Risk Factors and Comorbidities of Eating Disorders in a Large Military Cohort

The goal of this study is to determine the prevalence of eating disorders (EDs) among military personnel and examine risk factors for their onset and recurrence, especially military-specific exposures. We also described patterns of comorbidity between EDs and other mental health conditions (e.g. PTSD, depression, and problem drinking), particularly regarding order of onset. Finally, the study explores whether certain family system stressors as well as individual or relationship factors, are associated with EDs in military spouses. In the second year of the study, nearly all subtasks were completed on schedule, with finalization of all tasks imminent within the next two months. The prevalence of EDs using medical record and survey data ranged from less than 1 percent to 1.4 percent for Bulimia Nervosa (BN) and less than 1 percent to 5.4 percent for Binge Eating Disorder (BED; Table 2). Mental health disorders, lack of social support and stressful life events were strongly and consistently associated with the development of EDs (Table 4). Further, although evidence of bidirectionality emerged between BED and 3 of the 4 mental health outcomes (Depression, Anxiety, Problem Drinking), mental health was consistently a stronger predictor of subsequent BED. Finally, spouses who screened positive for PTSD, experienced an adverse childhood event, or were former smokers were more likely to develop BED. These findings have implications for the assessment and treatment of military personnel and spouses with eating disorders.