This article was contributed by a Mental Health Advisor from the Department of Veterans' Affairs
Eating disorders comprise a group of psychological conditions characterised by disordered food and body related cognitions, difficulties with self-regulation, and disordered eating behaviours (American Psychiatric Association [APA], 2013; Hay et al., 2014). Eating disorders present serious psychological and physical disability and have high rates of mortality (Bartlett and Mitchell, 2015).
There is limited research, particularly in Australia, exploring eating disorders in military populations, perhaps due to the misconception that eating disorders only affect females, and such concerns are not relevant in a male dominated environment. However, international research suggests that both male and female veterans do experience eating disorders (Bartlett & Mitchell, 2015). The rate of eating disorders in veterans is comparable to prevalence estimates of eating disorders in the general population (Mitchell, Rasmusson, Bartlett & Gerber, 2014). Such rates may be aligned with an increase in younger service members and female service members (Bartlett & Mitchell, 2015; Mitchell et al., 2014).
The research to date indicates increased exposure to stress and trauma to be linked to the development of disordered eating and eating disorders in both civilian and military cohorts (Brewerton, 2007; Forman-Hoffman et al., 2012; Rayworth, Wise, & Harlow, 2004). Additional evidence suggests that disordered eating behaviour may be a coping strategy to manage psychiatric symptoms, including negative affect (Jacobson et al., 2009; Forman-Hoffman et al., 2012; Maguan et al., 2012; Heatherton et al., 1991), with those veterans experiencing symptoms of post-traumatic stress disorder (PTSD) and depression more likely to meet criteria for binge eating disorder (Hoerster et al., 2015).
Bartlett and Mitchell (2015) conducted a review of the literature on eating disorders across military and veteran populations and found having comorbid mental disorders was linked, in both male and female veterans, to a higher incidence of eating disorders (Maguen, et al., 2012). There is also evidence to suggest that comorbid mental health conditions associated with an eating disorder diagnosis differ between men and women, with men experiencing mood disorders and substance abuse or dependence disorders and women experiencing mood disorders and personality disorders (Striegel-Moore, et al., 1999: Striegel-Moore, et al., 1999).
The military presents an environment that prides itself of discipline and high standards of physical fitness. The comparable prevelance of eating disorders in veterans to the general population (Mitchell et al., 2014) and the high rate of US veterans who are overweight and obese (Vieweg et al., 2007), highlights the risk that disordered eating behaviours may persist or develop following discharge from service as veterans attempt to lose or control their weight and cope with changes in lifestyle and routine.
National research in Australia focusing on lifetime prevalence of eating disorders among members who have left the military is yet to be undertaken. This could be a future direction for research to help inform targeted interventions and effective management of eating disorders for both current and ex-serving military personnel.
If you, or someone in your care is experiencing difficulties with an eating disorder, or other mental health concern, there are a number of resources available to support veteran and military personnel. These are discussed in the next article, ‘Veterans, ADF Personnel and Family Support Pathways’.
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