Homelessness and eating disorders among a sample of OEF/OIF recently returned U.S. veterans

Introduction: An estimated 11-14% of the homeless population in the U.S. is comprised of veterans. While the majority of homeless veterans have a mental health diagnosis, eating disorders (ED) remain understudied within this population. EDs are rare among veterans, however, understanding the association between homelessness and ED, while accounting for psychological covariates, could better inform our understanding of the unique mental health care needs of these veterans. Methods: Retrospective data on 265,806 Veterans from the Veterans Health Administration (VHA) were used in this study. Veterans were included in the sample if they had clinical follow-up data for at least five years after their first VA encounter. Logistic regression analysis was used to compute adjusted odds ratios (AOR) for ED as a function of homelessness, controlling for clinical and demographic covariates. Results: Of veterans seeking care at the VHA, 11,876 (4.5%) had evidence of homelessness. A documented diagnosis of ED was observed in 71 (0.6%) of these homeless veterans. EDs were three times more likely among veterans experiencing homelessness as compared to domiciled veterans (AOR=3.55, 95% confidence interval = 2.74-4.53), after accounting for demographic covariates. When controlling for both demographics and mental health comorbidities, ED was more than 50% more likely among veterans experiencing homelessness as compared to domiciled veterans (AOR=1.52, 95% Confidence interval=1.16-2.00; p Discussion: Homeless veterans are at heightened risk for ED. As EDs are potentially fatal, our results reveal that further research is necessary to identify who among homeless veterans are at higher risk for ED. Determination of these risk factors may inform targeted screening strategies among homeless veterans