A Silent Battlefront
Like many who struggle with eating disorders, my battle with Bulimia began as a means of exerting control but ultimately led to a loss of control. I joined the Navy when I was 18, but my experience with Bulimia didn’t start until around age 30. I hid it for a very long time. I was “good” at it. I had my rituals and my routines which kept my secret. Nobody suspected what I was fighting. I never “looked” like I had an eating disorder. I made it through the ranks quickly and after 17 years in the Navy, found myself selected for a position as a Master Chief Petty Officer, a Submarine Chief of the Boat (the Senior Enlisted Sailor on a Nuclear Attack Submarine).
Bulimia consumed every facet of my life. It almost cost me my family, and very nearly broke me. In September 2019, I came forward and said I couldn’t keep living my life the way I had been. This monster was going to kill me, either through self-hatred and depression or physically by causing damage to my body. I was fortunate to have good leadership within the Submarine Force, a care team that aggressively helped me get into treatment, and a family that supported my recovery. I entered treatment in October 2019 and I was medically retired from the Navy for Bulimia in May 2021.
I had learned that recovery and my continued Naval service were going to be incompatible with each other.
Since my retirement, I’ve tried to be an advocate for awareness about eating disorders within the military. I’ve since met many others who have had similar stories to mine. There are slight differences, but our stories are generally very similar. These are some of the things that fellow Veterans who have experienced eating disorders within the military and I have discussed:
The military is a profession that places an extremely high emphasis on body image. Typically, people think of models, actors, swimmers, dancers, etc., when they think of a job with a high emphasis on body image, but it’s present in the service too. Failing a weigh-in is a “career killer.” My dress uniform was that “little black dress” in my closet that got pulled out maybe three or four times a year for public events. Every time was nerve-wracking because I knew I was being judged for how I looked. All my self-worth was in that uniform and how it fit my body.
Saunas, sweat suits, excessive exercise, starvation, restriction, intermittent fasting, purging, laxatives. These behaviors are not only commonplace during the fitness test season, but are extremely high risk for falling down that slippery slope from disordered eating to an eating disorder.
Eating disorders are not really about the food. They are often about perfectionism and an insatiable self-critic. In the service, we operate in a “zero deficiency” world that is always chasing perfection. We are hyper-focused on critical-self-analysis. The traits that make you a high performer are things that an eating disorder can also latch onto. Chasing perfection, never celebrating victory because you’re too worried about the next obstacle, catastrophizing every situation, never focusing on yourself and always giving to the mission or your unit, being unable to receive a compliment and taking the good away from something, etc. Objectively, if that is your mindset, you’ll probably be a high performer. Some of the people who are our best, most dedicated team members – the people who look like they are firing on all cylinders and performing at their very peak – are also those at a higher risk for developing eating disorders.
Many of the other traditional maladaptive coping behaviors that have plagued the military are difficult to hide and have programs in place to help. Want to quit smoking? Medical will help you with that. Deter drug and alcohol use? There are random urinalysis and breathalyzers. The Navy has a zero-tolerance policy for drugs and harsh punitive measures for alcohol abuse offenders. It does, however, provide treatment for those who are suffering and ask for help. This has unintentionally created an environment that can lead people to begin trying to control food and/or their bodies instead. The “high” created by purging or restricting is very similar to the initial euphoric effect of drugs or alcohol. It’s an escape. A form of self-harm and self-destruction that can sometimes actually reinforce the behavior with “better” performance on a weigh-in or physical fitness test. And it’s hard to get caught. It’s secretive, shameful, and stigmatized. People want to support the mission and do right by their fellow service members, so they won’t be honest on pre-deployment health screenings. Because they care.
It’s challenging because we cannot just get rid of the standards that are necessary to maintain an effective fighting force for our country. It makes sense to hold our warfighters to a certain level of health and fitness so that they’ll be able to endure combat situations, but the standards should be just that – about stamina and strength, not body size. So what does doing better look like? How can we do right by those who have served and are now left with the fallout of an eating disorder that has a direct root in their service for their country? It looks like leadership being aware of the problem plaguing our Soldiers, Sailors, Aviators, Guardians, and Marines.
Leadership must understand the co-morbidity and risk factors for eating disorders. There is a direct, common-sense correlation between having a profession that places an extremely high priority on body image, weight, and fitness with eating disorders.
Leadership must be aware of the slippery slopes. The military focuses a lot on preventing suicide and sexual assault, providing drug and alcohol treatment, and improving mental health awareness (specifically about depression and anxiety). We must have that same level of awareness and energy focused on preventing and treating eating disorders. Hire therapists and medical professionals who are equipped to deal with the challenges of eating disorder treatments. De-stigmatize seeking help. Create engaged and involved leaders who are aware of warning signs and educated on treatment options. Educate leadership on the complexities of treatment for eating disorders and how unlike with substance abuse, abstinence/avoidance is not an option. Eating disorder treatment requires constant, daily, hourly confrontation.
Partner with TRICARE and its subsidiary/contracted health care providers to provide coverage for care at eating disorder treatment facilities. Remove the barriers that exist within the insurance paradigm. It is extremely difficult to navigate finding a treatment facility that will take TRICARE.
Ensure that the Veteran’s Health Administration updates and revises its standards for claims on eating disorders. The current Schedule for Ratings for Disabilities — Eating Disorders only provides a disability percentage for veterans with an eating disorder if they are medically underweight and have had an incapacitating period of bed rest. This is contrary to what is known about dating disorders – less than 6% of people with eating disorders are medically underweight.
Smash the incorrect stigma that eating disorders are “a female problem” in order to help men come forward if they are struggling. In reality, research shows that 25-40% of people with eating disorders are men or boys.
As with most problems and challenges, mitigations and solutions cannot begin to take effect until we admit that there is a problem to begin with. Military leadership must understand the correlations between the Military environment and eating disorders. We have unintentionally created a “perfect storm” of circumstances that will continue to lead to the development of eating disorders within our nation’s warfighters.
Retirement and recovery have gone hand-in-hand for me. I had tied so much of my self-worth into my professional identity and so much of my professional identity was tied to my eating disorder. The anxiety and self-hatred that came with Bulimia made me good at my job until I collapsed from the pressure and shame. I like to frame recovery as growth. Yes, I’ve grown into a larger body physically, but I’ve grown in a lot of other ways too. I’ve grown in my capacity for self-love, empathy, compassion, and love for my family and support network. There are many Veterans and service members who are continuing to fight these unseen battles in their minds and bodies. If you’re one of those people, know that you are not alone. There are others who have been on a similar journey. We’re out here and just like when we served together, we’ve still got your back.
