Responding to sailors' pleas, the Navy is working on a program to prevent and treat eating disorders

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Retired Navy senior chief Leah Stiles caused a stir this summer when she posted a personal account of her 20-year military career on social media. She revealed that she spent much of that time desperately trying to hide an eating disorder that now requires inpatient treatment.

“This is my life, man," she said. "I'm at the end of things here."

The 43-year-old former public affairs officer got used to purging, restricting her food intake, and over-exercising to pass the Navy’s twice annual weight screenings. Her routine included laxatives, hours in the sauna, dehydrating herself, and other extreme measures.

She remembered feeling humiliated when she failed to make weight. She was ordered to take off her shirt and be measured in front of her shipmates.

“I was like, ‘Okay, so I'm never doing that again," she said. "I'll be making weight from now on.’”

Stiles said purging turned into a coping mechanism. Some sailors smoked; Stiles vomited. She got promotions and received positive comments about her physique, so she connected the weight loss measures with success. Now, from her home in Florida one year into retirement, she said therapy and out-patient treatment aren’t working. She can’t stop.

Stiles, a two-time Sailor of the Year, wrote to the Navy’s top leaders with ideas to prevent harmful weight loss before it starts, including a widespread awareness campaign starting as early as boot camp and medical referrals for sailors who take extreme measures before weigh-in.

“I know that this is an epidemic that this culture is facing, and so I just wanted to come up with something that I could make an impact,” Stiles said.

Some service members and health experts say the military isn't doing enough to prevent and treat eating disorders. Troops who fail to meet the strict weight limits risk getting kicked out. And there aren't many places for sailors with eating disorders to turn for help — at sea or on land.

But some changes are underway. Lt. Commander Pamela Gregory, a Navy dietician, said she’s begun work on a program to streamline health care so that sailors with eating disorders have a pathway to treatment.

“We are working with leadership to hopefully bring around a program for this much needed population that has been, in a sense, underserved,” Gregory said, crediting the new program in part to Stiles — a high-ranking former senior chief — going public.

“Hopefully, it's not just a flash in the pan that’s gone the next day,” Gregory said.

Gregory’s program is just for Navy personnel. A broader response for the whole military would have to come from the Defense Health Agency, which declined an interview request.

“Proper nutrition helps achieve optimal emotional, cognitive, and physical performance and contributes to total force fitness,” DHA spokesperson Peter Graves said in a statement. “The Defense Health Agency is committed to helping our service members achieve optimal health and performance through nutritional counseling or other medically necessary treatments.”

There’s not much data on how prevalent eating disorders are among active duty troops. The Government Accountability Office found fewer than 1,800 troops were diagnosed from 2013 to 2017 — about a tenth of one percent of all active duty forces. But advocates say that’s a gross underestimate.

“It is definitely under-counted for sure because these were just the service members who were actually diagnosed and reported through the military health system,” said Katrina Velazquez, a public policy attorney with the Eating Disorders Coalition. “It’s significantly under-reported.”

It can also take a long time for mental health care providers to diagnose an eating disorder.

“The time of diagnosis is five to ten years after they've been living with this condition,” said Commander Monica Ormeno, a top psychiatric advisor to the Navy. “Unless they're caught, or something sends it over the edge to the point of somebody needing medical assistance, people live with eating disorders for several years.”

Ormeno said an anonymous, mandatory survey about the eating and weight loss habits for all forces could help the military better understand the scope of the problem.

“We really don't know how bad it is,” Ormeno said, “so I think that once we have a better assessment of our force’s eating habits, then we can really talk about a change in culture and a change in culture has to come with the understanding that weight standards are going to have to be adjusted.”

Stiles, the retired chief, said her focus now is on getting treatment for herself. She said she’s trying to help other sailors, not hurt the Navy.

“I think about all the sailors that are reaching out to me now, there's so many, and they're all just like, ‘Help me, how do I get help?’” Stiles said. “And so I feel like as a senior chief, who's going to speak for them?”

This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans. Funding comes from the Corporation for Public Broadcasting.

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