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This report contains details that some readers may find upsetting.

Retired Navy Chief Leah Stiles caused a stir this summer when she posted a personal account of her 20-year military career on social media. She revealed that she spent much of that time desperately trying to hide an eating disorder that now requires hospital treatment.

“It’s my life, man,” she said. “I’m at the end of things here.”

The 43-year-old former public affairs officer grew accustomed to purging, restricting her food intake and over-exercising to pass the Navy’s twice-a-year weight tests. His routine included laxatives, hours in the sauna, dehydration and other extreme measures.

She remembers feeling humiliated when she failed to gain weight. She was ordered to remove her shirt and be measured in front of her shipmates.

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

Stiles said the purge turned into a coping mechanism. Some sailors smoked; Stiles threw up. She got promotions and received positive comments about her physique, so she linked weight loss measures with success. Now, from her home in Florida a year after retiring, she says therapy and outpatient treatments aren’t working. She can’t stop.

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

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

Some military and health experts say the military isn’t doing enough to prevent and treat eating disorders. Troops that do not meet the strict weight limits risk being expelled. And there aren’t many places where sailors with eating disorders can seek help – at sea or on land.

But some changes are afoot. Lieutenant Commander Pamela Gregory, a Navy dietician, said she has started work on a program to streamline health care so that sailors with eating disorders have a pathway to 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,” Gregory said, attributing the new program in part to Stiles – a former senior chief. high-ranking – made public. .

“Hopefully it wasn’t just a flash in the pan that disappeared the next day,” Gregory said.

Gregory’s program is just for Navy personnel. 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 Government Accountability Office found that fewer than 1,800 soldiers had been diagnosed between 2013 and 2017, or about a tenth of one percent of all active duty forces. But advocates say that’s 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 where 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 force’s eating habits, we can really talk about a culture change. and a change in culture must come with the understanding that weight standards are going to 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 who are contacting 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.