Mengeling MA (University of Iowa), Booth BM
(Center for Mental Health Care Outcomes and Research (MHCOR): Central Arkansas Veterans HCS), Torner JC
(University of Iowa), Sadler AG
(Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP), Iowa City VAMC)
Previous studies have found associations between eating disorders and traumatic life events. Thus, female veterans who have experienced both sexual trauma as well as combat-related trauma may have increased risk of eating disorders as a reaction to negative life experiences. The objectives of this study were to: 1) determine the prevalence of eating disorders and related attitudes and behaviors, and 2) define the association between trauma (lifetime sexual assault attempts and post-traumatic stress disorder) and eating disorders in a sample of female veterans.
The cross-sectional sample included 774 female Gulf War and OIF/OEF veterans 20 to 51 years of age (mean=39.1, s.d.=8.5) who participated in a detailed computer-assisted telephone survey to determine: lifetime prevalence of eating disorders; weight; eating and health behaviors and attitudes; perceptions about their weight; prior sexual assaults and other trauma; and PTSD symptoms. Logistic regression was used to determine the associations of reported lifetime sexual assault and PTSD with lifetime eating disorders, adjusting for demographic and health-related covariates (e.g., weight category, alcohol abuse, drug use).
15% of respondents reported that they had previously been diagnosed with an eating disorder. Over half (56%) of respondents reported not being satisfied with their eating patterns, over two-thirds (67%) reported that weight affects how they feel, and 10% reported eating in secret. Those who had suffered from an eating disorder were more likely than those without eating disorders to have experienced a lifetime sexual assault (attempted and/or completed rape) (86% vs. 59%, p < .001) and to have PTSD (39% vs. 21%, p < .001). In adjusted logistic regression models, the relationships between suffering from an eating disorder and lifetime sexual assault attempt (OR=3.57, 95%CI=2.04-6.24) and PTSD (OR=2.10, 95%CI=1.36-3.24) remained significant.
The lifetime prevalence of eating disorders in female Gulf War and OIF/OEF veterans is substantial. Such veterans are at increased risk of PTSD and to have experienced sexual and other traumas.
Given the recurrent nature of eating disorders, female veterans should be monitored for comorbid eating disorders. This may be particularly true for women with PTSD and with histories of trauma exposures.