Several speakers at the workshop presented evidence to suggest there are some women within all branches of the military who practice what could be termed "disordered eating" behaviors in an attempt to meet the body fat standards required for retention. That is, their eating behaviors meet some of the criteria for an eating disorder but not enough so as to qualify as a full-blown eating disorder.

Hourani (1996), for example, reported on POWR'95, which included several questions from the Eating Disorders Inventory (Garner and Olmstead, 1991). Results indicated that 11 percent of the women polled reported having taken diet pills in the previous year to achieve a desired weight; in addition, 13 percent of the women reported eating in secret, and 50 percent were unsatisfied with their present weight. All three factors (items from the Eating Disorders Inventory) were determined in prior studies of eating disorders to be highly predictive of disordered eating behaviors. Administration of the Quick Diagnostic Interview Schedule² to a group of 784 Navy and Marine personnel indicated a 1.5 percent lifetime prevalence and a 1.2 percent recent (within the previous year) incidence of bulimia (characterized by self-induced vomiting or laxative or purgative abuse for the purpose of losing or maintaining weight) similar to results reported for a group of college students (Pemberton et al., 1996).

Drake (1996) reported the results of ongoing studies involving U.S. Naval Academy midshipmen who took the Eating Disorders Inventory. Ten percent of women and 3.5 percent of men sampled showed evidence of being at risk for eating disorders. For women, this correlated with a tendency for greater weight gain in the first year and a greater incidence of menstrual dysfunction. However, no differences were seen in level of physical fitness. According to Drake, these observations could be accounted for by high stress levels.

Tracey Sbrocco (1996), in an overview of eating disorders among military women, emphasized that eating disorders as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV, 1994) are uncommon in the military. The DSM-IV divides eating disorders into three categories: anorexia nervosa, bulimia nervosa, and "eating disorders, not otherwise specified (NOS)"; each has its own diagnostic criteria. Sbrocco cited the prevalence rate for anorexia both in the military and in the general population of young, Caucasian females as approximately 1 percent, with a prevalence rate for bulimia of 1 to 3 percent. What is also found among military women, she cautioned, is a high incidence of subclinical eating disorders, or disordered eating. An example she cited was chronic dieting. According to a Health Survey of the Air Force, for example, 40 percent of a sample of Caucasian women and 18 percent of a sample of African American women reported dieting chronically. Additional indications include restricting individual foods or food groups, engaging in compulsive exercise, and exhibiting a body image disturbance. She added that these factors may affect deployment by negatively affecting physical status and performance. She also cautioned, however, that all information regarding eating disorders and disordered eating in the military is subject to question because eating disorders represent grounds for separation; thus, the problem is at least partially a hidden one. She expressed the commonly held belief that because "appearance" is of primary

Front Matter (R1-R16)

Executive Summary (1-24)

1 Introduction (25-32)

2 Body Composition (33-60)

3 Physical Fitness Policies and Programs (61-86)

4 Weight Management (87-108)

5 Nutritional Concerns of Military Women (109-126)

6 Pregnancy and Lactation and Postpartum Return-To-Duty Fitness (127-156)

7 Conclusions and Recommendations (157-170)

Appendixes (171-172)

A Workshop Summary, Agenda, Participants, and Abstracts (173-252)

B Practices and Policies Tables (253-262)

C Military Occupational Specialty Classification Tables (263-280)

D Search Strategy for Literature Review (281-284)

E Civilian Inquiry Letter and Table of Responses (285-290)

F Abbreviations (291-294)

G Bibliography (295-334)

H Biographical Sketches (335-338)

Index (339-352)