Why veterans are at a higher risk of eating disorders
A Veterans Affairs study concluded that veterans experience bulimia at about three times the civilian rate. Risk factors include chaotic eating situations, weight requirements and a culture of being in control.
This report contains details that some listeners might find upsetting.
Marine veteran Chandler Rand has struggled with various eating disorders since she was a child. She said she’s healthy now, but she describes her recovery as an ongoing process. She still has to fight off negative thoughts about her body image and weight.
“It's basically like walking a tightrope is what it means for me day to day,” Rand said.
Back in 2016, Rand was a Marine. She was successfully treated for anorexia as a teenager, but after boot camp, she began to binge eat and became bulimic.
“I don't think I saw that as part of my eating disorder at the time,” Rand said. “I think I just saw it as part of being a good Marine.”
To Rand, that meant meeting the strict military standards for weight and body fat percentages. At the same time, she was coping with a sexual assault that happened while she was in college.
She said the assault affected her eating habits.
“You just want to obsess over something other than fear and panic or sadness and guilt,” she said. “So you try to place this moral high ground on food and fitness.”
People like Rand, who develop harmful eating habits during their service, have not received much attention from the Departments of Defense or Veterans Affairs. But a study by the VA in Connecticut shows that veterans experience bulimia at about three times the civilian rate.
Some develop eating disorders while they’re in the military, and others grapple with eating habits after they’re out.
Robin Masheb is a research psychologist and the founder of the Veterans Initiative for Eating and Weight. It’s one of the few programs that studies eating disorders in veterans.
“I was seeing very high rates of binge eating disorder in the veteran population, but I also wanted to know about these other disorders,” Masheb said, noting that there isn’t much research available.
She said risk factors unique to military service go beyond the strict weight requirements.
“People talked about being in very chaotic eating situations where one had to either go for a long period of time without eating anything or having to eat very quickly under certain conditions,” Masheb said. “Those types of things also seem to be risk factors for setting people up for problems with their eating later in life.”
She also said veterans who were sexually assaulted are more likely to develop eating disorders.
For Chandler Rand, the ex-Marine, it was all of the above.
“I think the military environment, aside from height and weight requirements, can be a perfect storm for an eating disorder," Rand said.
She said that’s because so much of military life is based on numbers and rules.
“You're scored on your fitness tests and your combat fitness tests, and there's point systems for conduct and proficiency and the rifle range,” Rand said. “You always want to be in that perfect score range, and so to me, that was just another score I had to meet.”
Masheb’s new study is focused on how VA doctors can screen veterans for eating disorders. She’s experimenting with different ways to ask veterans questions about their relationship with food.
“Typically, men — and more typically, our veterans — are uncomfortable with that language of being out of control,” Masheb said. “Being in the military is about being in control.”
Masheb received a Department of Defense grant to test virtual therapy to help veterans with eating disorders. But she said they face other challenges, like busting the myths that eating disorders only occur in young women, or that patients who are overweight can’t have an eating disorder.
In March, the department released new guidelinesthat grant more leeway for the service branches to loosen the restrictions on weight and fitness standards.
Masheb and Rand agree that’s a small step in the right direction. But the guidelines still leave it to each branch to decide if they want to continue to rely on body mass index, a measurement that uses height to determine weight goals.
Rand said the height and weight standards don’t make sense to her.
“If people see that you don't have to meet this number, or be less than that number, I think that will hopefully not make so many people at higher risk," she said. “I think it would ease the mindset.”
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans. Funding comes from the Corporation for Public Broadcasting.
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