Part 1: The Intersection of the US Military and Eating Disorders

Part 1: How Does Diet Culture Show Up in the Military?

It is no secret that talk about weight, size, and body shape is everywhere we look today. Diet culture is widely defined as a system of beliefs that value the appearance of the body over actual health and well-being. Usually, we consume diet culture through words and images that promote weight loss as a means of achieving higher status, worshiping thinness or relating thinness to health and moral virtue, and demonizing certain ways of eating while celebrating others. If you think of ways in which diet culture shows up in your everyday life, you might notice that there are very few places where it does not. What might be more difficult to realize is the harmful effect that diet culture has on our health and wellbeing, and it exists in places we might not have considered before. This series is meant to shine a light on those places to better our understanding of the harm and take action improving prevention and care–specifically for members of the United States Military.

The military branches that serve the United States–Army, Coast Guard, Air Force, Navy, Marine Corps, and now Space Force– consist of brave and selfless service members who give up so many liberties to protect our country’s freedom. My grandfathers, uncle, cousin, father, and sister all earned and proudly wear the title of United States Marine. Their values of integrity and hard work have laid a proud foundation for my entire family. I also had the opportunity to work under a Marine Corps dietitian during my own schooling to become a registered dietitian. It is during this time that I was able to witness the training and care that goes into the making and maintenance of a United States Marine in an even closer setting. Due to my direct experience with the Marines, you will see many references to this branch throughout this series.

Members of the military are considered some of the nation’s most elite athletes–with the ultimate goal of being combat-ready at all times. Understandably, there are standards in place as a framework for goals of physical and mental preparation and performance. Beyond regular fitness tests, however, there are also gender specific weight-for-height and body fat standards required to enter and stay in the services. These standards exist and vary across each branch.

These body standards are based on BMI and offer little ‘wiggle room,’ with some branches even lowering the percent body fat, weight, and BMI requirements after entrance in order to remain in the service. The Marines also do not change their standards for weight as their members age. Those who do not meet the standards for height and weight might have their waist/hip ratio or neck circumference measured for a second chance to prove they fall within the ‘minimum standard.’ If they do not meet the standard, they are placed into a Body Composition Program, where they undergo mandated counseling to lose weight to achieve the set standards. Being placed in this program results in an automatic negative annual report for those holding rank as sergeant or above.

Why is This Problematic?

The BMI, as well as the other above measuring techniques, are inaccurate and outdated measurements that do not inform us of the individual’s health or physical ability (for more information regarding why BMI is a poor indicator for health, click here). What these practices do result in, however, are disordered habits that are driven by the primary goal to lose weight as opposed to focusing on behaviors that promote positive relationships with food and adequately nourishing the body.

Now that we have an introduction to military body standards and their connection to diet culture, I will leave you with a few thoughts for Part 2, which highlights the effects of these standards through the prevalence of eating disorders amongst members of the military.

“Bulimic behaviors such as vomiting, strenuous exercise, and use of saunas or steam rooms were four times more common in those assigned to a military weight-management program. These results are more notable in that this group of individuals was predominantly male (Peterson, 1995)”

“Studies show that over 20% of children of servicemembers and 34% of female active duty military members are at risk of eating disorders, and according to a recent study 16% of female veterans meet the diagnostic criteria for an eating disorder (Eating Disorders Coalition, 2019)”

References

1. Artz, N. (2021, June 8). Diet culture: Definition, examples, & impacts. Choosing Therapy. Retrieved October 22, 2022, from https://www.choosingtherapy.com/diet-culture/
2. Bartlett, B. A., & Mitchell, K. S. (2015, December). Eating disorders in military and veteran men and women: A systematic review. The International journal of eating disorders. Retrieved September 10, 2022, from https://pubmed.ncbi.nlm.nih.gov/26310193/
3. Bodell, L., Forney, K. J., Keel, P., Gutierrez, P., & Joiner, T. E. (2014, December). Consequences of making weight: A review of eating disorder symptoms and diagnoses in the United States military. Clinical psychology : a publication of the Division of Clinical Psychology of the American Psychological Association. Retrieved September 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309979/
4. Disabled Vets. (2021, March 24). Eating disorders veterans benefits. Disabled Vets. Retrieved October 23, 2022, from https://www.disabledvets.com/claim-types/mental-impairments/eating-disorders/
5. Elisa. (2022, March 13). 8 reasons why BMI doesn’t Reflect Health. Follow the Intuition. Retrieved September 10, 2022, from https://followtheintuition.com/8-reasons-why-bmi-doesnt-reflect-health/
6. Huck, E. (2020, December 22). Military families experience eating disorders, too. National Military Family Association. Retrieved October 26, 2022, from https://www.militaryfamily.org/military-families-experience-eating-disorders-too/#:~:text=However%2C%20TRICARE’s%20low%20reimbursement%20rates,offering%20treatment%20for%20eating%20disorders.
7. Institute of Medicine (US) Subcommittee on Military Weight Management. (2004). Weight management: State of the science and opportunities for military programs. National Academies Press.
8. McNulty, P. A. (2001, January). Prevalence and contributing factors of eating disorder behaviors in active duty service women in the Army, Navy, Air Force, and Marines. Military medicine. Retrieved September 10, 2022, from https://pubmed.ncbi.nlm.nih.gov/11197099/
9. National Alliance for Eating Disorders. (2022). The National Alliance for Eating Disorders. Retrieved October 24, 2022, from https://findedhelp.com/
10. National Eating Disorders Association. (2019, August 22). Eating disorder statistics. National Eating Disorders Association. Retrieved September 10, 2022, from https://www.nationaleatingdisorders.org/toolkit/parent-toolkit/statistics
11. REDC. (2020). Serve Act (S. 2673/H.R. 2767). REDC . SASC/HASC. Retrieved September 2022, from http://redcconsortium.org/wp-content/uploads/2020/09/serve-infographic_house-senate-final.pdf.
12. Touma, D. A., Quinn, M. E., Freeman, V. E., & Meyer, E. G. (2022, July 5). Eating disorders in U.S. active duty military members and Veterans: A Systematic Review. Military medicine. Retrieved September 10, 2022, from https://pubmed.ncbi.nlm.nih.gov/35788384/
13. United States Government Accountability Office, Congressional Requesters: Department of Defense: Eating Disorders in the Military1–28 (2020). Washington, DC; GAO.