Robin Masheb, PhD, professor of psychiatry and director of the Veterans Initiative for Eating and Weight (The VIEW), has received a medical research program award grant from the Department of Defense (DoD) for a new clinical trial, Building an Equitable and Accessible System of Eating Disorder Care for VA, DoD, and Underrepresented Americans with Eating Disorders (EASED Study).
Participant recruitment for the study begins in March.
Eating disorders and access to care for these conditions are emerging concerns for active-duty service members, veterans, and underrepresented Americans, according to Masheb.
“It is becoming clearer and clearer that our society’s focus on weight and weight loss has masked problematic eating behavior and eating disorders amongst a large segment of the population,” she said.
The perception that eating disorders are disorders primarily affecting teenage girls and college-age women of low weight is a myth, she said. Most people who struggle with disordered eating and eating disorders are overweight or become overweight over time.
Unfortunately, when adults seek medical attention, they are often told to lose weight even though treatments for weight loss rarely work, Masheb said. Rarely does screening take place for eating disorders before recommendations are made for weight loss treatment.
Masheb and other VA researchers have conducted studies demonstrating that military factors, such as engaging in extreme weight loss behaviors to meet military weight standards and military sexual trauma, place service members at risk for disordered eating later in life. These risks affect male veterans as well as a growing number of female veterans.
One focus of Masheb’s center is to overhaul existing screening and diagnostic measures for eating disorders. Through a VA-funded grant she is working to develop and validate screening and diagnostic tools for Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) Eating Disorders for diverse populations. The new tools will additionally capture the full range of today’s recognized eating disorder diagnoses including binge eating disorder, the most prevalent eating disorder that is commonly observed in men, veterans, and people who are overweight and older.
Even newer diagnoses, such as atypical anorexia and night eating syndrome, will be captured as high rates have been observed in veterans.
Masheb’s new project builds on this line of research by creating capacity to treat eating disorders in the VA system. Eating disorder treatment is expensive and difficult to access, and studies rarely address cultural sensitivity and trauma-informed care. The clinical trial will test and improve state-of-the-art, evidence-based eating disorder treatment specifically for the military population. This will be the first virtual care delivery model for eating disorders with the most diverse treatment sample to date.
A computerized dashboard and military adapted cognitive-behavioral therapy treatment manual will be tested in patients with bulimia nervosa and binge eating disorder. Findings will be used to inform DoD and VA clinical practice guidelines for eating disorders. Ultimately, the newly developed tools will provide a pathway to better health for service members, veterans, and underrepresented Americans with eating disorders.
The announcement of Masheb’s study coincides with National Eating Disorders Awareness Week, which this year is Feb. 22-28. This year’s theme is “Every Body Has a Seat at the Table.” The week raises awareness of underrepresented communities that struggle with eating disorders, challenging systemic biases, and sharing stories from all backgrounds and experiences.
VA Connecticut Healthcare System and Yale investigators involved in the DoD-funded study include Sally Haskell, MD; Christopher Ruser MD; and Eugenia Buta, PhD. Additional VA Connecticut Healthcare System colleagues involved in these studies are Lindsay Fenn, MS; Mark Lawless, MS, LCSW; and Jennifer Snow, MSc.