Eating disorder measures in a sample of military veterans: A focus on gender, age, and race/ethnicity.

Abstract

Early detection of eating disorders (EDs) is crucial for both prevention and treatment; however, few ED measures have been validated among older adults, men, and racially/ethnically diverse individuals, who may have varying symptom presentations. We examined the psychometric quality of three self-report ED measures within a diverse sample of U.S. military veterans, a population that may have elevated rates of EDs. Participants (N = 1,187) completed the Eating Disorder Diagnostic Scale-5 (EDDS-5), the Eating Disorder Examination-Questionnaire (EDE-Q), the SCOFF (Sick, Control, One, Fat, and Food) questionnaire, and measures of associated mental health symptoms. We examined proportions of probable EDs and reliability estimates, associations among ED measures, and their relationship with mental health measures for the sample as a whole and based on age, gender, and race/ethnicity. Proportions of probable EDs ranged from 9.9% to 27.7% and were comparable for White, Black, and Latinx participants. Participants aged 40–49 had significantly higher proportions of EDs compared to other age groups, whereas participants aged ≥60 had significantly lower proportions of EDs. Participants with obesity had significantly higher proportions of probable EDs compared to participants with healthy weight or overweight. There was fair to moderate agreement between the ED measures, with varying evidence for psychometric quality across demographic subsamples. Overall, the EDDS-5 performed best in this sample and yielded estimates of probable EDs consistent with expectations. These data add to the growing body of literature on the assessment of EDs and provide insight into measures that may be most useful in research and intervention efforts.

Disordered eating in sexual minority post‐9/11 United States veterans

“…Finally, findings from the present study support a small but growing body of literature showing that DE is prevalent and significantly impacts veterans (Bartlett & Mitchell, 2015; Cuthbert et al, 2020). Consistent with previous research examining eating disorder diagnoses based on self‐report in veterans (Mitchell et al, 2021), approximately 17% of female and 7% of male veterans in our national sample met criteria for a probable eating disorder diagnosis. A sizeable percentage of female and male veterans also reported regular DE behaviors.…”

“…Consistent with previous research examining eating disorder diagnoses based on self-report in veterans (Mitchell et al, 2021), approximately 17% of female and 7% of male veterans in our national sample met criteria for a probable eating disorder diagnosis. A sizeable percentage of female and male veterans also reported regular DE behaviors.…”

“…In this study, the diagnostic scoring algorithms proposed by developers yielded higher estimates of bulimia nervosa (BN) and lower estimates of binge‐eating disorder (BED) compared to other nationally representative studies. We used an alternative diagnostic scoring algorithm that excluded exercise and fasting items from the probable BN and BED diagnoses (Mitchell et al, 2021). To reduce participant burden, participants who did not endorse binge eating skipped items that assessed for compensatory behaviors and night eating syndrome.…”

“…In an early study, Striegel‐Moore, Garvin, Dohm, and Rosenheck (1999) found that 0.02% of male and 0.3% of female hospitalized veterans had a current eating disorder diagnosis based on Veterans Health Administration medical records. Data utilizing medical records likely provided an underestimate of prevalence rates, and a recent study using a national sample found that 18.3% of female and 8.5% of male veterans met criteria for a probable eating disorder diagnosis on a self‐report measure (Mitchell et al, 2021). Another study with post‐9/11 veterans found that 18.6% of women and 7.9% of men self‐reported DE.…”

Gender differences in direct and indirect associations of trauma types with disordered eating in a national U.S. veteran sample.

“…A random sample of individuals from the national veteran population were recruited ( N = 4,176) from the VA/Department of Defense Identity Repository to participate in the parent study on DE among veterans (Mitchell, Masheb, et al, 2021). Female veterans were oversampled to facilitate a gender-balanced sample.…”