P3.T387: Prevalence and Risk Factors of Disordered Eating Behavior in Military Dependent Adolescents

Background: Eating disorders are increasing in prevalence and have adverse health effects, but remain underdiagnosed. Active duty (AD) military personnel and individuals with obesity have a higher prevalence of disordered eating behavior (DEB), a broader category of unhealthy eating behaviors, than the general population. Unlike the general population, AD males have more similar DEB prevalence compared to AD females. Studies of military dependent adolescent females and persons with overweight/obesity have found that these groups have increased risk for DEB. DEB prevalence in the general military dependent adolescent population (including males and all BMI categories) is unknown. We hypothesized that DEB prevalence in military dependent adolescents is higher than the general population, and that obesity, female gender, and key military characteristics (including current AD parent, number of lifetime moves, and number of parental deployments) are associated with higher DEB risk.

Methods: Retrospective cross-sectional study of military dependents aged 11–19 years seen in the adolescent clinic at a naval medical center for routine health encounters. We excluded patients presenting for acute concerns or mental health diagnoses, and patients with diabetes mellitus or significant developmental delay. We collected data from electronic health record abstraction, including results of the ChEAT-26 questionnaire, a validated eating disorder screening tool that is conducted at annual routine health encounters in the clinic. We compared DEB prevalence using a one-sample z-test of proportions (p0=0.1) and estimated DEB risk by obesity, gender, and military demographics (current parental deployment, military parent, AD status, military branch, number of lifetime moves, and number of parental deployments) using multivariable generalized linear models.

Results: Of 92 participants, 49% identified as male, 1% as transgender, 7% as African American; 9% had obesity; 63% had an AD parent and 81% were Navy families. DEB prevalence was 13%. Obesity was associated with higher DEB screening score (adjusted RR 6.3, 95% CL 0.4 to 12.1), as was having a parent in the Air Force (β 10.2, 95% CL 1.0 to 19.3). There was no significant difference in DEB risk by gender.

Conclusion: DEB prevalence in military-dependents seen in adolescent clinic is similar to the general adolescent population, and obesity confers increased risk of DEB in this population. Military dependent males may have comparable DEB rates to females and benefit from routine screening. Further research is needed to determine the effect of military branch and other military demographics on DEB risk.