# Eating disorders in Veterans: Risk, resilience, and service use

> **NIH VA I01** · VA BOSTON HEALTH CARE SYSTEM · 2024 · —

## Abstract

Background
Eating disorders (EDs) likely affect a significant proportion of female and male Veterans; however, they remain
understudied and under-treated in VA. Individuals with EDs are likely to be high users of medical care, which is
at least partly due to the physical complications of EDs. Nonetheless, EDs often go undetected in general
medical settings, unless providers screen for them. Currently, the VA does not routinely screen for EDs; thus,
enhancing VA's capacity nationally to provide comprehensive care for Veterans with EDs is a priority area of
focus. This proposal will address four major gaps: the lack of prevalence estimates of EDs in nationally
representative samples of Veterans, the lack of knowledge of healthcare needs and preferences of Veterans
with EDs, the paucity of findings regarding military/Veteran-specific risk factors for EDs, the lack of a validated
screening measure for EDs in Veterans, and the lack of knowledge regarding Veteran preferences for ED
screening. These gaps are barriers to screening for and treating Veterans with EDs in VA healthcare.
Objectives
The specific aims are to establish a nationally representative cohort of male and female Veterans in order to: 1)
a) examine the prevalence of male and female Veterans reporting full and subthreshold EDs and b) to examine
the potential prevalence of EDs among vulnerable subgroups of Veterans; 2) to identify service use and needs
among male and female Veterans with full and subthreshold EDs; 3) to estimate models of risk and protective
factors for EDs, including military sexual trauma, combat trauma, and unit and family deployment support; and
4) to validate an existing screening measure of EDs in a Veteran sample and assess screening preferences.
Methods
In order to achieve these aims, we will recruit a nationally representative sample of 1500 male and female
Veterans. We will request that the VA/DoD Identity Repository (VADIR), a VA office with access to Department
of Defense records, assist in randomly selecting 3750 individuals from the national Veteran population. We will
stratify the sample based on race/ethnicity and oversample women to achieve a 1:1 ratio. We will mail a
comprehensive survey to potential participants using a multi-pronged, six-stage mailing strategy.
Participants will complete survey measures of ED symptoms, risk and protective factors, and VA and non-VA
healthcare service and needs. Aim 1: sample weighting procedures will be used in order to calculate nationally
representative prevalence estimates of EDs among male and female Veterans. Aim 2: Poisson regression will
be used to compare healthcare service use for Veterans with EDs to Veterans without EDs. In addition, we will
use descriptive statistics to report service use among male and female Veterans with full and subthreshold
EDs and which services, if available, they would like to use. Aim 3: structural equation modeling will be used to
estimate models of risk and protective factors for...

## Key facts

- **NIH application ID:** 11145598
- **Project number:** 5I01HX002435-04
- **Recipient organization:** VA BOSTON HEALTH CARE SYSTEM
- **Principal Investigator:** KAREN Suzanne MITCHELL
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-05-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11145598

## Citation

> US National Institutes of Health, RePORTER application 11145598, Eating disorders in Veterans: Risk, resilience, and service use (5I01HX002435-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/11145598. Licensed CC0.

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