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GAO-20-611R 1 (2020-08-07)

handle is hein.gao/gaobaebmp0001 and id is 1 raw text is: GAOU.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 August 7, 2020 Congressional Requesters Department of Defense: Eating Disorders in the Military Eating disorders are complex conditions affecting millions of Americans, which raise the risk of mortality, and which are associated with serious physical and mental health problems. They involve dangerous eating behaviors, such as the restriction of food intake or binge eating, and can have a severe effect on heart, stomach, and brain functionality. Many with eating disorders also experience co-occurring conditions such as anxiety, depression, substance use, or post- traumatic stress disorder. The potential effects that eating disorders can have on the health and combat readiness of servicemembers and their dependents underscores the importance of screening and treating this population. The Department of Defense (DOD) requires regular health screenings of its servicemembers and provides health care services to approximately 9.5 million eligible beneficiaries, including services to treat those diagnosed with eating disorders.1 DOD provides its health care services through TRICARE, DOD's regionally structured health care system. Servicemembers can obtain these services at military treatment facilities-referred to as direct care-or receive care purchased from civilian providers. You asked us to review DOD's screening, prevention, and treatment of eating disorders. In this report, we describe (1) how DOD screens servicemembers for eating disorders; and (2) how DOD provides eating disorder treatment to servicemembers and their dependents. To describe how DOD screens for eating disorders among servicemembers, we reviewed DOD policies and procedures related to health screening, as well as several health assessment questionnaires used by DOD to screen for health issues. We interviewed officials and behavioral health specialists from the Army, Navy, Air Force, and Marine Corps to determine if specific branch policies or procedures are in place for the screening of health conditions, including eating disorders. We also discussed with these officials whether any prevention programs related to eating disorders have been implemented. Additionally, we interviewed representatives from the Eating Disorder Coalition, Uniformed Services University of Health Sciences, and the University of Kansas to understand approaches to screening for eating 1Eligible beneficiaries include active duty personnel and their dependents, medically eligible National Guard and Reserve servicemembers and their dependents, and retirees and their dependents and survivors. Active duty personnel include Reserve component members on active duty for at least 30 days.

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