Eating disorders are among the deadliest psychiatric conditions, and among the most misunderstood. Within military and veteran communities, the risks are heightened by a complex mix of culture, trauma, and access barriers. Yet treatment remains difficult to obtain, and too often, it arrives too late.
Military life imposes intense demands on the body and mind. Appearance standards, disrupted eating routines, trauma exposure, and pressure to perform under stress all contribute to an environment where disordered eating can take root. These challenges don’t end with discharge. Veterans frequently carry both physical and psychological scars into civilian life. And yet, access to comprehensive eating disorder care remains limited.
What We Know: Elevated Risks in Military and Veteran Populations
Military service can significantly increase the risk of developing an eating disorder. These illnesses are not limited to a single demographic, and the stereotype that they only affect young women leaves many people undiagnosed and untreated.
Contributing Risk Factors:
- Weight and appearance standards tied to readiness and promotion
- High rates of trauma, depression, anxiety, and PTSD
- Irregular food access during deployment or training
- Cultural norms that discourage vulnerability or emotional disclosure
Symptoms are frequently missed or misinterpreted. Restriction may be praised as discipline. Excessive exercise can be reframed as commitment. Among men or people in larger bodies, disordered behaviors are often dismissed entirely.
Our 2020 blog explored these patterns in depth. Since then, the Blue Star Families 2023 Healthcare Snapshot has provided further evidence. One in four respondents screened positive for disordered eating. Forty percent said their provider did not seem knowledgeable about eating disorders. Many had never received a diagnosis.
Without proper recognition, people cannot access appropriate treatment. When providers do not know what to look for—or who is at risk—diagnosis is delayed. By the time care is sought, the illness is often more severe and more difficult to treat.
Who Gets Left Out—and Why
TRICARE covers residential eating disorder treatment for dependents under age 21, offering an essential option for military families seeking care for their children. This is critical, given that eating disorders occur at significantly higher rates in military youth compared to their civilian peers. Risk factors include disrupted routines, frequent relocations, chronic stress, and the emotional impact of parental deployments. When these symptoms are recognized early, timely intervention can prevent escalation.
But the scope of coverage ends there. Adult dependents, including spouses and those over age 20, are still denied access to residential eating disorder treatment under TRICARE policy. This reflects an outdated stereotype that eating disorders only affect teenage girls. In reality, eating disorders occur across all age groups, and when treatment is delayed, outcomes worsen.
That same stereotype shapes how eating disorders are recognized—or dismissed—within military culture. June is Men’s Mental Health Month, a time when conversations about stigma and silence take on added weight.
Although men make up the majority of military personnel, they remain significantly underrepresented in eating disorder treatment. Behaviors like restriction or compulsive exercise are often seen as discipline or commitment rather than signs of distress. Many men delay seeking help, and many providers still overlook eating disorder symptoms in male or higher-weight individuals.
Veterans face additional challenges. While the VA does offer some eating disorder services, access is inconsistent, and residential care is rarely available. Wait times are long, and few programs accept VA insurance. Those of us that do serve as rare points of entry in a system that leaves many without options.
The SERVE Act: A Law Still Waiting
In 2021, the SERVE Act was signed into law as part of the National Defense Authorization Act. It was designed to:
- Clarify that under TRICARE, eating disorders treatment shall be provided to beneficiaries without age limitations when medically necessary.
- Require the Secretary of Defense to take steps to identify, treat, and rehabilitate service members affected by eating disorders.
- Direct the Department of Defense to establish clinical practice guidelines on eating disorder treatment.
Four years later, the law has still not been implemented.
In March 2023, nine bipartisan U.S. Senators sent a letter to the Department of Defense urging them to act. They cited disturbing statistics: nearly 20,000 military dependents diagnosed with eating disorders between 2014 and 2018, and a documented impact on readiness among active duty servicewomen. Their request was simple: honor the law and provide comprehensive care equivalent to civilian standards. And still, nothing has changed.
Eating disorders carry one of the highest mortality rates of any psychiatric illness. Suicide is 23 times more likely among those with an eating disorder than in the general population. Veterans also experience elevated suicide risk, often connected to unresolved trauma, untreated mental illness, and systemic failures in care. These are separate public health crises. But they share a pattern: when access to treatment is delayed or denied, lives are lost.
Athena McDowall, a former service member and EDC Ambassador, spoke to this in her 2023 testimony:
“Throughout my deployment overseas, I was constantly being punished for my eating disorder and mental health concerns. I was told that eating disorders in the military were not common, which was the reason for my delay in treatment, but upon admission to a treatment program I realized that was not true. I met several members of the military who were also suffering from eating disorders.”
Her experience is not isolated. We hear these stories regularly from those who felt dismissed, punished, or invisible while trying to access care. The longer they wait, the harder healing becomes.
Where Do We Go From Here?
The path forward requires more than waiting for the SERVE Act to be enforced. It requires meaningful change across the entire care ecosystem.
Steps that can make a difference
- Increasing military provider education about eating disorders that don’t match stereotypes
- Investing in earlier intervention, not just crisis-level care
- Fund early interventions and prevention efforts that reduce the risk of escalation
- Embedding routine screening into primary care and behavioral health appointments
- Improving transitions between active duty, VA, and civilian healthcare systems
- Reducing logistical and financial barriers that delay access to treatment
- Offering culturally aware care that addresses trauma, disconnection, and identity, not just symptoms
The Bottom Line
Disordered eating is not a fringe issue in military or veteran communities. It is common, serious, and often overlooked. Treatment delayed is treatment denied. At ‘Ai Pono, we work with clients across a wide range of diagnoses, identities, and lived experiences. We accept TRICARE for dependents under age 21 and work with VA-insured veterans. Our approach integrates holistic treatment, trauma-informed care, family support, and a deep respect for the realities our clients carry.
Healing should not depend on age, gender, or insurance coverage. For military families and veterans, the gaps in care are not just bureaucratic oversights—they are life-threatening failures.
