisfaction, a major risk factor for some types of eating disorders.

But what image comes to mind first when you think of someone with an eating disorder or body image concerns? Is it a teenage girl? If so, you’re definitely not alone. This is often the image we see in popular media.

Eating disorders and body image concerns are most common in teenage girls, but their prevalence in adults, particularly in women, aged in their 30s, 40s and 50s, is actually close behind.

So what might be going on with girls and women in these particular age groups to create this heightened risk?

The 3 ‘P’s

We can consider women’s risk periods for body image issues and eating disorders as the three “P”s: puberty (teenagers), pregnancy (30s) and perimenopause and menopause (40s, 50s).

A recent report from The Butterfly Foundation showed the three highest prevalence groups for body image concerns are teenage girls aged 15–17 (39.9%), women aged 55–64 (35.7%) and women aged 35–44 (32.6%).

We acknowledge there’s a wide age range for when girls and women will go through these phases of life. For example, a small proportion of women will experience premature menopause before 40, and not all women will become pregnant.

Variations in the way eating disorder symptoms are measured across different studies can make it difficult to draw direct comparisons, but here’s a snapshot of what the evidence tells us.

Puberty

In a review of studies looking at children aged six to adolescents aged 18, 30% of girls in this age group reported disordered eating, compared to 17% of boys. Rates of disordered eating were higher as children got older.

Pregnancy

During pregnancy, eating disorder prevalence is estimated at 7.5%. Almost 70% of women are dissatisfied with their body weight and figure in the post-partum period.

Perimenopause

It’s estimated more than 73% of midlife women aged 42–52 are unsatisfied with their body weight. However, only a portion of these women would have been going through the menopause transition at the time of this study.

The prevalence of eating disorders is around 3.5% in women over 40 and 1–2% in men at the same stage.

So what’s going on?

Although we’re not sure of the exact mechanisms underlying eating disorder and body dissatisfaction risk during the three “P”s, it’s likely a combination of factors are at play.

These life stages involve significant reproductive hormonal changes (for example, fluctuations in oestrogen and progesterone) which can lead to increases in appetite or binge eating and changes in body composition. These changes can result in concerns about body weight and shape.

These stages can also represent a major change in identity and self-perception. A girl going through puberty may be concerned about turning into an “adult woman” and changes in attitudes of those around her, such as unwanted sexual attention.

Pregnancy obviously comes with significant body size and shape changes. Pregnant women may also feel their body is no longer their own.

While social pressures to be thin can stop during pregnancy, social expectations arguably return after birth, demanding women “bounce back” to their pre-pregnancy shape and size quickly.

Women going through menopause commonly express concerns about a loss of identity. In combination with changes in body composition and a perception their appearance is departing from youthful beauty ideals, this can intensify body dissatisfaction and increase the risk of eating disorders.

These periods of life can each also be incredibly stressful, both physically and psychologically.

For example, a girl going through puberty may be facing more adult responsibilities and stress at school. A pregnant woman could be taking care of a family while balancing work and other demands. A woman going through menopause could potentially be taking care of multiple generations (teenage children, ageing parents) while navigating the complexities of mid-life.

Research has shown interpersonal problems and stressors can increase the risk of eating disorders.

We need to do better

Unfortunately most of the policy and research attention currently seems to be focused on preventing and treating eating disorders in adolescents rather than adults. There also appears to be a lack of understanding among health professionals about these issues in older women.

In research I (Gemma) led with women who had experienced an eating disorder during menopause, participants expressed frustration with the lack of services that catered to people facing an eating disorder during this life stage. Participants also commonly said health professionals lacked education and training about eating disorders during menopause.

We need to increase awareness among health professionals and the general public about the fact eating disorders and body image concerns can affect women of any age – not just teenage girls. This will hopefully empower more women to seek help without stigma, and enable better support and treatment.

Jaycee Fuller from Bond University contributed to this article.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. For concerns around eating disorders or body image visit the Butterfly Foundation website or call the national helpline on 1800 33 4673.

Gemma Sharp, Professor, NHMRC Emerging Leadership Fellow & Senior Clinical Psychologist, The University of Queensland; Amy Burton, Lecturer in Clinical Psychology, University of Technology Sydney, and Megan Lee, Assistant Professor, Psychology, Bond University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

You wake up after a night out. Your head’s pounding and a wave of unease hits before you’ve even looked at your phone. Restlessness, self-doubt and flashes of regret creep in as last night’s conversations start to replay.

“Hangxiety” is not a clinical term but the anxious, uneasy feeling that follows drinking is widely recognised. Most people expect a headache, but the emotional comedown can hit just as hard.

Alcohol disrupts brain systems that regulate mood and stress. It boosts gamma-aminobutyric acid (GABA), a calming chemical, and suppresses glutamate, which keeps you alert. That’s why confidence rises and worries fade.

As your body processes alcohol, this balance flips. Calming signals drop, excitatory ones surge and your nervous system swings into overdrive.

Alcohol also disrupts the hypothalamic–pituitary–adrenal (HPA) axis – the body’s stress system – spiking cortisol, our main stress hormone.

Combine that with poor sleep, dehydration and low blood sugar, and you’ve got the perfect recipe for feeling on edge.

To understand how common these feelings are, we analysed 22 studies spanning four decades and involving more than 6,000 adults worldwide. Our systematic review published today included lab experiments, surveys and interviews capturing real-world experiences.

Despite differences in study designs and the challenge of asking hungover people to accurately recall their experiences, the results were consistent: hangovers triggered higher levels of anxiety, stress, guilt, irritability and sadness.

Certain traits make hangxiety hit harder

People prone to anxiety or low mood, or those who drink to cope with stress, experience hangxiety more intensely – not because hangovers create new problems, but because alcohol temporarily dulls negative emotions.

When the effects wear off, those feelings return in sharper focus, which can amplify stress and worry.

Hangxiety also hits harder when people act out of character while drunk. Saying or doing things that clash with personal values can trigger embarrassment or shame the next day, fuelling harsh self-criticism and intensifying emotional distress.

People who struggle with emotional regulation – recognising and managing your emotions in healthy ways – face particular challenges.

Good emotional regulation might mean noticing stress and choosing to go for run or call a friend, rather than reaching straight for a drink. It’s pausing to ask “what do I actually need right now?”

Without these skills, people get stuck in cycles of self-blame, amplifying the emotional rebound.

What traits make it less bothersome?

Not everyone experiences hangxiety the same way. People with higher emotional resilience – the ability to adapt to stress and keep perspective – tend to cope more effectively.

Reframing “I’m falling apart” into “my body’s recovering” shifts hangxiety from crisis into something temporary.

Social support helps too. Sharing a laugh about the night before or talking it through eases isolation and shame. Knowing you’re not alone makes the experience less overwhelming.

Bad hangxiety doesn’t stop people drinking

You might assume a brutal hangover would deter future drinking, but most people in our review saw hangovers as a routine inconvenience or rite of passage.

Rather than reducing their alcohol intake, people relied on short-term fixes such as, drinking water or eating beforehand to lessen the severity of their hangover.

When alcohol becomes a coping tool for stress, hangxiety can actually reinforce the cycle. Alcohol dulls discomfort, but when it wears off, the same feelings return, prompting another drink for relief.

This loop helps explain why even frequent hangovers rarely lead to meaningful behaviour change.

If you’re experiencing hangxiety, aside from planning to drink less next time, to get through the day:

• hydrate, rest and eat well to support your body’s recovery
• skip the “hair of the dog”. More alcohol only delays the crash
• ground yourself with slow breaths or a short walk to calm the nervous system
• reach out to friends or loved ones. Connection eases both guilt and anxiety.

In the longer term, reflect on why you drink and whether it’s become a way to manage stress.

If you’re drinking daily to manage emotions, if hangxiety disrupts your work or relationships, or if anxiety lingers long after the hangover fades, it’s time to seek professional help. A GP or a psychologist can assess whether underlying anxiety or problematic drinking patterns need support.

Hangxiety is more than a bad mood after drinking – it’s your brain and body recalibrating after chemical turbulence, where brain chemistry, personality and coping strategies interact.

Some people feel it mildly, others more deeply, depending on levels of emotional awareness, resilience and support. Understanding this can help replace self-criticism with self-compassion, and perhaps rethink what the “morning after” really means.

Rebecca Rothman, PhD Candidate in Clinical Psychology, School of Health Sciences, Swinburne University of Technology and Blair Aitken, Postdoctoral Research Fellow in Psychopharmacology, Swinburne University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.