Eating Disorders, Post-Traumatic Stress, and Sexual Trauma in Women Veterans

Abstract

We examine lifetime eating disorders (EDOs) and associations with post-traumatic stress disorder (PTSD) and sexual trauma during various stages of the life course (childhood, during military service, and lifetime) among women veterans. The sample included 1,004 women aged 20 to 52 years who had enrolled at 2 Midwestern Veterans Affairs Medical Centers or outlying clinics completed a retrospective telephone interview. Over 16% reported a lifetime EDO (4.7% had received a diagnosis, and an additional 11.5% self-reported suffering from an EDO). Associations were found between lifetime EDO, PTSD, and sexual trauma. Relationships maintained significance for both diagnosed and self-reported EDOs as well as lifetime completed rape and attempted sexual assaults. Sexual trauma during military service was more strongly associated with lifetime EDOs than childhood sexual trauma. The significant associations found between EDOs, PTSD, and sexual trauma indicate that EDO screening among women veterans with PTSD or histories of sexual trauma may be warranted.

The Role of Borderline Personality Disorder and Depression in the Relationship Between Sexual Assault and Body Mass Index Among Women Veterans

“…We did not find significant relationships between current depression and PTSD and greater BMI in this sample. Furthermore, even though our null findings regarding PTSD is consistent with recent work among veterans (Barber, Bayer, Pietrzak, & Sanders, 2011), these results were surprising especially because PTSD among women veterans has been associated with weight-related conditions, ranging from eating disorders (Forman-Hoffman, Mengeling, Booth, Torner, & Sadler, 2012;Maguen, Ren, Bosch, Marmar, & Seal, 2010) to obesity (Dobie et al, 2004). But although leading theoretical models show PTSD as the primary mechanism leading to poor physical health (Schnurr & Green, 2004), we found that a lifetime diagnosis of depression and BPD were associated with poor physical health conditions, specifically greater BMI in this population.…”

Eating disorders and associated mental health comorbidities in female veterans

“…Third, approximately 75% of individuals with anorexia nervosa (AN) and bulimia nervosa (BN) are female (Hudson et al, 2007), and the number of female service members has increased markedly during the current conflicts. Fourth, exposure to potentially traumatic experiences may put male and female service members and veterans at increased risk for EDs (Forman-Hoffman et al, 2012; Mitchell et al, 2012), as disordered eating behaviors may be used to cope with negative affect (Heatherton and Baumeister, 1991). …”

“…Two recent studies examined EDs in more general VA samples. One investigation of 1004 female veterans found that 4.7% had been diagnosed with an ED, and an additional 11.5% reported that they had ED symptoms (Forman-Hoffman et al, 2012). A second study administered the Structured Clinical Interview for the DSM-IV and found that 4.6% of female veterans ( n = 346) and 0.7% of male veterans ( n = 1354) of the current Iraq and Afghanistan conflicts had a lifetime history of any ED (Curry et al, 2014).…”

Gender Disparities Among Veterans: The High Rate of Post-Traumatic Stress Disorder Among Women in the Military

“…Dissociation from the body, as a result of sexual trauma, may also lead to eating disorders. The VA offers few, if any, eating disorder programs (Forman-Hoffman, Mengeling, Booth, Torner, & Sadler, 2012). The need for better screening of PTSD risk factors, such as eating disorders, and treatment for comorbidity with other psychiatric disorders has never been greater.…”