A new study finds that eating disorder diagnoses in the U.S. military remain somewhat rare, but perhaps not surprisingly, female troops are 20 times more likely to have such issues than males.
The overall low numbers — 3,527 cases from 2004 to 2013 — also likely do not reflect the full scope of the problem, given the secrecy that often shadows these illnesses.
The Armed Forces Health Surveillance Center in September released a review of eating disorder diagnoses among active-duty personnel.
By combing through medical records, researchers found that in the past decade, 443 troops were diagnosed with anorexia, 1,743 suffered from bulimia and 1,341 had a nonspecific eating disorder, a designation that includes behaviors such as chewing food but not swallowing, binging without purging, and aggressively working out after eating just small amounts of food to make up for the calories.
Among females, younger and junior enlisted members were more likely to be diagnosed than older, more senior women; Caucasian women had the highest incidence rate of any ethnic group; and female Marines were diagnosed at significantly higher rates than their counterparts in other services — more than twice the rate of female airmen and 1½ times that of female soldiers and sailors.
Previous research has found that troops suffer from eating disorders at rates far higher than the general population.
A 2001 Military Medicine study based on a survey of 3,000 active-duty women found more than 63 percent had some sort of problem behavior associated with eating, and nearly 98 percent of Marine respondents met the criteria for having an eating abnormality.
That study also indicated that Marine women suffered from bulimia at more than 10 times the rate of civilians — 15.9 percent versus 1.5 percent — while female soldiers had bulimia at six times the rate of civilian women.
Yet, according to the recent AFHSC report, diagnoses of these disorders among service members remain low overall.
AFHSC editor Dr. Frank O'Donnell said the discrepancy could be the result of patients avoiding medical care for their disorder because they don't think they have a problem, are embarrassed, or worry that it would jeopardize their military careers.
But the number of diagnoses also could be low because personnel policies ban those previously diagnosed with the condition from serving in the military — and many of these disorders begin in early adolescence, O'Donnell said.
Still, the fact that some service women and men have eating disorders should be of concern to physicians, he added.
Although deaths are rare from the most common eating disorders seen in the military — bulimia and nonspecified eating disorders — they affect the health of the patient as well as their job proficiency, according to the researchers.
"We have hundreds of new cases of diagnosed disorders every year. Presumably, it's the tip of the iceberg," O'Donnell said. "This study gives doctors a perspective on how likely it is they'll come across it, and when they do, they should call in the troops to help the patient."
According to the study, the most common eating disorder among male troops from 2004 to 2013 was the nonspecified type, although starting in 2010, diagnoses for bulimia among men began to rise, and bulimia has surpassed the nonspecified type as the top disorder for male troops since 2011.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.
