The challenging lifestyle of the military means that service members must maintain required weight and fitness standards. A study examined data from a survey conducted by the Uniformed Services University of the Health Sciences on the prevalence of disordered eating and eating disorder risk among military personnel. Because weight standards are often used to determine career advancement, the study examined the patterns of behavior before and after weigh-ins among military personnel in different branches of service.

Navy Capt. Peggy McNulty conducted a study titled "A Comparative Analysis of the Prevalence and Contributing Factors of Eating Disordered Behaviors Among Active Duty Army, Navy and Air Force Service Women in the Health Care Arena." She found that eating disorders exist at a higher rate among women who lead highly regimented lives, regulated by rules and weight standards. She concluded that eating disorders exist in all military women regardless of service. Anorexia nervosa, bulimia nervosa and other eating disorders affect all ages, all ranks, and all professional areas of practice in all services studied.

Military lifestyle has a significant impact on the prediction and manifestation of anorexia nervosa, bulimia nervosa, and other eating disorders. Specific attention should be afforded the military woman who "feels fat," particularly those who have had a history of an eating disorder in the past and who practices unhealthy purging behaviors during physical fitness height and weight measurement periods.

Supervisors and peers should be very concerned when a member shows rapid weight loss, or when a member seeks the use of drugs such as phen-fen, laxatives or diuretics. Concern should be given to those who seek liposuction when not medically indicated. All members would benefit by the opportunity to seek proper assistance without the "fear of separation" from active duty for issues related to binge-purge activities. Eating disorders not properly diagnosed and treated may compromise operational readiness, job performance, safety, wellness and life itself.

Eating disorders are not eclusive to women. In a study among active duty Navy men, McNulty found that anorexia nervosa prevailed at 2.5 percent, bulimia nervosa at 6.8 percent, and other eating disorders at 40.8 percent for Navy men studied. Men classified in the "normal" category (49.9 percent of those sampled), reported current behaviors of vomiting, water pills, diet pills, laxatives and binging at between 1.5 to 2 percent and fasting at 7 percent, but not to the extent to be categorized with other men studied for a eating disorder.

These studies also emphasized that military environmental factors played a strong part in the manifestation and prediction of anorexia nervosa, bulimia nervosa and other disorders among both active duty women and men.

Anorexia nervosa

A person who suffers from anorexia is one who refuses to maintain a body weight at a minimally normal weight for their height and age. They have an intense fear of gaining weight or becoming fat and strive for perfection.

Two types of anorexia nervosa exist. Those suffering from the so-called restricting type severely restrict their caloric intake by extreme dieting, fasting, and excessive exercise. Those of the so-called binge-eating purging type exhibit the same restricting behavior but also fall victim to bouts of gorging, which they follow with vomiting or abusing laxatives or diuretics in an attempt to counteract the overeating.

Bulimia nervosa

A person who suffers from bulimia is an individual who binges and purges. They will eat a large quantity of food in a short amount of time and then self-induce vomiting. They do this as a way to punish themselves or because they feel overwhelmed, sometimes with feeling fat but sometimes out of frustration or anger with other factors in their life. Binging and purging will occur at least twice a week for three months.

Compulsive eating

Someone suffering from a compulsive eating disorder has an "addiction" to food and uses food as a way to fill a void or hide from their emotions, or even to cope with their problems. They tend to be overweight and use their physical appearance as a block against society. They typically have very low self-esteem and feel shame in their weight, using food as comfort thus creating a cycle of mental highs and lows.

Binge eating disorder

A person who suffers from binge eating periodically goes on a large binge (like in bulimia) but does not purge afterwards. As among bulimics, those experiencing BED feel a lack of control and undergo bingeing an average of twice a week. They are typically normal or overweight. They typically binge to hide their emotions or fill a void in their lives or as self-punishment. Binging will occur at least twice a week for six months.

Bulimia and BED are more common than anorexia. Many experts believe the rise in rates of bulimia has to do in part with western society's obsession with thinness and the shifting role of women in a culture that glorifies youth, physical appearance, and high achievement.

Over exercise

Someone who suffers from an over-exercise disorder is difficult to diagnose, because is there such a thing as too much exercise? These people have instances where they repeatedly exercise outside the requirements of what is considered safe. They usually exercise to burn calories to relieve the guilt from having eaten or binged or to give them permission to eat a big meal.

Without treatment, up to 20 percent of people with serious eating disorders die. With treatment, that number falls to 2 to 3 percent. With treatment, about 60 percent of people with eating disorders recover. In spite of treatment, about 20 percent of people with eating disorders make only partial recoveries. The remaining 20 percent do not improve, even with treatment.

For more information on the vigils, contact the National Association of Anorexia Nervosa and Associated Disorders at 847-831-3438 or visit

www.anad.org.

Nutritional Counseling is available in Walter Reed's Wellness Services, Ward 73, call 782-0907. Psychological counseling is available through Internal Medicine Services, 1B or Ward 73, call 782-1773.