Combat may raise eating disorder risk in women

Among military personnel, women who were deployed to combat areas were more likely to develop disordered eating and experience extreme weight loss than were women who were deployed but did not have combat exposure, according to the findings of a large study of the U.S. military.

Previous research identified high rates of disordered eating, such as the binge eating, induced vomiting, and excessive exercise to control weight characteristic of bulimia nervosa, among military personnel.

The current study, among 48,378 U.S. military personnel followed for 2.7 years on average, suggests that combat exposure may play a role in the development of disordered eating and weight loss, but only among women, report Isabel G. Jacobson, at the Naval Health Research Center in San Diego, California and colleagues.

Their study showed that deployed women who reported combat exposure were 1.78-times more likely to develop disordered eating, and 2.35-times more likely to lose 10 percent or more of their pre-deployment body weight, than were deployed women who were not exposed to combat.

"These associations were not found among men," the investigators note in the American Journal of Epidemiology.

Jacobson and colleagues followed the development of disordered eating and weight changes among 12,641 female and 33,578 male military personnel assessed from 2001 to 2003 and again from 2004 to 2006. The areas of deployment included Afghanistan and Iraq.

During this time, deployed personnel included 1,085 women and 4,351 men without combat exposure, and 870 women and 4,397 men with combat exposures. The remaining were non-deployed personnel.

In analyses of non-deployed and deployed personnel that took into consideration personal, military and behavioral characteristics, Jacobson's team did not find deployment significantly associated with the development of disordered eating among either women or men.

But further analyses of subgroups revealed an association between combat deployment and extreme weight loss and disordered eating among women, but not among non-combat exposed women or men with or without combat exposures.

The investigators suggest the need for further investigations to determine if combat-related trauma exposures or other factors, contribute to changes in weight and eating habits among military personnel.

SOURCE: American Journal of Epidemiology, February 2009.