Reported incidents of eating disorders among female soldiers in the Israel Defense Force have tripled in the past ten years. There remains concern that the actual number of soldiers who suffer from an eating disorder could be higher, as some are reluctant to risk the stigma that comes along with it.

Using a pseudonym, Noa spoke to Israel’s Channel 2 in a report earlier this month to shed light on the growing phenomenon. “My friends who were with me in basic training told me that they put their fingers down their throats and didn’t eat all day. That was when I started asking questions: How do I get skinny? How do I take off the weight? Do I eat or not? Do I throw up or not? I used to throw up right after every meal.”

The soldier went on to explain how common she noticed the problem was once she began sharing a space with other female soldiers. “When I got to the army, I realized that there were many others like me,” she said in the TV report. “During basic training I found that half the girls with me were bulimic.”

Another soldier, Danielle Aharoni, began struggling with an eating disorder only after enlisting. Weighing 132 pounds (60 kilograms) when she started her service, Aharoni came under such intense pressure to succeed that she lost one third of her body weight in less than three months.

Now post army at the age of 25, she lectures at workshops given on army bases as part of the Simply You program, a positive self-image program initiated by Israeli fashion photographer and model agent Adi Barkan. Barkan has also campaigned for laws forbidding the use of anorexic models in advertising.

According to Dr. Hezi Levy, the director of Barzilai Medical Center and the army’s former chief medical officer, these eating disorders can be traced to the transition to army life. “It’s a new and highly demanding setting,” he told Channel 2. “A female soldier doesn’t always have space for herself, so it’s a completely new emotional situation that combines with a previous emotional situation — and that’s a recipe for how eating disorders can become prevalent.”

One male army instructor said, “Two or three out of every ten women soldiers has been affected physically by the discourse of being thin.”

Eating disorders often go undetected in the army because it is common to avoid eating in the mess hall, baggy uniforms can disguise weight loss, and commanding officers and parents each assume the other is on top of the soldier’s well-being.

Life-long stigma may be one of the key reasons suffering soldiers keep their struggles to themselves. “It means a lower score on their mental profile, which could affect them for the rest of their lives,” the instructor said. “It may also mark the soldier as needing to take medication, which disqualifies her from certain jobs. It’s a black mark against her.”

Adi Barkan concurs.  “A female soldier suffering from an eating disorder can’t approach anyone about it because the moment she goes to someone in authority, such as a psychiatrist or mental-health officer, she’s out,” he said. “She doesn’t want that to happen. She wants to keep on serving. We need to bear in mind that girls like this are making themselves throw up and they can’t tell anyone about it. They’re going through hell.”

The IDF’s current protocol is not to dismiss a soldier for an eating disorder, but to use her desire to stay in the army as motivation to eat properly and gain weight as needed, the report added.

The IDF Spokesperson’s Office commented: “Members of the Medical Corps’s mental health department — physicians, mental-health officers and nutritionists — make every effort to find and treat these disorders, in full cooperation with the officers who are trained for that and with the families, in order to conduct professional workshops on the subject and make the commanding officers aware of it.”