By: Emily Ricker, PhD, CHAMP Scientist, Injury Prevention Laboratory
Are you stuck in rigid diet rules? Do you assign morality to food? Do you justify your food choices based on the exercise you did or didn’t do that day? Have you fallen into restrict–binge–restrict cycles? Think about the following statements:
“I can’t eat after 6 p.m., or else I’ll gain weight.”
“Bananas have so much sugar, so I can never eat them.”
“I was so ‘good’ this morning with my food restriction, but now I can’t stop eating everything in my pantry!”
“I ate so much at Thanksgiving last night, now I have to run 10 miles to work it off.”
“Sorry, no thanks to a piece of birthday cake. I don’t let myself have gluten or added sugar.”
If any of these sentiments resonate with you, or if you often find yourself having similar thoughts, it’s possible you’ve experienced disordered eating.
Disordered eating (DE) refers to irregular eating attitudes and behaviors that might not fit the criteria for eating disorders, but can be detrimental to physical and mental health and performance. Behaviors can include frequent dieting, skipping meals, unwarranted avoidance of certain food groups, compulsive or binge eating, guilt and shame associated with eating, compulsion to eat in secret, constant thoughts about eating and body image, restricting food or fasting to make up for “bad” eating or overeating, and more. Eating disorders fall on the severe end of the disordered eating spectrum.
Eating disorders are serious psychiatric conditions—anorexia nervosa, bulimia nervosa, binge eating disorder, and more—that have strict diagnostic criteria. DE is important to recognize, as it might progress to serious ED if not addressed.
Prevalence of disorders
DE is more common among athletes who participate in sports that emphasize weight or aesthetics, such as distance running, gymnastics, figure skating, dancing, diving, and others. In the military, unique triggers for DE include the pressure to maintain a certain body weight and body fat to meet military requirements, operating in psychologically and physically stressful environments, or rigorous training schedules with minimal time to eat. These triggers result in learned poor eating habits. It’s important to note, you don’t have to look a certain way—underweight or overweight—to suffer from DE or ED. Although females are more often affected than males, emerging research suggests transgender and nonbinary individuals are also impacted by DE and ED.
Only 5–8% of females and 0.1% of male Service Members are actually diagnoses with ED. However, 63% of women and 41% of men in the military self-report some form of disordered eating. This suggests that Service Members might be hesitating to seek medical care for ED and DE. Because ED is a psychiatric condition, Service Members might fear being stigmatized or removed from their training or duty assignments for reporting them. In reality, discharge from service for ED can only occur if the Service Member is unresponsive to treatment or the disorder substantially interferes with their military duties. One of the most proactive ways to prevent discharge is to seek medical care.
Medical care
What happens if you seek medical care? There is such a wide range of DE and ED behaviors, but a variety of medical treatments and medical professionals are available. For instance, a diagnosis of anorexia nervosa requires more rigorous intervention, including inpatient or outpatient medical supervision to safely increase nutrient intake and restore body weight, while also addressing the underlying mental processes which led to the development of the disorder. Psychological therapy—especially cognitive behavioral therapy (CBT)—is an important part of treatment to support healing your relationship with food and eating.
As awareness for ED and DE in the military grows, policymakers are working to make changes that will improve care and treatment for those who suffer from these conditions. The 2022 National Defense Authorization Act includes provisions to expand access to health care for ED among Service Members and their dependents. This policy highlights the need for medical intervention for these serious psychological conditions.
Help is available if you, or someone you know, is experiencing symptoms of DE or ED. Healthcare providers—including registered dietitians, psychiatrists, and psychologists—are trained to help you overcome DE and ED. For more information visit, the National Disorders website. Optimal nutrition—unimpeded by DE and ED—is a vital part of your health. As a Service Member, you deserve to have a positive relationship with food and eating
The opinions and assertions expressed herein are those of the author and do not reflect the official policy or position of USUHS or DoD. The contents of this publication are the sole responsibility of the author and do not reflect the views, opinions, or policies of The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government. The author has no financial interests or relationships to disclose.
