Thomas Burke, his wife Gretchen Wright and emotional support dog Rosie. Burke said Wright and Rossi were an important part of his recovery. Burke is the co-founder of the Highland Veterans Advocacy Organization, where he guides veterans in advocating for local, state, and national policies. He is the pastor of Weston Norfield Congregational Church.

The food makes Thomas Burke sick. Burke, a former Marine, will not eat in front of people because he is likely to vomit. He hardly eats, never finishes what is on the plate.

For more than a decade, he has struggled with anorexia and bulimia at different times. Like many other veterans with eating disorders, he blamed these on his experience in the military.

Weston’s Burke said that in the basic training of his Marine Corps, the instructors would not eat in front of the troops. He thought this was a message that eating was a weakness. In Iraq and Afghanistan, he did not eat for a few days while focusing on military missions. In Afghanistan, he witnessed children being blown up by roadside bombs and he had to pick up their body parts. It triggered a suicide attempt, long-term suicidal ideation and post-traumatic stress disorder (PTSD). He considers himself a person "not worthy of eating", he said.

Veterans’ eating disorders are related to exposure to trauma and stress to meet military weight and health requirements, said Dr. Sara Rubin, a psychiatrist who is the leader of the eating disorders program at VA Connecticut Healthcare. In addition, she said that women who have been sexually assaulted in the military are prone to eating disorders.

Robin M. Masheb, a psychologist at Yale University School of Medicine and a researcher at the U.S. Department of Veterans Affairs (VA), said, "Many veterans seem to be distressed by their diet and body image, but they are not recognized."

A study of veterans after 9/11 found that bulimia, binge eating, and atypical anorexia nervosa (AAN) are associated with depression, anxiety, post-traumatic stress disorder, insomnia, and lower quality of life. AAN has symptoms of anorexia, including hunger and extreme fear of weight gain, but not dangerously low weight. The study of more than 1,100 veterans led by Masheb was the first to examine AAN veterans. The study found that 14% of women and 5% of men may have AAN, "a clinically significant diet and mental health disorder." The study also showed that 6% of women and 3% of men suffer from bulimia (bulimia), which is three times the incidence of civilians.

Eating disorders can also lead to death. A study by Deloitte Access Economics found that 10,200 people die every year due to eating disorders. According to data from the American Eating Disorders Association, the death rate of anorexia nervosa is second only to opioid use disorder, the second highest death rate of all mental illnesses, and one in five deaths of anorexia patients is suicide.

Rubin said that the Virginia Eating Disorders Program was established in 2019, shortly before the start of the COVID-19 pandemic, which affected participation. She said that patients must be referred by clinicians, who usually do not find signs of eating disorders, especially in overweight patients. So far, 29 men and 26 women have been referred. Services include diagnosis, remote group meetings, cognitive behavioral therapy, nutrition counseling, psychotherapy and medication.

Robin Masheb's study is the first to examine atypical anorexia nervosa in veterans.

Masheb, director of the Virginia Veterans Diet and Weight Program, said that eating disorders have been masked among military and veterans because most studies have focused on whites, teenage girls, and young women, leading people to mistakenly believe that men, women, The elderly and overweight women and people of color have no eating disorders.

Masheb is conducting multiple studies on eating disorders. They include designing mechanisms so that the VA can screen patients for eating disorders, which is not done now; determining appropriate treatments for veterans with binge eating disorder; separating the treatment of binge eating disorder and bulimia in the military from weight management; And train VA providers to recognize eating disorders.

According to spokesperson Captain David Pittlick, the Connecticut National Guard has developed a fitness improvement program to help soldiers struggling with weight and health. He said it focuses on sleep, nutrition, mental health and exercise, adding that if soldiers’ eating habits cause concern, they will be referred to behavioral or medical practitioners.

Burke said that female veterans told him that they starved to death before the army weighed in, and it was difficult to regain the required weight after giving birth. He knows that someone gains muscle through weight training and is considered overweight. He called for a change in military culture and emphasis on self-care, including nutrition.

A study led by Masheb showed that there is a relationship between changing eating habits to meet military weight standards and overeating and eating pathology in later life. The study reported that between 1992 and 2006, nearly 24,000 soldiers were fired for exceeding the maximum body fat limit.

Burke was diagnosed with eating disorders in Virginia about four years ago, but the focus is on his physical health, excluding mental health care. He now sees a private therapist addressing the mental and physical needs related to eating disorders.

"I'm in a better place, but I'm still struggling," he said.

This is a journey. After returning from the army, he wanted to eat more, but he didn't know how to eat. "I can't regulate my food intake," he said. He became overeating, ate all the groceries in one breath, and then vomited. When he was a wrestler at Sacred Heart University, he broke his ribs many times due to malnutrition. The pain made him afraid of learning the right diet and lifting weights to build muscle. He said that part of his hunger was related to the desire to lose weight, which is a characteristic of anorexia.

"My feeling about what I deserve is related to eating and taking care of myself, doing what I need to do to be happy," Burke said. His wife tried trial and error to find food that appealed to him. He also drinks protein shakes.

He is now 5 feet 7 inches tall and his weight has increased from a minimum of 120 pounds to 150 pounds. At the age of 32, his life was very fulfilling. He graduated from Yale Theological Seminary and is the associate pastor of children, youth and family affairs at Weston Norfield Congregational Church. He is the co-founder and treasurer of High Ground Veterans Advocacy, an organization that trains veterans to advocate for veteran issues. He got married last year. He said his wife Gretchen helped him “be healthier, both mentally and physically”, and his service dog Rosie helped him calm his anxiety.

Burke recently encountered a setback when the Navy Discharge Review Committee rejected his application to upgrade a veteran from non-honor (OTH) to honor. He said that his discharge status was based on smoking marijuana after the death of Afghan children. OTH is "completely related" to the feeling of "a person who is not worthy of eating", he said with tears.

For help with eating disorders, please contact Nationaleatingdisorders.org.

This article was originally published by the Connecticut Health Survey Team on November 3, 2021.

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