According to the National Guard Association of the United States, Eating disorder diagnoses among military members have risen 26% over five years (1). The military and anorexia have a complicated relationship. Military personnel undergo unique life experiences that can make them more vulnerable to these disorders.
In this 3-part series, we will examine how military members’ life and experiences can make them vulnerable to each of the three main eating disorder diagnoses and make accessing treatment a challenge, beginning here with anorexia nervosa.
Unique Vulnerabilities in the Military for Anorexia
Anorexia nervosa is characterized by an intense fear of weight gain, distorted body image, and restrictive eating behaviors. Individuals struggling with anorexia are often fixated with the “thin ideal” perpetuated by society and have an intense fear of having body fat.
Military culture can precipitate or worsen these fears due to the fitness culture required for members to be “deployment ready.”
Many military objectives related to exercise, food, and the body indicate that “body fat connotes a lack of personal discipline, distracts from military appearance, and may incite a poor state of health, physical fitness, or stamina (2).”
While none of this is accurate, it is accepted in military culture. The consequences of not meeting requirements based on these misconceptions are great. Military members can face retribution from their chain of command or be discharged from service, losing their job, stability, and income.
Anorexia nervosa is also a disorder related to mental and emotional concepts of power and control, both of which are extremely prevalent in the military. Military culture values individuals giving the appearance of control over themselves, their behaviors, and their physical and emotional state.
“Discipline, rank, teamwork, strict regimens, and designated rules are all factors of control and perfection” and can precipitate the onset of ineffective coping and weight exultation skills that can lead to anorexia (3).
In a culture that values these traits, the shame and guilt inflicted on those who have “lost” them can be damaging both to the individual and to their career.
Our knowledge of military members with anorexia is fairly limited, and a large part of that is due to a lack of reporting. The consequences related to acknowledging a mental health issue in the military deter individuals from reporting their struggles with eating disorders, which then acts as a barrier to seeking and receiving treatment.
Eating disorder treatment is not a short process and can involve months, or years, of intensive treatment depending on the severity of the disorder.
For those with anorexia, this can take even longer, as they may need to be medically stabilized before they can even begin the deeper work of examining what thought patterns and beliefs contribute to their dangerous behaviors.
Taking this much time out of work is not accepted in our culture whatsoever and is particularly not in the military. Not only that, but the military also differs from any other career in that the individual’s boss and employer are wrapped up in many aspects of their lives, such as their insurance or medical treatment.
The belief of many military personnel is that they would rather continue to struggle or attempt self-help than reach out for help and have their chain of command aware of their disorder and its impact on their functioning.
That aside, it is also difficult to find treatment centers that are approved to provide services for those with Tricare, the military insurance company. Additionally, individuals have to do the same song-and-dance that many others struggling with anorexia must do, fight with their insurance companies to have treatment approved.
A bill is currently in Congress requesting broader access to eating disorder treatment. The bill would “encourage – but not require – the Defense Department to cover residential treatment centers under Tricare for adults with eating disorders and train leaders to recognize the signs of such behaviors (4).”
This hope is that, if passed, some of the deterrents to those struggling with anorexia nervosa in the military will be reduced, allowing them to be honest about their struggles and receive the help that they need.
Resources Unknown (2020). Eating disorders rise among military members. National Guard Association of the United States, retrieved from https://www.ngaus.org/about-ngaus/newsroom/eating-disorders-rise-among-military-members.  Bodell, L.,et al. (2015). Consequences of making weight: a review of eating disorder symptoms and diagnoses in the United States military. Clinical Psychology, 21:4.  Unknown (2019). Eating disorders in the military. Center for Discovery, retrieved from https://centerfordiscovery.com/blog/eating-disorders-military/.  Kime, P. (2019). Bills seek to improve training, Tricare health coverage for eating disorders among troops, family members. Military Times, retrieved from https://www.militarytimes.com/pay-benefits/2019/10/24/bills-seek-to-improve-training-tricare-health-coverage-for-eating-disorders-among-troops-family-members/.
About the Author:
Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.
As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.
The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published September 17, 2020, on EatingDisorderHope.com
Reviewed & Approved on September 17, 2020, by Jacquelyn Ekern MS, LPC