Military Veterans with Eating Disorders: Prevalence, Incidence, Patterns of Comorbidity and Cost of Care
Abstract
Background: Eating disorders (ED), including anorexia nervosa, bulimia nervosa, and binge eating disorder, are serious illnesses that lead to disturbance in one’s eating behaviors and can result in poorer health, lower quality of life, and long-term expensive treatment. About 30 million Americans at some point in their lifetimes will have an ED. Individuals with ED often suffer from substance use disorders and other mental health problems, including anxiety and depression. However, very little is known about the prevalence of ED and the patterns of co-occurring mental health and substance use problems among military Veterans. Researchers are beginning to recognize that additional evidence of the prevalence, patterns of co-occurring illness, and costs of ED among Veterans is needed to accurately evaluate the overall burden of disease and to design effective ED screening and treatment programs. Proposed Research: We will address several critical questions identified in the Fiscal Year 2018 Peer Reviewed Medical Research Program (PRMRP) Area of Encouragement of eating disorders. (1) Using the largest and most comprehensive database of US military Veterans, we will generate precise estimates of ED prevalence (percentage of Veterans with ED within a year) and incidence (new cases by year) among Veterans in the aggregate. We will also estimate ED prevalence/incidence by sociodemographic groups, including by age, gender, race/ethnicity, obesity status, and age cohort. (2) Our study will document patterns of co-occurring mental health and substance use problems among Veterans with ED. These disorders affect military Veterans at disproportionately high rates compared to the general population but are often left untreated, resulting in unnecessary health burden and excess costs of care. We will evaluate whether such co-occurring problems precede (and may lead to) ED or if they develop subsequently to an ED episode (and may be caused in part by ED). This information can be used by medical providers to develop effective screening and treatment programs for Veterans with ED based on the progression of the disease and co-occurring illnesses. (3) Our study will document the added utilization and cost of care to the Veterans Health Administration (VHA) associated with ED, which can be used by policymakers to evaluate the burden of disease to the VHA and in future evaluations of the cost-effectiveness of ED prevention and treatment. Impact: Our study has the potential for an unprecedented impact on the health and quality of life among Veterans with the condition. We will produce the most accurate estimates to date of the scope and impact of ED on Veterans’ health as a whole and in high-risk subgroups, changes in incidence over time and with age, and the health services and cost burden posed by ED for the VHA, in addition to Medicare. Through better detection of ED and through better understanding of the co-occurring illnesses among those with ED, our research can directly help medical providers assess risk of developing ED and mental health and substance use disorders, which will have a significant beneficial impact on the health, well-being, and quality of life of Veterans. Findings from this study will likely lead to several profound benefits for Veterans and the larger general population by informing the development of: (1) more accurate screening tools for use in large EHR databases to identify undiagnosed eating disorders cases in healthcare samples; (2) indicators for early identification of emerging eating disorders symptoms to enable early intervention when treatments are known to be most effective to prevent onset of full-blown disorder; and (3) effective models of care for integrated treatment of ED and co-occurring mental health and substance use disorders.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jul 16, 2019
- Source ID
- W81XWH1910239
Entities
People
- S. Austin
Organizations
- United States Army