Award-winning USU Graduate Student Studies the Impact of Eating Disorders on Military Health

 

Graduate student Megan Parker accepts an HJF Fellowship Award from HJF President and CEO, Joseph Caravalho, Jr., M.D. (Photo credit: Tom Balfour, USU)

By Claire Pak

“What do eating disorders have to do with the military?” Graduate student Megan Parker hears this question often when new acquaintances learn about her Ph.D. research focus at the Uniformed Services University of the Health Sciences School of Medicine. Parker, a fourth-year Medical and Clinical Psychology (MCP) student, who was recently awarded the 2022 Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF) Fellowship, works under the mentorship of Dr. Marian Tanofsky-Kraff investigating disordered eating in children and adolescents.

“That is a good question,” she says, acknowledging that many people think that medical research in the military focuses only on battlefield medicine topics such as combat surgery, acute care, or PTSD treatment. But, according to her mentor, the rates of eating disorders are likely higher among service members compared with the civilian population. Tanofsky-Kraff explains that fitness standards may place susceptible individuals at risk for engaging in disordered eating behaviors. Moreover, the high-stress nature of service can also be a potent risk for eating disorders. 

Eating disorders also affect military dependents. “People in the military have families,” Parker says, noting that military dependents often suffer from eating disorders, and that stressors unique to military family life (frequent moves, parental deployments) may increase the likelihood of unhealthy eating behaviors in the children of military parents. Eating disorders are a health and readiness issue for the military, whether it is active duty military members or their family members who are suffering. 

Megan Parker was raised in Hartland, Michigan. A graduate of Hartland High School, she earned a Bachelor’s in Psychology at The Pennsylvania State University, and began her graduate studies with Dr. Adrienne Jauarascio at the Center for Weight, Eating and Lifestyle Science at Drexel University in Philadelphia. As an undergraduate, she considered medical school, but after studying with Dr. Kenneth Levy at Penn State’s Laboratory for Personality Psychopathology and Psychotherapy Research, she realized that research was a better fit. Levy's lab studies Borderline Personality Disorder in adults, and as a student, Parker observed a connection between BPD and eating disorders. “Emotion dysregulation is associated with both BPD and eating disorders,” she said, “and many of our research subjects were engaged in disordered eating.” Parker learned that eating disorders are very common (though not well studied) and until recently, were the most deadly mental health disorders. 

While studying adult eating disorders and observing development of novel treatments at Drexel, Parker became interested in early intervention and prevention, and her focus shifted toward eating disorders in children and adolescents. “I wanted to know how eating disorders develop,” she said, “and to identify the changes during puberty that increase the risk of disordered eating.” She also knew that she wanted to continue her graduate studies in a medical school setting. “I’m very interested in studying the biological origins” of psychological diseases and disorders, she said, “and I knew that an academic medical center would be the best place to do that.” Parker discovered USU through research on potential mentors for her doctoral study. When she learned about Tanofsky-Kraff’s work, she knew that she wanted to study and work in the Tanofsky-Kraff Lab. Parker entered USU in 2019, and under Tanofsky-Kraff’s mentorship, began work on her thesis, "The effects of sex and puberty on food cravings and loss of control eating among youth in the natural environment and laboratory."

Parker sees it as part of her mission to help dispel misconceptions about eating disorders. There is a “harmful myth,” she says, that eating disorders affect only young, affluent white women. But Parker’s research has taught her that susceptibility to eating disorders does not discriminate - people of every race, body size, gender, and socioeconomic status can be affected. While young women may focus on achieving or maintaining an ideal body weight through unhealthy means such as starvation diets or inappropriate use of laxatives or diuretics, young men may attempt to bulk up and build muscle mass through excessive exercise or use of unsafe dietary supplements. Poverty can also be a factor - Parker notes that people who live with food insecurity can be at risk for developing unhealthy eating habits or disordered relationships with food. 

USU graduate student Megan Parker (right) and Dr. Marian Tanofsky-Kraff, Parker's mentor. (Photo credit: Tom Balfour, USU)
USU graduate student Megan Parker (right) and Dr. Marian Tanofsky-Kraff, Parker's mentor. (Photo credit: Tom Balfour, USU)

She also hopes to end the stigma associated with disordered eating. As Parker explains, many people who struggle with eating disorders also experience guilt and embarrassment; not just because they believe that their bodies don’t measure up to a certain standard, but because of the disorder itself. “Eating disorders can create feelings of shame,” Parker says. “It can seem like ‘everyone eats, so why can’t I do it, right? There must be something wrong with me.’”

Through her contributions to her mentor’s research, Parker has learned that rates of disordered, “loss of control” eating are higher among children and adolescents who have larger bodies, and she is working to better understand the physiological and psychological reasons for this. American children, she points out, are constantly exposed to aggressive marketing promoting "highly palatable” but unhealthy processed foods. “American society also places value on people based on their bodies and appearance,” she says, noting that healthcare professionals often encourage people with larger bodies to lose weight, without first talking to them about eating disorders or other factors that may be impacting their health and well-being. “Screening for eating disorders is not common in clinical settings,” she says, although validated questionnaires that help to identify or predict eating disorders in patients are available. 

Parker’s choice of language - “people with larger bodies,” rather than “overweight or obese people” -- is intentional, she explains. “We are learning that language is so important - the word obesity can be stigmatizing.” In patient interactions, she says, “we let the patient take the lead on how they describe their body.” Even in conversations outside a clinical setting, Parker says, researchers should be careful to avoid language that “stigmatizes people in larger bodies or suggests that higher body weight is equivalent to moral failure.” 

*Over the past few years, Parker has earned a number of awards for her research. In 2021, she received an NIH Fellows Award for Research Excellence grant for her research “State Negative Affect in Relation to Loss-Of-Control Eating among Youth in the Natural Environment.” Parker also received a $1000 Student Research Grant from the Academy for Eating Disorders (2022), the Obesity Society’s George A. Bray’s Master’s Thesis Award (2021), and the NIH Summer Research Mentor Award (2020). With the travel award portion of the HJF Fellowship, Parker plans to attend the International Conference on Eating Disorders, and to travel for additional training on the role of gonadal hormones in eating disorders. 

“These awards are well-deserved - with the support of her mentor and in collaboration with NICHD, Megan has contributed to multiple publications and presented her work widely, all while assuming substantial leadership and service roles at USU and beyond,” says Dr. Saibal Dey, associate dean for Graduate Education at USU.  

"The work that Dr. Tanofsky-Kraff and her students are engaged in is important for overall military readiness and healthcare, and illustrates the breadth of the School of Medicine's scientific research portfolio,” says Dr. Eric Elster, School of Medicine dean, referring to Parker’s work on eating disorders.

USU’s Medical and Clinical Psychology doctoral program is five years long, plus an additional year of clinical internship, so Parker still has more than a year of study and her internship left to complete. Asked about her career plans, she emphasizes her love for research, but she also hopes to continue with clinical work as well, perhaps in an academic medical center or a research-focused clinic or hospital within the Military Health System. 

In any setting, however, Parker is dedicated to this topic. “I cannot imagine not doing research on eating disorders.”