Eating Disorders & the Military (August 2019)

Margot Rittenhouse, MS, PLPC, NCC
Instagram: @mentalhealthmargot

We all reminisce on the dreaded physical fitness tests of middle and high school gym class.

Do you remember the pressures of trying to compete with your classmates in running, push-ups, or sit-ups?

Many of us look back on those grateful that they aren’t required in the working world.

But, for the brave members of the US military, being able to run and do push-ups is a job requirement.

This is just one aspect that lends to the military subculture.

Those willing to sacrifice their lives for our country experience unique stressors and regulations that might increase their likelihood of developing a complicated relationship with themselves, their bodies, and food.

Physical Fitness Tests

The military is comprised of many different jobs. However, there is one thing that is required of each member – that they be combat-ready.

This is the ultimate reason for the existence of the Armed Forces and is also the reason behind the Physical Fitness Test.

Military members are required to maintain a degree of physical fitness and meet weight requirements as part of their agreement to serve.

Whether or not these requirements have their place and reasoning within the military establishment will not be argued in this article, as this is a larger subject with many facets.

However, it is important to note that, whether necessary or not, these requirements are associated with increased disordered eating and exercise behaviors.

One study found that 3.1% of active duty female personnel engaged in “situational eating disorder” behaviors, for example, “abnormal eating behaviors…practiced intermittently, typically in anticipation of weigh-ins or fitness testing, that are associated with significant distress or were judged as abnormal or dangerous [1].”

Engaging in these behaviors leading up to a Physical Fitness test does not appear to be uncommon, as many studies have found similar results such as high purging behaviors through vomiting, laxatives, and diet pills in female and male military” personnel [2].

These studies all come to the similar conclusion: that “military members may resort to unhealthy weight control behaviors to meet weight standards” set by the military [1].

Mental Health

Many things contribute to the relationship with food and our bodies, our mental health being one of them.

The pressure of the job, and potential trauma related to deployments and engagement in combat, can result in mental health challenges.

Nearly 1 in 4 active duty members of the US military show signs of a mental health condition, with a large number reporting the most common disorders as Major Depressive Disorder and Post-Traumatic Stress Disorder (PTSD), disorders that are strongly correlated with dual diagnosis of disordered eating [3].

Military members experience a unique trauma in that many of them engage in combat, an unimaginable stressor that can absolutely result in trauma and increases the risk for eating disorders.

In fact, one study found that “women who were deployed and experienced combat were almost twice as likely to develop an eating disorder as women who were deployed but did not have combat exposure [2].”

Many individuals that have been deployed experience PTSD, a disorder correlated with increased risk of eating disorder diagnoses [1].

Why This Matters

It should be quite clear why this information is incredibly important – these brave individuals are at risk.

Military members sacrifice their time, their families, their careers, and, sometimes, their lives to serve our country. While they are proud to do so, aspects of this puts them at higher risk for mental distress and disordered eating.

Individuals in the military already have an increased risk of suicidal ideation and behaviors, a risk that is also increased in individuals with eating disorders.

As such, the risk of suicide in military populations struggling with an eating disorder is incredibly high.

It is the hope of researchers, clinicians, and mental health advocates that awareness of these risks and their association with the unique experiences and subculture of the military allow for better screening during active duty and increased access to mental health support.