Military Values Manifested in Eating Disorders
Dedication:
Service demands unwavering loyalty; in eating disorders, dedication can be redirected towards rigid practices and rules often manifesting as an inflexible adherence to unhealthy routines.
Perfectionism:
Military precision is commendable; but in eating disorders, individuals may obsess in achieving an idealized body image or meeting Weight / BMI /BCA requirements.
Order and Control:
Discipline is a cornerstone of military life. However, the military can be chaotic at times. To maintain a sense of order, some people develop a need for extreme control over food intake, exercise, supplement use, appearance, or body weight, often to the detriment of one's health and well-being.
WHAT PEOPLE SAY
LT Meghan Quinn
"I ate less and exercised more. I knew something was not right, but I did not want anyone to notice. But people did notice, eventually. I brushed off comments and played dumb when concerns were brought up in medical appointments. It was only when I was directly confronted by a physician-mentor that I broke. But I refused to engage in treatment until my body quite literally gave up on me. I was so close to graduating from medical school that I was more worried about losing my future career than I was about losing my life."
Geoffrey Walker,
STSCM(SS), Ret
"They suffer in silence in order to continue to lead and take our ships to sea, using a coping mechanism that, although unhealthy and incredibly dangerous, secretly pushes them to the highest ranks of our Navy."
Carrie Hammond, ISCM(IW/SW/AW)
“My bosses loved me; my Sailors respected me. Up until the day of my panic attack not a single person knew the truth. The truth is that Senior Chief had an eating disorder.”
Eating Disorder Myths
EARLY INTERVENTION CAN PREVENT ESCALATION
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Stages to Eating Disorder
Intuitive Eating
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Food choices mainly influenced by hunger and preference
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Absence of guilt or shame around food
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Eat with spontaneity and flexibility
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Eat socially without stress or concern
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Use hunger and fullness cues to guide quantities at meals
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No fear foods or rules around eating
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Eat a variety of foods
Disordered Eating
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Food choices strongly influenced by desire to maintain a certain weight or body type
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Often feel guilt around eating certain foods
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Ignore hunger/fullness cues
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Comparing what you eat to others
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Have rigid rules around foods that you eat
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Think of food in “good and bad” mindset
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Directly links food intake to exercise compensation
Eating Disorder
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Food choices consistently influenced by goals of restriction, weight loss, or binge/purge behaviors
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Eat in isolation and avoid social occasions
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Engage in strict diet rules and behaviors, like measuring and weighing food
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Very limited variety of foods in diet
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Focus on food and weight directly impacts major areas of their life
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Feel a sense of panic or loss of control when eating foods that aren’t “safe”
Impacts of Eating Disorders on Health
A 2021 study reported that up to one-third of veteran women and one-fifth of veteran men report symptoms consistent with an eating disorder.
Eating disorders cause one death every 52 minutes, the second highest mortality rate among psychiatric conditions.
Suicide is the leading cause of death for those suffering with an eating disorder.
Exertion during active restriction or recovery can be life-threatening.
Active restriction includes various behaviors like bulimia, orthorexia, and reactive eating, not just anorexia.
Restrictive behaviors damage the heart muscle, cause electrolyte imbalances, and demyelinate nerves.
Effects on Health
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Muscle
Restriction leads the body to pilfer energy from muscles, bones, and organs, not just fat.
Fat is a critical hormone-producing organ; the body doesn't discriminate in energy deficit compensation.
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Electrolytes
Restriction and compensatory behaviors disrupt electrolyte balance.
Electrolytes support heart contraction; imbalances can be elusive in screenings.
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Arrhythmias
Arrhythmias result from muscle damage or electrolyte imbalances.
Tachycardia and bradycardia are common; low resting heart rates may be dismissed without proper evaluation.
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Nerves
Recovery from arrhythmias is quicker than nerve restoration.
Demyelination from energy deficits affects nerve function, crucial for heart regulation.
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Poor circulation, lack of available energy, electrolyte disturbances, increased physical demands, and hormonal imbalances can result in organ failure (heart, liver, and kidney).
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Dental problems, sleep disturbance, skeletal system complications, and reproductive system complications are common results of eating disorders.
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Depression and anxiety often occur with an eating disorder and can either precede and/or follow the disorder, and complicate treatment.
Effects on Health
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Athletes can sometimes perform well despite having a eating disorder, but eventually the athlete’s eating disorder begins to affect the athlete both physically and psychologically.
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Following a period of intense dieting / restricting, running speed usually decreases.
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Inadequate carbohydrate intake results in early glycogen depletion and fatigue.
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Inadequate carbohydrate intake results in increased use of protein as fuel.
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Inadequate protein intake can lead to muscle weakness, wasting and injury (increased risk of musculoskeletal injuries due to inability to build/repair muscle tissue damage).
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Dehydration leads to fatigue, poorer performance, and earlier glycogen depletion.
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Most athletes with eating disorders find they lose concentration and the capacity to play with emotion, in addition to the negative effects on the athlete’s physiology.
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Low Energy Availability Impact
Recognizing Disordered Eating Symptoms
"RED FLAG"
Intermittent Fasting/Restriction: Regularly skipping meals or boasting about fasting could indicate restrictive eating behaviors.
Fad Dieting: Obsession with trendy diets may be a red flag.
Weight Fluctuations: Frequent, unexplained changes in weight.
Pre-BCA (Body Composition Assessment) Anxiety:
Noticeable stress might suggest unhealthy preoccupation.
Compensatory Behaviors: Urgent bathroom trips post- meals (watch for watery eyes, flushed face). Misuse of laxatives, diet pills, ‘detox’ products.
Body Checking: Regularly measuring body parts or constant weighing can indicate body image concerns.
Excessive Exercise:
Intense and compulsive workout routines, beyond fitness requirements, may signal an issue.
Dehydration Tactics: Deliberate dehydration, (limited fluid intake followed by excessive use of a sauna or intense sweating)
What is Weight Stigma?
Weight stigma refers to the negative attitudes, beliefs, and stereotypes that society holds toward individuals based on their body weight or size. It encompasses discrimination, prejudice, and bias, often leading to harmful consequences for mental and physical health.
In a 2017 study of active duty service members, nearly half reported at least one experience of stigma within the military based on shape and/or weight. Stigma was associated with harmful thoughts and behaviors, including diet pill and laxative use, purging, and overeating.
Weight stigma can manifest in various ways such as:
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Weight stigma can occur in various settings such as:
HOME
WORKPLACE
GYM
Discrimination and Bias
Unfair treatment of individuals in various areas of life, such as employment, education, healthcare, and social interactions, solely based on their body weight or size.
Healthcare Disparities
In healthcare settings individuals may receive biased treatment or be subject to assumptions about their health based on their appearance. This can lead to avoidance of healthcare or delayed medical care.
Stereotyping
Assigning certain characteristics or traits to individuals solely based on their body weight. For example, assuming that someone with a higher body weight lacks discipline or has poor health habits.
Media Influence
The portrayal of idealized and often unrealistic body images in the media contributes to societal standards that stigmatize individuals who do not conform to these ideals.
What YOU CAN DO...
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Learn about eating disorders
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Find an appropriate time and place to talk to the individual in private.
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Communicate your concerns using “I” statements.
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Stress the importance of professional and specialized help.
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Validate their feelings, struggles, and accomplishments and express your support.
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Don‘t attempt to solve or “fix“ their problems.
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Don’t comment on calorie/food intake, weight, appearance, etc.
