Eating disorders are mental health disorders that come with additional physical health problems. Anorexia nervosa and bulimia nervosa are two of the most common eating disorders.
Active-duty service members have an increased risk of developing disordered eating during their service. The VA uses the General Rating Formula for Eating Disorders to determine the disability rating, which ranges from 0% to 100%.
In this article about eating disorders:
Eating Disorders and Mental Health
Eating disorders are severe mental health conditions. In fact, a death related to eating disorders happens every 52 minutes.
People who struggle with disordered eating are likely to focus intensely on weight and body image. As a result, they develop negative relationships with food leading to unhealthy eating habits that threaten their ability to get adequate nutrients. Although it is a mental health diagnosis, an eating disorder impacts the heart, digestive system, bones, and more.
Eating Disorders in the Military
Active-duty service members have a high risk of developing an eating disorder while in service.
Though the exact percentages found in studies vary, experts agree that eating disorders are prevalent in the military and may be increasing over time.
According to an Armed Forces Health Surveillance Center study, 3,527 service members were diagnosed with anorexia nervosa, bulimia nervosa, or an unspecified eating disorder between 2004 and 2013.
Marines were the most likely of any military group to receive a diagnosis, and younger service members were more likely to develop an eating disorder than older members.
Eating Disorder Prevalence in Women Service Members
Women in the military are 20 times more likely to struggle with disordered eating than men.
A 2014 study found that 33.6% of active-duty women studied were at risk for an eating disorder compared to 10 to 16% of civilian women. In addition, women service members who experienced combat were twice as likely to be diagnosed with disordered eating than women who did not see combat.
Eating Disorder Causes and Risk Factors
Military situations that increase the risk of developing an eating disorder include:
Trauma and Stress
Trauma and stress are significant contributors to the development of eating disorders.
Specifically, veterans with military sexual trauma (MST) saw an increased likelihood of being diagnosed with an eating disorder. Male veterans with MST were twice as likely to have an eating disorder than male veterans without MST.
Experts also cite post-traumatic stress disorder (PTSD) from combat as a cause for developing an eating disorder. If a veteran has been diagnosed with PTSD due to their service, they may be eligible for service connection for an eating disorder on a secondary basis.
A Focus on Military Height and Weight Standards
Not meeting weight or physical fitness standards could mean an end to a service member’s career. With that consequence looming, service members can become obsessed with meeting or exceeding these standards, ultimately developing an eating disorder.
Another risk factor is the act of being weighed in front of fellow service members, a moment especially significant in an environment where 50% of service members reported a negative experience with weight stigma.
U.S. Army Height and Weight Standards
The Army has had some version of weight or body fat requirements in place since 1808. The latest version, Army Regulation 600-9, was proposed in 1976. This regulation created the Army Body Composition Program (ABCP), a systematic approach to body fat requirements. Under AR 600-9, active-duty soldiers are weighed at least every six months.
Soldiers who weigh above the amount listed in the Army Weight for Height Table, depending on their age and height, must have their body fat measured via a tape test. If their body fat also exceeds the Army’s listed maximum, they must participate in the ABCP, where the unit’s master fitness trainer and dietitian are tasked with getting the soldier to meet the body fat standards.
According to the table, a 25-year-old 5’7” male soldier should weigh a maximum of 169 lbs, and a 25-year-old 5’7 female soldier should weigh 161 lbs. The table is available here beginning on page 23.
The Military Tape Test and Eating Disorders
When soldiers weigh above the maximum weight standard for their sex, age, and height, they must have their body fat measured.
As set in Army Regulation 600-9, body fat is measured with a measuring tape. Different parts of the soldier’s body are measured, and a chart determines their body fat percentage.
For many soldiers, the military tape test is a stressful ordeal and a significant risk factor for developing an eating disorder.
Dietitians and eating disorder experts note that the scale used was created in the 19th century and may not have a scientific basis. The thresholds of the scales also result in weights below national civilian health guidelines. Another criticism of the tape test is that there are too many opportunities for human error. Measurements must be precise and taken at the exact right spot for each body part. The Army is reviewing the process and expects to complete a report about it in early 2022.
Symptoms of Eating Disorders
Veterans with eating disorders may see symptoms related to weight loss and a focus on controlling food and eating habits. They may experience both emotional and behavioral symptoms.
Some of the symptoms of eating disorders include :
- Frequent dieting or skipping meals
- Refusing to eat around others
- A focus and concern with body size
- Mood swings
- Weight changes
- Gastrointestinal issues
- Anemia and weakness
- Dental problems
Anorexia nervosa
Veterans with anorexia nervosa undergo dramatic weight loss. They are unable to maintain an appropriate weight. They may either excessively diet, excessively exercise, or both.
Bulimia nervosa
Veterans with bulimia nervosa eat large amounts of food in a short period, then purge the food. They may induce vomiting manually or with drugs or take laxatives.
How Does the VA Rate Eating Disorders?
The VA rates eating disorders using the General Rating Formula for Eating Disorders, which includes Anorexia nervosa (diagnostic code 9520) and Bulimia nervosa (9521).
The agency rates these disorders at 0, 10, 30, 60, or 100%. The ratings are based on:
- Severity of the symptoms
- Weight (using a formula that includes sex and height to determine minimum weight standards)
- Number of incapacitating episodes (periods when a veteran diagnosed with an eating disorder is under a physician’s care, either at a hospital, or home on bed rest)
VA ratings for eating disorders
| Rating | Description |
|---|---|
| 0% | Veterans with symptoms of bulimia nervosa or veterans who are avoiding weight gain while below their expected minimum weight may be rated at 0% if they have been diagnosed with an eating disorder but have had no incapacitating episodes. |
| 10% | Veterans with symptoms of bulimia nervosa or veterans who are avoiding weight gain while below their expected minimum weight may be rated at 10% if they have been diagnosed with an eating disorder and have had up to two weeks of incapacitating episodes. |
| 30% | Veterans who weigh less than 85% of their expected minimum weight and have experienced two to six weeks of incapacitating episodes are rated at 30%. |
| 60% | Veterans who weigh less than 85% of their expected minimum weight and have had at least six weeks of incapacitating episodes are rated at 60%. There is no hospitalization minimum. |
| 100% | Veterans who weigh less than 80% of that expected minimum may receive a 100% rating if they also have had incapacitating episodes for at least six weeks in one year and have been hospitalized at least three times during the year to receive additional nutrition. |
Filing a Claim for Eating Disorder VA Benefits
Veterans with an eating disorder must file a claim explaining how their military service caused their disorder. They should mention their specific diagnosis, when they were diagnosed, and any hospitalizations or incapacitating periods.
For a free review of the initial claim, veterans should contact a Woods & Woods VA disability lawyer before filing. The Woods & Woods team will make sure the claim includes all the required and recommended pieces of information and that it arrives at the correct office.
Here are some tips on your C&P exam from one of our VA disability lawyers.
How Woods and Woods Can Help
Consulting with Woods and Woods for free guidance on your initial claim will get veterans the benefits they need quicker and help avoid the appeals process.
If you are going through an appeals process, an experienced Woods and Woods VA disability lawyer will develop an innovative and strong case strategy with a research support team of accomplished lawyers and doctors. Woods and Woods has represented thousands of veterans and can provide all the resources your case needs to be successful.
Talk to Us About Your Claim:
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FREQUENTLY ASKED QUESTIONS
Trauma and stress can be significant contributors to the development of eating disorders. Specifically, veterans with military sexual trauma (MST) are more likely to be diagnosed with an eating disorder. Male veterans with MST are twice as likely to have an eating disorder than male veterans without a positive screen for MST. Experts also cite post-traumatic stress disorder (PTSD) from combat as a cause for developing an eating disorder.
Women in the military are 20 times more likely to receive an eating disorder diagnosis than men. A 2014 study found that 33.6% of active-duty women studied were at risk for an eating disorder compared to 10-16% of civilian women. In addition, women service members who experienced combat were twice as likely to be diagnosed with an eating disorder than women who did not see combat.
