Changes in Eating Disorder Symptoms in Perinatal US Military Servicewomen

The perinatal period is a window of exacerbated vulnerability for eating disorder symptoms. Moreover, US military servicewomen represent a population at increased risk for eating disorder psychopathology relative to civilians. However, no study has evaluated changes in eating disorder symptoms across the perinatal period in servicewomen.

Active-duty servicewomen (N = 192, ages 20-41), between 12- and 27-weeks' gestation at study enrollment (between 2023 and 2024), completed questionnaires assessing binge-eating, avoidance of eating/dietary restraint, eating concerns, and body dissatisfaction at three time points: second trimester, third trimester, and postpartum. A series of general estimating equations and linear mixed models were used to evaluate eating disorder symptoms over the three time points.

Mean frequencies of past-month binge-eating episodes were high (~9-10 across time points) and did not change across pregnancy and the postpartum period (p = 0.452). Similarly, eating concerns did not significantly change over time (p = 0.078). Avoidance of eating/dietary restraint did not change from second to third trimester (p = 0.593) but significantly increased during the postpartum period (ps < 0.001). Body dissatisfaction decreased from second to third trimester (p = 0.008), followed by a significant increase in the postpartum window (ps < 0.008).

Risk for binge-eating and eating concerns among servicewomen was not significantly different across the time points during the perinatal period, whereas body dissatisfaction and avoidance of eating/dietary restraint were highest postpartum. Findings are consistent with military culture and policies requiring Service women to return to meeting specific fitness and anthropometric standards after giving birth. Results support postpartum screening for eating disorder symptoms in the military.