Anorexia nervosa and bulimia in female adolescents with insulin dependent diabetes mellitus: a systematic study

An unselected sample of 46 female adolescents with insulin-dependent diabetes mellitus (IDDM) for more than one year were assessed systematically for the presence of anorexia nervosa and bulimia. These disorders and their partial syndromes were found in 19.5% of this population. Anorexia nervosa and bulimia diagnosed on the basis of DSM-III criteria were each found in 6.5% of the population representing approximately a 6-fold and 2-fold increase respectively in the expected prevalence for similar nondiabetic individuals. Bulimic symptoms were associated with poor metabolic control as reflected in blood levels of glycosylated hemoglobin (HbAl). These findings have important implications both for the pathogenesis of anorexia nervosa and bulimia and for the management of some cases of IDDM with unstable metabolic control.     

Eating disorders in patients with insulin-dependent diabetes mellitus

The frequency of anorectic/bulimic disturbances in a sample of male and female subjects with insulin-dependent diabetes mellitus was compared to that of male and female normal controls. The results suggest an overrepresentation of anorexia/bulimia in the female diabetics. Prevalence of eating disorders was determined from the scores on the Eating Attitudes Test. As a group, the female diabetics had significantly (p less than .05) higher scores on the test, suggesting a greater "awareness" of topics related to food and eating. The results are discussed within a risk-factor model, in which insulin-dependent diabetes mellitus may be viewed as one factor in the development of eating disorders.     

Eating disorders in young women with type 1 diabetes mellitus

Research findings from the past decade regarding the association of type 1 diabetes mellitus and eating disorders are critically reviewed in this paper. Although there has been much debate regarding the specificity of this association, a recent large multisite case-controlled study demonstrated that the prevalence rates of both full syndrome and subthreshold eating disorders among adolescent and young adult women with diabetes are twice as high as in their nondiabetic peers. Further, a 4-year follow-up study showed that disordered eating behavior in young women with diabetes often persists and is associated with a threefold increase in the risk of diabetic retinopathy. These eating disturbances tend to be associated with impaired family functioning and with poor diabetes management. Health care professionals should maintain a high index of suspicion for the presence of an eating disturbance among young women with diabetes, particularly among those with persistently poor metabolic control and/or weight and shape concerns. Screening for such disturbances should begin during the prepubertal period among girls with diabetes. A brief psychoeducational intervention leads to a reduction in disturbed eating attitudes and behavior but is not sufficient to improve metabolic control. More intensive treatment approaches, which should include a family-based component, may be needed to improve metabolic control. The evaluation of these and other treatment approaches is indicated in view of the serious short- and long-term health risks associated with eating disorders in young women with diabetes.     

Hypofibrinolysis associated with vasculopathy in non insulin dependent diabetes mellitus

The pathogenesis of diabetic vasculopathy has been related to modifications in hemostasis and fibrinolysis. 50 non insulin dependent diabetes mellitus patients have been studied. Euglobulin clot lysis time, fibrin plate, tissue plasminogen activator (t-PA) antigen, plasminogen activator inhibitor (PAI) activity, Protein C and S, cholesterol, triglycerides and Hb A1c were determined in blood samples. Diabetic patients showed decreased fibrinolytic activity, as measured by ECLT, with clearly increased PAI levels. Fibrinolytic response to venous occlusion was lower than normal. Vascular complications were associated both with an even higher PAI activity and with a decreased fibrinolytic response to venous occlusion. Elevated PAI activity and decreased fibrinolytic response to stimulus may contribute to vascular disease in diabetes.     

Eating and emotional disorders in adolescent obese girls with insulin-dependent diabetes mellitus

OBJECTIVE To study eating and emotional disorders in adolescent insulin-dependent diabetic (IDDM) girls.METHODS 98 adolescent girls, aged 13–19 years, were studied: 15 obese and 37 non-obese IDDM girls, 22 obese non-diabetic and 24 non-obese girls, DSM-III-R eating disorders (anorexia nervosa, bulimia nervosa, eating disorders NOS) and eating habits (snacking, sweet compulsions) were evaluated by a semi-structured diagnostic interview (Kiddie-SADS-E and Eating Habits Interview). Emotional disorders were assessed using self-questionnaires (State-Trait Anxiety Inventory for Children, Beck Depression Inventory, Coopersmith Self-Esteem Inventory). Psychological characteristics were correlated with BMI and, for IDDM girls, with HbA1C. RESULTS: IDDM and non-diabetic obese girls showed high rates of eating disorders NOS (sub-clinical bulimia: 60 and 41%, respectively) and they had more extra-snacks than non-obese girls, suggesting that obesity was the main risk factor for additional eating disorders. However, non-obese IDDM girls had more eating disorders NOS (sub-clinical bulimia: 27%) than did the normal girls (4%). Three IDDM girls had typical bulimia nervosa, while none of the non-diabetic girls did. The risk of depression was increased by both IDDM and obesity (16 and 18% dysthymia, respectively; 8% in normal girls); both factors cumulated in obese IDDM girls (47% dysthymia). Obesity was linked to marked changes in self-esteem scores and mild effects on anxiety. IDDM had little effect on anxiety and none on self-esteem; it even seemed to preserve the self-esteem of obese girls. Patients with bulimia nervosa had poorer metabolic control than other girls with IDDM. There was no correlation between HbA1C and eating or emotional disorders.CONCLUSIONS Adolescent IDDM girls are at increased risk of eating and emotional disorders. Obesity appears to be an important factor for psychiatric complications; more obese IDDM girls suffered from eating disorders NOS (sub-clinical bulimia), dysthymia, anxiety disorders, depression and low self-esteem (Family Satisfaction SEI sub-score) than did non-obese IDDM girls.

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ZusammenfassungZiel Die Untersuchung von Eßstörungen und emotionalen Störungen bei weiblichen Jugendlichen mit einem insulinpflichtigen Diabetes Mellitus (IDDM).Erfassung, Strategie und Methoden: 98 weibliche Jugendliche im Alter von 13 bis 19 Jahren wurden untersucht: 15 übergewichtige und 37 nicht-übergewichtige Mädchen mit IDDM, 22 übergewichtige Mädchen ohne IDDM und 24 Mädchen, die nicht übergewichtig waren. Das Vorliegen von Eßstörungen nach DSM-III-R (Anorexia nervosa, Bulimia nervosa, nicht näher bezeichnete Eßstörungen) und Eßgewohnheiten Snacks, Verlangen nach Süßem, wurden mittels eines semistrukturierten diagnostischen Interviews (Kiddie- SADS-E und das Eating Habits Interview) erfaßt. Emotionale Störungen wurden mit Fragebögen erfaßt (State-Trait Anxiety Inventory for Children, Beck Depression Inventory, Cooper-smith Self-Esteem Inventory). Die psychologischen Merkmale wurden mit dem BMT und bei Mädchen mit IDDM zusätzlich mit dem HbA1C-Spiegel korreliert.Ergebnisse Übergewichtige Mädchen mit und ohne IDDM wiesen hohe Raten an nicht näher bezeichneten Eßstörungen auf (subklinische Bulimie: 60 bzw 41%), und sie nahmen mehr Snacks zu sich als nicht-übergewichtige Mädchen. Dies deutet darauf hin, daß Übergewicht der Hauptrisikofaktor für zusätzliche Eßstörungen ist. Jedoch hatten nicht-übergewichtige Mädchen mit IDDM häufiger nicht näher bezeichnete Eßstörungen (sub-klinischeBulimie 27%) als die Mädchen der Kontrollgruppe (4%). 3 Mädchen mit IDDM erfüllten die Kriterien für eine Bulimia nervosa, während dies auf keines der nicht-diabetischen Mädchen zutraf. Das Risiko für eine Depression war erhöht durch IDDM und Übergewicht (16 bzw. 18% mit Dysthymie, 8% bei der Kontrollgruppe); am stärksten waren die übergewichtigen Mädchen mit IDDM betroffen (47% Dysthymie). Übergewicht war mit ausgeprägten Veränderungen der Skalen zur Erfassung des Selbstwertgefühles und mit geringeren Effekten im Hinblick auf Angst-Skalen assoziiert. IDDM hatte keinen Effekt im Hinblick auf erhöhte Ängstlichkeit und keinen Effekt auf das Selbstwertgefühl; der Diabetes schien sogar das Selbstwertgefühl von übergewichtigen Mädchen zu heben. Patienten mit Bulimia nervosa wiesen eine schlechtere Stoffwechsel-Einstellung auf als andere Mädchen mit IDDM. Es gab keine Korrelation zwischen den HbA1C und Eß- bzw. emotionalen Störungen. Übergewicht scheint ein wichtiges Merkmal für das Zustandekommen psychiatrischer Komplikationen zu sein; übergewichtige Mädchen mit IDDM litten häufiger an nicht näher bezeichneten Eßstörungen (subklinische Bulimie), Dysthymie, Angststörungen, Depressionen und niedrigem Selbstwertgefühl (Family Satisfaction SEI subscore) als nicht adipöse Mädchen mit IDDM.

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RésuméObjectif le but de cette étude est d'évaluer les troubles émotionnels et des conduites alimentaires chez des adolescentes diabétiques insulino-dépendantes (DID).Population et méthode: 98 adolescentes, âgées de 13 à 19 ans, ont été étudiées. 15 diabétiques obèses et 37 non obèses, 22 obèses non diabétiques alimentaires (grignotages, compulsions sucrées) ont été évalués à l'aide d'un entretien diagnostique semi-structuré (kiddie-SADS-E et Eating Habits Interview). Les troubles des conduites alimentaires ont été évalués à l'aide d'auto-questionnaires (State-Trait Anxiety Inventory for Children, Beck Depression Inventory, Coopersmith Self-Esteem Inventory). Les caractéristiques psychopathologiques ont été corrélées avec l'indice de masse corporelle (BMI) et, pour les filles DID, avec l'hémoglobine glycosylée (HBA1C).Résultats les adolescentes obèses diabétiques et non diabétiques montraient des taux élevés des troubles alimentaires non spécifiés (boulimie subclinique: 60% et 41%, respectivement) et elles avaient plus de grignotages que les filles non obèses, suggérant que l'obésité était le principale facteur de risque pour d'autres troubles des conduites alimentaires. Cependant, des diabétiques non obèses avaient plus de troubles des conduites alimentaires non spécifiés (boulimie sub-clinique: 27%) que les filles normales (4%). Trois filles DID avaient une boulimie nerveuse typique, contre aucune fille non diabétique. Le risque de dépression était augmenté à la fois par le diabète insulinodépendant et l'obésité (16% et 18% de dysthymie, respectivement; 8% chez les filles normales); les deux facteurs se cumulaient chez les adolescentes obèses diabétiques (47% des troubles dysthymiques). L'obésité était associée à des modifications marquées dans les scores d'estime de soi et des effets modérés sur l'anxiété. Le diabète insulino-dépendant avait des effets faibles sur l'anxiété et nul sur l'estime de soi; il semblait même préserver l'estime de soi des filles obèses. Les patientes avec une boulimie nerveuse avaient un équilibre métabolique plus mauvais que les autres filles diabétiques. Il n'y avait pas de corrélation entre l'hémoglobine glycosylée et les troubles émotionnels ou des conduites alimentaires.Conclusions les adolescentes diabétiques insulino-dépendantes paraissent avoir un risque accru de troubles des conduites alimentaires et de troubles émotionnels. L'obésité semble être un facteur de risque important pour les complications psychiatriques; plus d'adolescentes diabétiques obèses souffraient de troubles des conduites alimentaires non spécifiés (boulimie sub-clinique), de troubles dysthymiques, de troubles anxieux, de dépression et d'une faible estime de soi (SEI de Satisfaction Familiale) que les filles diabétiques non obèses.

     

Eating disorders and body image in Spanish and Mexican female adolescents

OBJECTIVE: To compare the prevalence of eating disorders (ED), socio-cultural risk factors, and body image characteristics in two populations of female adolescents, one Mexican and one Spanish, from similar socio-economic backgrounds. METHOD: A total of 467 Spanish and 329 Mexican girls aged from 11-12 to 17-18 years were assessed using the Eating Attitude Test-26 (EAT-26), the CETCA (Eating Disorders Assessment Questionnaire), the CIMEC (Questionnaire on Influences on Body Shape Model), and a survey of socio-demographic and risk factors produced for this study. RESULTS: One out of four subjects showed a significant risk of an eating disorder and 6-7% probably already had one. No significant differences were found between the two samples. Significant differences were found in risk behaviors: more Spanish girls reported body dissatisfaction and binging; more Mexican girls had a history of psychiatric and psychological treatment, pressure from parents and friends to lose weight, dieting, physical activity and vomiting to lose weight, and a history of greater weight loss. In both the groups around 50% of subjects wanted to increase the size of their breasts. However, significantly more Mexican girls desired thinner arms and narrower shoulders and back, and more Spanish girls wanted thinner hips, buttocks, and legs, parts of the body that many Mexicans wanted to increase. CONCLUSIONS: Risk behaviors and the ideal body models of these Spanish and Mexican adolescent girls varied significantly, indicating major socio-cultural differences. However, the prevalence of ED was similar. Further research should aim to clarify whether the similarities found between this Spanish sample and a Mexican sample taken from an upper-middle class urban environment, a minority that is unrepresentative of the general population, are also observed in samples from other sectors of Mexican society.     

Coagulation and fibrinolytic system impairment in insulin dependent diabetes mellitus

Selected coagulation and fibrinolytic parameters were assessed in 40 insulin dependent diabetes mellitus patients with varying degrees of metabolic control; 30 healthy subjects matched for age and sex formed the control group. Activated Partial Thromboplastin Time, Prothrombin Time, Fibrinogen, Factor VII, Antithrombin III, Protein C, Plasminogen, ₂-Plasmin Inhibitor, Plasminogen Activator Inhibitor-1, tissue-Plasminogen Activator were functionally evaluated. Antigenic levels of tissue-Plasminogen Activator, Thrombin-Antithrombin complexes and fibrinolytic specific product Bβ 15–42 were also determined. Compared to the control group diabetic patients displayed significantly higher levels of Fibrinogen (p<0.01), Factor VII (p<0.01), Thrombin-Antithrombin complexes (p<0.01) and Plasminogen Activator Inhibitor-1 activity (p<0.01). Regardless of the normal level of the tissue-Plasminogen Activator-related antigen, diabetic patients had tissue-Plasminogen Activator activity lower than the control group (p<0.05). Coagulation Factor VII and Thrombin-Antithrombin complexes were increased only in the patients with poor metabolic control (p<0.01). Activated Partial Thromboplastin Time, Prothrombin Time, Antithrombin III, Protein C, Plasminogen, ₂-Plasmin Inhibitor, Bβ 15–42 fibrin peptide were found to be in the normal range. Fibrinogen correlated positively with fasting blood glucose (p<0.05) and Thrombin-Antithrombin complexes with glycosylated haemoglobin (p<0.05), whereas Factor VII was positively correlated with glycemia (p<0.01) and glycosylated haemoglobin (p<0.05). Higher levels of Fibrinogen were found in patients affected by nephropathy (p<0.005) or neuropathy (p<0.05).

These results demonstrate an impairment of the haemostatic balance in diabetic patients, that is a possible hypercoagulable state, which represents an important factor in the pathogenesis of atherosclerotic complications.     

Eating disorders in adolescents and young adults

Adolescence and young adulthood mark the convergence of substantial biologic and social change. Individuals differ in their innate capacity to tolerate change. Research suggests that some of the personality characteristics that are fundamental to individuals with eating disorders may render them particularly vulnerable to the impact of a changing body and changing social demands. The fact that eating disorders emerge primarily during adolescence and often run a protracted course can deprive the afflicted individual of the core social, emotional, and biologic developmental processes that normally occur during this time of life.     

Eating disorders and aggressiveness among adolescents

OBJECTIVE: To explore the links between propensity to aggression and eating disorders in a sample of school-aged adolescents in a northeastern area of Italy. METHOD: In a mixed male-female sample of 1000 adolescents (10% of the district's population aged 15-19 years) we administered the Eating Attitudes Test, the Bulimic Investigatory Test of Edinburgh and the Body Attitudes Test, as measures of abnormal eating attitudes and behaviours, and the Aggression Questionnaire, as a measure of the propensity to aggression. RESULTS: Females scored significantly higher than males at all eating disorders inventories (P < 0.0001). Males scored higher than females at the Aggression Questionnaire. In both genders, there was a positive correlation between scores at any of the eating disorders inventories and those at the Aggression Questionnaire (P < 0.0001). CONCLUSION: Overtly expressed aggression might have a negative impact on the course of eating disorders and on the compliance with treatment, also enhancing the risk of suicide.     

Movement disorders in patients with diabetes mellitus

Movement disorders are not infrequent in patients with diabetes mellitus. These may occur on the basis of both central and peripheral nervous system dysfunction and can be secondary to severe hyperglycemia, complications of diabetes or its treatment and less often to diseases in which both diabetes and a movement disorder are primary manifestations of the same underlying disease. We present a typical case of a severe movement disorder complicating diabetes as a springboard to review the spectrum of disorders associated with this condition.     

Anxiety disorders in adults with diabetes mellitus

Anxiety disorders are common among patients with diabetes and appear to recur in a substantial proportion of cases. The presence of generalized anxiety disorder is associated with both poorer glucose control and the increased report of clinical symptoms of diabetes. A complex interactive model best accommodates observations from psychiatric-diabetic research, one wherein diabetes may affect psychiatric status or vice versa in an independent or reciprocal fashion. No information from systematic studies is available currently to determine if treatment of the psychiatric disorder will have a beneficial impact on glucose regulation, despite the direct clinical relevance of such information to management of diabetes.     

Neuropathy in children and adolescents with diabetes mellitus

Nerve conduction velocities were studied in the median, posterior tibial, radial and sural nerves of 50 juvenile diabetics, average age 13 +/- 1.3 years and mean duration of diabetes 2.3 +/- 1.4 years. Motor conduction velocity (MCV) in the median nerve was reduced in 10% of the subjects, and in the posterior tibial in 32%. Sensory conduction velocity (SCV) in the radial nerve was reduced in 30% of the subjects, and in the sural in 44%. No relationship was found between the reduction in conduction velocity and the duration of diabetes; nevertheless, a correlation was observed between this reduction and the degree of glycaemic control represented by the glycosylated haemoglobin concentration. The authors emphasize the importance of good glycaemic control for the prevention of diabetic neuropathy.     

Effect of controlled hyperglycaemia on factor VIII concentrations in insulin dependent diabetes mellitus

Patients with diabetes mellitus have higher levels of coagulation factor VIII than the non-diabetic population. This may be a result of poor metabolic control and could contribute to the development of microvascular complications. During ketoacidosis there are acute changes in plasma concentrations of coagulation factors, some of which may be mediated by the rise in vasopressin that occurs. We have investigated the effects of hyperglycaemia without ketosis on some aspects of haemostasis by manipulating blood glucose concentrations using a Biostator. After a 1h run-in period with the blood glucose at 5 mmol/l, the blood glucose was maintained at 5, 15 and 25 mmol/l and maintained for one hour at each level in six male patients with insulin-dependent diabetes. Insulin was infused at 0.25 mu/kg/min. Venous blood samples were taken at the beginning and end of each hour after the run-in period for assays of factor VIII coagulant activity (FVIII:C), von Willebrand factor antigen (vWF:Ag), ristocetin co-factor (FVIIIR:Co), activated partial thromboplastin time (APTT) and vasopressin (aVP). There was a slight, though statistically insignificant fall in median factor VIII:C concentration at each incremental level of increase in blood glucose. Values (at the beginning and end of each hour) were: 1.0 and 1.1 iu/ml at 5 mmol/l; 0.95 and 0.79 iu/ml at 15 mmol/l; and 0.74 and 0.84 iu/ml at 25 mmol. vWF:Ag and FVIIIR:Co were unchanged. Plasma aVP fell slightly from 1.1 to 0.5 pg/ml. The results indicate that high levels of FVIII seen in diabetes are not due to short-term increases in blood glucose and that acute hyperglycaemia does not promote pro-coagulant changes in blood.     

The effect of adverse life events on glycaemic control in children with insulin dependent diabetes mellitus

Forty-five children aged 6 to 14 years with insulin-dependent diabetes mellitus were recruited from a paediatric diabetic clinic. Glycaemic control, child emotional and behavioural problems, and maternal mental state were assessed at recruitment and after 12 months. Life events were measured at 12 months using a standardised semi-structured interview schedule. A between-groups comparison design was used to explore the effect of life events, child emotional and behavioural problems, and maternal mental state on glycaemic control. The children had relatively high rates of emotional and behavioural problems. Overall, the children had a similar number of life events to healthy children in the general population, but proportionally, experienced fewer desirable events. Children who had experienced at least one event in a family setting, or a disappointing event, were more likely to have high glycated haemoglobin levels afterwards than were children who had not experienced such events. Linear regression models showed that only disappointments, family events and glycated haemoglobin at the start of the study made important independent contributions to glycated haemoglobin at 12 months. Child age, emotional and behavioural problems, and maternal mental state, had no effect on glycaemic control. Accepted: 10 August 1998     

Eating disorders and insulin-dependent diabetes mellitus (IDDM): relationships with glycaemic control and somatic complications

This study was designed to assess (by means of a diagnostic interview based on DSM-III-R criteria) the prevalence of eating disorders in 69 insulin-dependent diabetic (IDDM) out-patients, and the relationship with somatic risks. We found no cases of anorexia nervosa or bulimia nervosa, current or lifetime, in male patients with IDDM. No female patients with IDDM had anorexia, and 4.8% had current and lifetime bulimia. Eating disorders not otherwise specified (bulimic type) were significantly more frequent in women than in men (lifetime incidence 43% vs. 21%; current incidence 33% vs. 5%), and generally occurred after the onset of IDDM. Self-reports of bulimic behaviours according to the Bulimic Investigatory Test of Edinburgh (BITE) were associated with high levels of glycosylated haemoglobin. There was no association between eating disorders (current or lifetime), with somatic complications being more likely to be explained by a long duration of illness and impaired glycaemic control.     

Eating disorders in children and adolescents: an update

PURPOSE OF REVIEW: Children and adolescents with eating disorders frequently present to child mental health and paediatric services and have significant morbidity, psychosocial impairment and mortality. Efforts to treat these individuals have been hampered by a poor evidence base for effective interventions. This article reviews research published during 2004 with a primary focus on this challenging clinical area. RECENT FINDINGS: Research published during 2004 has replicated past epidemiological findings and expanded our understanding of the relationship of family meal structure and disordered eating. Research has provided assistance in the well known clinical conundrums of excessive exercising in anorexia nervosa and predicting when return of menses will occur. There has also been clarification of adolescent bingeing. Potential advances include a new, noninvasive method of measuring body composition and investigations in adolescents on leptin, neuro and gastrointestinal peptides. Importantly, further evidence of the effectiveness of family therapy for anorexia nervosa and short-term benefits from intervention programs have been published. SUMMARY: The research base that will influence clinical practice in child and adolescent eating disorders is increasing. More research is required in all areas of intervention.     

Eating disorders in children and adolescents: pharmacological therapies

Anorexia nervosa and bulimia nervosa do exist in childhood, frequently have their onset in adolescence, and can result in serious medical and psychiatric sequelae that impede physical, emotional, and behavioral development. Although we use the same Diagnostic and Statistical Manual of Mental Disorders-Version 4 [DSM-IV] definitions to diagnose eating disorders in children, adolescents, and adults, these disorders may be expressed somewhat differently in younger populations, requiring assessment and treatment procedures that are tailored to their developmental needs. Significant advances have been made in recent years in our understanding of treatments for eating disorders in adults, and specifically pharmacological treatments for these disorders. Multiple double-blind, placebo-controlled studies have documented the short-term efficacy of antidepressant medications in bulimia nervosa. While the usefulness of pharmacological treatments for the acute treatment of anorexia nervosa is less clear, recent evidence suggests a role for medication in the relapse-prevention stage of the illness. The majority of the medication trials for the eating disorders have been conducted with adults, and the literature on the pharmacological treatment of children and adolescents with these disorders is very limited. This review article summarizes the current literature on the role of medication in the treatment of anorexia nervosa and bulimia nervosa, with particular emphasis on studies conducted in child and adolescent populations.

     

Eating disorders and social maladjustment in female medical students

A survey of eating disorders in female medical students showed that 15% had a lifetime history of bulimia or anorexia nervosa. On the work, social/leisure, and overall subscales of the Social Adjustment Scale Self-Report, those medical students who had current or previous eating disorders reported greater social maladjustment then medical students who did not have eating disorders.     

Eating disorders and associated mental health comorbidities in female veterans

Eating disorders (EDs) remain understudied among veterans, possibly due to the perception that primarily male population does not suffer from EDs. However, previous research suggests that male and female veterans do experience EDs. The high rates of posttraumatic stress disorder (PTSD), depression, and obesity observed among veterans may make this group vulnerable to disordered eating. Retrospective chart review was used to obtain data from 492 female veterans who were presented to a women?s primary care center at a large, urban VA medical center between 2007 and 2009. A total of 2.8% of this sample had been diagnosed with an ED. In bivariate analyses, presence of PTSD and depression were significantly associated with having an ED diagnosis. However, when these two disorders were included in a multivariate model controlling for age, only depression diagnosis and lower age were significantly related to ED status. In sum, the rate of EDs in this sample is comparable to prevalence estimates of EDs in the general population. Current findings underscore the importance of assessing for EDs among VA patients and the need for further research among veterans.