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Editor’s Note: This report contains details that some listeners may find shocking.

Retired Navy Chief Leah Stiles caused a stir this summer when she posted a personal account of her 20-year career on social media. For years she has desperately tried to hide an eating disorder that has gotten so bad that she is seeking hospitalization.

“This is my life, man. I’m at the end of things here,” Stiles said.

The 43-year-old former public affairs officer got used to purging, restricting his food intake and excessive exercise to pass the Navy’s twice-a-year weight tests. His routine included laxatives, hours in the sauna, dehydration and other extreme measures.

She recalls feeling humiliated when she failed to gain weight – she was ordered to take off her shirt and be measured in front of her shipmates.

“I was like, ‘Okay, so I’m never going to do this again. I’m going to gain weight from now on.

Then she said the purge turned into a coping mechanism. Some sailors smoked; Stiles threw up. She was getting promotions and getting positive feedback about her physique, so she linked weight loss to success. Now, from her home in Florida a year after retiring, she says therapy and outpatient treatment aren’t working. She can’t stop.

Stiles, two-time Sailor of the Year, has written to top Navy leaders with his ideas for preventing harmful weight loss before it starts, including a widespread awareness campaign starting as early as boot camp and medical references for sailors who take extreme measures before weighing.

“I know this is an epidemic that this culture is facing so I just wanted to come up with something where I could have an impact,” Stiles said.

Some military and health experts say the military isn’t doing enough to prevent and treat eating disorders. Troops are held to strict weight limits or risk being kicked out. This leads some to take extreme weight loss measures that can turn into eating disorders if not identified and treated.

There aren’t many places sailors with eating disorders can turn to for help – at sea or on land. But some changes are afoot. Lieutenant Commander Pamela Gordon, a Navy dietitian, said she has started work on a program to streamline health care so that when sailors develop eating disorders there is a pathway to recovery. treatment.

“We are working with leaders to hopefully put in place a program for this much-needed population that has been, in a sense, underserved,” Gordon said, attributing the new program in part to Stiles – a former officer. high-ranking – made public.

Leah Stiles was promoted to Senior Chef on June 16, 2017.

“I hope it wasn’t just a flash in the pan that disappeared the next day.”

Gordon’s program is just for the Navy. A broader response for the entire military is expected to come from the Defense Health Agency, which declined an interview request.

“Good nutrition helps achieve peak emotional, cognitive and physical performance and contributes to total physical fitness,” DHA spokesperson Peter Graves said in a statement. “The Defense Health Agency is committed to helping its service members achieve optimal health and performance through nutritional counseling or other medically necessary treatment.”

There is not much data on the prevalence of eating disorders among active duty troops. The Office of Government Accountability found less than 1,800 soldiers were diagnosed from 2013 to 2017, or about 0.10% of all active duty forces. But defenders said that was a gross understatement.

“It’s certainly understated because it was only service members who were diagnosed and reported through the military health system,” said Katrina Velazquez, public policy lawyer with the Eating Disorders Coalition. . “It’s grossly underreported.”

It can also take a long time for mental health care providers to diagnose an eating disorder.

“The time of diagnosis is five to 10 years after they’ve lived with this condition,” said Commander Monica Ormeno, a senior Navy psychiatric adviser. “Unless they get caught or something sends them to the point that someone needs medical assistance, people live with eating disorders for many years.”

Ormeno said a mandatory, anonymous survey of eating and weight loss habits for all forces could help the military better understand the scope of the problem.

“We really don’t know how bad it is,” Ormeno said. “So I think once we have a better assessment of our strength eating habits, we can really talk about a culture change and a culture change has to come with the understanding that the weight standards will have to be adjusted. “

Stiles, the retired chef, said she is now focused on her treatment. She said she was trying to help other sailors – not hurt the Navy.

“I think of all the sailors reaching out to me now, there are so many, and they’re all like, ‘Help me, how can I get help?'” Stiles said. “And so I feel like as the main boss, who’s going to speak for them?”

This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans. Funding comes from the Corporation for Public Broadcasting.