DSM-5 eating disorder prevalence, gender differences, and mental health associations in United States military veterans

Int J Eat Disord. 2021 Jul;54(7):1171-1180. doi: 10.1002/eat.23501. Epub 2021 Mar 5.

Abstract

Objective: Little is known about prevalence estimates of new and revised DSM-5 eating disorders diagnoses in general, and especially among high-risk, underserved and diverse eating disorder populations. The aim of the current study was to determine prevalence, gender differences and correlates of DSM-5 eating disorders in veterans.

Method: Iraq and Afghanistan war era veterans (N = 1,121, 51.2% women) completed the Eating Disorder Diagnostic Scale-5 and validated measures of eating pathology and mental health between July 2014 and September 2019.

Results: Overall more women than men (32.8% vs. 18.8%, p < .001) reported symptoms consistent with a DSM-5 eating disorder. Prevalence estimates (women vs. men) for the specific diagnoses were: Anorexia Nervosa (AN; 0.0% vs. 0.0%), Bulimia Nervosa (BN; 6.1% vs. 3.5%), Binge-Eating Disorder (BED; 4.4% vs. 2.9%), Atypical AN (AAN; 13.6% vs. 4.9%), Subclinical BN (0.0% vs. 0.2%), Subclinical BED (1.4% vs. 0.6%), Purging Disorder (2.1% vs. 0.7%), and Night Eating Syndrome (NES; 5.2% vs. 6.0%). Women were more likely to have BN or AAN, and there was no difference for BED or NES among genders. The eating disorder group had a higher mean BMI, and significantly greater eating pathology and mental health symptoms than the non-eating disorder group.

Discussion: Approximately one-third of women, and one-fifth of men, reported symptoms consistent with a DSM-5 eating disorder diagnosis. These high prevalence estimates across genders, and associated mental health concerns, suggest an urgent need to better understand and address eating disorders in military and veteran populations.

Keywords: anorexia; atypical anorexia; binge-eating disorder; bulimia; eating disorders; night eating syndrome; other specified feeding and eating disorders; prevalence; veterans.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anorexia Nervosa*
  • Binge-Eating Disorder*
  • Bulimia Nervosa*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Feeding and Eating Disorders* / diagnosis
  • Feeding and Eating Disorders* / epidemiology
  • Female
  • Humans
  • Male
  • Mental Health Associations
  • Prevalence
  • Sex Factors
  • United States / epidemiology
  • Veterans*