Abstract：
OBJECTIVE: We aimed to explore US veteran perspectives on eating disorder screening, diagnosis, patient-provider conversations, and care in the Veterans Health Administration (VHA).
METHODS: Rapid qualitative analysis of 30-45 min phone interviews with 16 (N = 16) veterans with an electronic health record ICD-10 eating disorder diagnosis, who received care at one of two VHA healthcare systems in Connecticut or California. Topics covered included: conversations with providers about eating disorder symptoms, diagnosis, and referral to treatment; feedback about an eating disorder screener, and; reflections on eating disorders among veterans and VHA\'s effort to address them.
RESULTS: Most veterans reported difficulty understanding and defining the problems they were experiencing and self-diagnosed their eating disorder before discussing it with a provider. Treatment referrals were almost universally for being overweight rather than for an eating disorder, often leading veterans to feel misunderstood or marginalized. Overall, veterans were enthusiastic about the screener, preferred screening to be conducted by primary care providers, and noted that conversations needed to be non-stigmatizing. There was consensus that VHA is not doing enough to address this issue, that group support and therapy could be beneficial, and that resources needed to be centralized and accessible.
CONCLUSIONS: For the most part, veterans felt that, at best, eating disorders and disordered eating are overlooked, and at worst, conflated with overweight. The majority of veterans got referred for weight loss or weight management services but would welcome the opportunity to be screened for, and referred to, eating disorder treatment.
METHODS: Rapid qualitative analysis of 30-45 min phone interviews with 16 (N = 16) veterans with an electronic health record ICD-10 eating disorder diagnosis, who received care at one of two VHA healthcare systems in Connecticut or California. Topics covered included: conversations with providers about eating disorder symptoms, diagnosis, and referral to treatment; feedback about an eating disorder screener, and; reflections on eating disorders among veterans and VHA\'s effort to address them.
RESULTS: Most veterans reported difficulty understanding and defining the problems they were experiencing and self-diagnosed their eating disorder before discussing it with a provider. Treatment referrals were almost universally for being overweight rather than for an eating disorder, often leading veterans to feel misunderstood or marginalized. Overall, veterans were enthusiastic about the screener, preferred screening to be conducted by primary care providers, and noted that conversations needed to be non-stigmatizing. There was consensus that VHA is not doing enough to address this issue, that group support and therapy could be beneficial, and that resources needed to be centralized and accessible.
CONCLUSIONS: For the most part, veterans felt that, at best, eating disorders and disordered eating are overlooked, and at worst, conflated with overweight. The majority of veterans got referred for weight loss or weight management services but would welcome the opportunity to be screened for, and referred to, eating disorder treatment.
摘要：
目的：我们旨在探索美国退伍军人对饮食失调筛查的看法，诊断,患者-提供者对话，和护理在退伍军人健康管理局（VHA）。
方法：对16名（N=16）退伍军人进行30-45分钟的电话访谈进行快速定性分析，并有电子健康记录ICD-10进食障碍诊断，他在康涅狄格州或加利福尼亚州的两个VHA医疗保健系统之一接受护理。涵盖的主题包括：与提供者就饮食失调症状进行对话，诊断,和转诊治疗；关于饮食失调筛查者的反馈，以及对退伍军人饮食失调和VHA努力解决这些问题的思考。
结果：大多数退伍军人报告在与提供者讨论饮食失调之前，难以理解和定义他们所经历的问题并自我诊断。治疗转诊几乎普遍是因为超重而不是饮食失调，经常导致退伍军人感到被误解或边缘化。总的来说,退伍军人对放映机充满热情，由初级保健提供者进行的首选筛查，并指出对话必须是非污名化的。人们一致认为，VHA在解决这个问题上做得不够，团体支持和治疗可能是有益的，资源需要集中和可访问。
结论：在大多数情况下，退伍军人觉得,充其量,饮食失调和饮食失调被忽视，在最坏的情况下，与超重混为一谈。大多数退伍军人被推荐接受减肥或体重管理服务，但欢迎有机会接受筛查，并提到，饮食失调治疗。
方法：对16名（N=16）退伍军人进行30-45分钟的电话访谈进行快速定性分析，并有电子健康记录ICD-10进食障碍诊断，他在康涅狄格州或加利福尼亚州的两个VHA医疗保健系统之一接受护理。涵盖的主题包括：与提供者就饮食失调症状进行对话，诊断,和转诊治疗；关于饮食失调筛查者的反馈，以及对退伍军人饮食失调和VHA努力解决这些问题的思考。
结果：大多数退伍军人报告在与提供者讨论饮食失调之前，难以理解和定义他们所经历的问题并自我诊断。治疗转诊几乎普遍是因为超重而不是饮食失调，经常导致退伍军人感到被误解或边缘化。总的来说,退伍军人对放映机充满热情，由初级保健提供者进行的首选筛查，并指出对话必须是非污名化的。人们一致认为，VHA在解决这个问题上做得不够，团体支持和治疗可能是有益的，资源需要集中和可访问。
结论：在大多数情况下，退伍军人觉得,充其量,饮食失调和饮食失调被忽视，在最坏的情况下，与超重混为一谈。大多数退伍军人被推荐接受减肥或体重管理服务，但欢迎有机会接受筛查，并提到，饮食失调治疗。
