Anorexia Nervosa
Anorexia nervosa involves restriction of food intake leading to significantly low body weight, intense fear of gaining weight, and distorted body image. Unlike other mental health conditions, VA rates it on weight loss and incapacitating episodes rather than occupational and social impairment.
How the VA rates it
Eating disorders are the exception in 38 CFR 4.130: they use their own rating formula (0, 10, 30, 60, or 100 percent) based on self-induced weight loss below expected minimum weight and the duration of incapacitating episodes. An incapacitating episode is a period during which bed rest and treatment by a physician are required. Note there is no 50 or 70 percent tier - the formula jumps from 30 to 60 percent.
Rating criteria by percentage
Rated up to 100%Self-induced weight loss to less than 80 percent of expected minimum weight, with incapacitating episodes of at least six weeks total duration per year, and requiring hospitalization more than twice a year for parenteral nutrition or tube feeding.
Self-induced weight loss to less than 85 percent of expected minimum weight, with incapacitating episodes of six or more weeks total duration per year.
Self-induced weight loss to less than 85 percent of expected minimum weight, with incapacitating episodes of more than two but less than six weeks total duration per year.
Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with a diagnosed eating disorder and incapacitating episodes of up to two weeks total duration per year.
A diagnosed eating disorder with binge eating followed by purging or other weight-gain prevention measures, or resistance to weight gain, but without incapacitating episodes.
What those terms mean
- incapacitating episode
- — A flare-up so bad that a doctor prescribed bed rest for it. The VA counts how many days of doctor-prescribed bed rest you had in the past year.
Secondary condition strategy
Commonly claimed secondary to this
Conditions veterans often develop from this one — each can be its own rating under 38 CFR 3.310.
- Anemia — Nutritional deficiency from restrictive eating commonly causes anemia, claimable as secondary to the eating disorder.
- Osteoporosis / bone loss — Prolonged malnutrition and hormonal disruption cause bone density loss, a recognized medical complication of anorexia.
- Cardiac arrhythmias — Electrolyte disturbances and low weight can cause bradycardia and other heart rhythm problems.
This is often secondary to
If you already have one of these service-connected, it may support connecting this condition.
- PTSD — Eating disorders frequently develop secondary to trauma, including military sexual trauma; anorexia can be claimed secondary to service-connected PTSD.
- Major Depressive Disorder — Anorexia commonly co-occurs with and can be aggravated by depression.
- Generalized Anxiety Disorder — Anxiety disorders are a common precursor to and driver of restrictive eating behavior.
Evidence that strengthens this claim
- The formula is built on numbers - documented weights over time relative to your expected minimum weight are the core evidence. Gather all records showing weight history.
- Document incapacitating episodes precisely: dates when a physician ordered bed rest and treatment. Casual sick days without physician involvement do not count under the definition.
- Records of hospitalization for nutritional support (tube feeding or parenteral nutrition) are what separate the 100 percent level from 60 percent.
- If the eating disorder began after military sexual trauma or other in-service events, develop that service-connection evidence the same way as a PTSD claim, including marker evidence.
Rating rules to know
Eating disorders are rated under their own formula, separate from the single combined rating VA assigns for mental disorders under the general formula. An eating disorder rating can coexist with a general-formula mental health rating (e.g., PTSD), but any overlapping symptoms cannot be counted in both ratings (38 CFR 4.14).
Related diagnostic codes
More mental health conditions
Post-Traumatic Stress Disorder (PTSD)
PTSD is a trauma-related condition marked by re-experiencing, avoidance, negative mood changes, and hyperarousal after an in-service traumatic event. VA rates it on how much it impairs your ability to work and maintain relationships, not on the severity of the trauma itself.
Rated up to 100%
Major Depressive Disorder
Major depressive disorder involves persistent low mood, loss of interest, and changes in sleep, energy, and concentration. VA rates it on the degree of occupational and social impairment, and it is one of the most common conditions claimed secondary to chronic pain.
Rated up to 100%
Generalized Anxiety Disorder
Generalized anxiety disorder involves persistent, excessive worry that is hard to control, with physical symptoms like restlessness, muscle tension, and sleep problems. VA rates it on how much it impairs work and social functioning.
Rated up to 100%
Chronic Adjustment Disorder
Chronic adjustment disorder is an ongoing emotional or behavioral reaction to a stressor - often a service-connected disability, injury, or major life change - with symptoms of depression, anxiety, or both. VA rates it the same way as every other mental disorder: by occupational and social impairment.
Rated up to 100%
Panic Disorder and/or Agoraphobia
Panic disorder involves recurrent, unexpected panic attacks and persistent fear of future attacks; agoraphobia is avoidance of places where escape feels difficult. VA rates both under one diagnostic code based on occupational and social impairment.
Rated up to 100%
Bipolar Disorder
Bipolar disorder causes cycling episodes of mania or hypomania and depression. VA rates it under the general mental disorders formula based on occupational and social impairment across the full cycle of the illness, not just during episodes.
Rated up to 100%
Disclaimer: Valor Rating is not affiliated with the U.S. Department of Veterans Affairs. This content is for educational purposes only and does not constitute legal or medical advice. Always review your documents carefully before submitting to the VA. For official guidance, consult an accredited VSO, claims agent, or attorney.