Eating Disorders and Psychiatric Comorbidity among Iraq and Afghanistan Veterans



      Individuals with mental health problems are at elevated risk for eating disorders. Veterans serving in support of the conflicts in Afghanistan and Iraq (OEF/OIF) have a high prevalence of deployment-related mental health problems, but little is known about their risk for eating disorders. Our aim was to determine rates of eating disorder diagnoses among OEF/OIF veterans with mental health problems, particularly among those with comorbid mental health problems.


      This retrospective, cross-sectional analysis of nationwide VA healthcare facilities used descriptive statistics and regression analyses to determine eating disorder rates in OEF/OIF veterans who were new users of VA healthcare from October 7, 2001 to December 31, 2010 (N = 593,739).


      Although the prevalence of eating disorder diagnoses was 0.007% (n = 465) in women and <0.001% (n = 192) in men, veterans diagnosed with mental health problems were significantly more likely to have an eating disorder than those without mental health diagnoses. Eating disorders were significantly more common in women with depression, posttraumatic stress disorder, and alcohol and/or drug use disorders than in women veterans without these mental health disorders. Among men, the associations between eating disorder diagnoses and comorbid mental health diagnoses closely paralleled those observed in women.


      Rates of eating disorders are significantly higher among returning veterans with comorbid mental health problems compared with those without mental health diagnoses. Further research should examine methods to improve detection and treatment of eating disorders in this population.
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      Shira Maguen is a Research Psychologist at the San Francisco VA Medical Center and Assistant Professor in the Department of Psychiatry at the University of California, San Francisco. She specializes in PTSD research, with an interest in women veterans' mental health.


      Beth Cohen is a Staff Physician at the San Francisco VA Medical Center and Assistant Professor in the Department of Medicine at the University of California, San Francisco. Her research focuses on the effects of PTSD on physical health.


      Greg Cohen was a Research Associate at the San Francisco VA Medical Center. He is now at the Mailman School of Public Health at Columbia University.


      Erin Madden is a Data Analyst at the San Francisco VA Medical Center with an expertise in quantitative methods and analysis.


      Daniel Bertenthal is a Data Analyst at the Mental Illness Research, Education, and Clinical Center at the San Francisco VA Medical Center.


      Karen Seal is an Associate Professor of Medicine and Psychiatry at the University of California, San Francisco. As Co-Director of the Iraq/Afghanistan Veteran Integrated Care Clinic at the San Francisco VA Medical Center, she investigates primary care-mental health integration.