[Congressional Record Volume 167, Number 190 (Thursday, October 28, 2021)]
[Senate]
[Pages S7503-S7504]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 4022. Mrs. SHAHEEN (for herself and Mr. Tillis) submitted an 
amendment intended to be proposed to amendment SA 3867 submitted by Mr. 
Reed and intended to be proposed to the bill H.R. 4350, to authorize 
appropriations for fiscal year 2022 for military activities of the 
Department of Defense, for military construction, and for defense 
activities of the Department of Energy, to prescribe military personnel 
strengths for such fiscal year, and for other purposes; which was 
ordered to lie on the table; as follows:

        At the end of subtitle A of title VII, add the following:

     SEC. 704. TREATMENT FOR EATING DISORDERS FOR MEMBERS OF THE 
                   ARMED FORCES AND DEPENDENTS OF MEMBERS OF THE 
                   UNIFORMED SERVICES.

       (a) Findings.--Congress finds the following:
       (1) Eating disorders affect approximately 30,000,000 
     individuals in the United States, or nine percent of the 
     population, during their lifetime, including individuals from 
     every age, gender, body size, race, ethnicity, and 
     socioeconomic status.
       (2) Eating disorders are severe, biologically based mental 
     illnesses caused by a complex interaction of genetic, 
     biological, social, behavioral, and psychological factors.
       (3) Eating disorders result in the second highest case 
     fatality rate of any psychiatric illness, with one death 
     every 52 minutes as a direct result of an eating disorder due 
     to serious medical comorbidities and suicide.
       (4) Untreated eating disorders cost the economy of the 
     United States $64,700,000,000 annually, with individuals and 
     their families experiencing an economic loss of 
     $23,500,000,000 annually.
       (5) A study from the Armed Forces Health Surveillance 
     Branch found that diagnoses of eating disorders among 
     military personnel increased by 26 percent from 2013 to 2016.
       (6) Although accurate estimates are challenging due to 
     underreporting, the prevalence of eating disorders among 
     members of the Armed Forces is two to three times higher than 
     in the civilian population.
       (7) The Defense Health Board found that women members of 
     the Armed Forces on active duty experience high rates of 
     eating disorders, which can adversely affect the readiness 
     and health of such members.
       (8) Risk factors for eating disorders among members of the 
     Armed Forces include pressure to maintain weight and fitness 
     standards, trauma, sexual harassment, weight stigmatization, 
     and post-traumatic stress disorder.
       (9) Family members of members of the Armed Forces have a 
     higher prevalence of eating disorders than the general 
     population, with 21 percent of children and 26 percent of 
     spouses of members of the Armed Forces found to be at risk of 
     developing an eating disorder.
       (10) Research demonstrates a strong correlation in the risk 
     of developing an eating disorder between a military spouse 
     and their adolescent child. An adolescent female dependent of 
     a member of the Armed Forces is more likely to be at risk for 
     an eating disorder if their nonmilitary parent is at risk for 
     an eating disorder.
       (b) Treatment for Eating Disorders for Dependents of 
     Members of the Uniformed Services.--Section 1079 of title 10, 
     United States Code, is amended--
       (1) in subsection (a), by adding at the end the following 
     new paragraph:
       ``(18) Treatment for an eating disorder may be provided in 
     accordance with subsection (r).''; and
       (2) by adding at the end the following new subsection:
       ``(r)(1) The provision of health care services for an 
     eating disorder under subsection (a)(18) shall include 
     treatment at facilities providing the following services:
       ``(A) Inpatient services, including residential services.
       ``(B) Outpatient services for in-person and telehealth 
     care, including--
       ``(i) Partial hospitalization services; and
       ``(ii) Intensive outpatient services.
       ``(2) A dependent may be provided health care services for 
     an eating disorder under subsection (a)(18) without regard to 
     the age of the dependent, except with respect to residential 
     services under paragraph (1)(A), which may be provided only 
     to a dependent who is not eligible for hospital insurance 
     benefits under part A of title XVIII of the Social Security 
     Act (42 U.S.C. 1395c et seq.).
       ``(3) In this section, the term `eating disorder' has the 
     meaning given the term `feeding and eating disorders' in the 
     Diagnostic and Statistical Manual of Mental Disorders, 5th 
     Edition (or successor edition), published by the American 
     Psychiatric Association.''.
       (c) Identification and Treatment of Eating Disorders for 
     Members of the Armed Forces.--
       (1) In general.--Section 1090 of title 10, United States 
     Code, is amended--
       (A) by striking ``The Secretary of Defense'' and inserting 
     the following:
       ``(a) Identification and Treatment of Eating Disorders and 
     Drug and Alcohol Dependence.--The Secretary of Defense'';
       (B) by inserting ``have an eating disorder or'' before 
     ``are dependent on drugs or alcohol'';
       (C) by adding at the end the following new subsections:
       ``(b) Facilities Available to Individuals With Eating 
     Disorders.--For purposes of

[[Page S7504]]

     this section, necessary facilities described in subsection 
     (a) shall include the facilities described in section 
     1079(r)(1) of this title.
       ``(c) Eating Disorder Defined.--In this section, the term 
     `eating disorder' has the meaning given that term in section 
     1079(r)(3) of this title.''; and
       (D) in the section heading, by inserting ``eating disorders 
     and'' after ``treating''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 55 of such title is amended by striking 
     the item relating to section 1090 and inserting the following 
     new item:

``1090. Identifying and treating eating disorders and drug and alcohol 
              dependence.''.
       (d) Clinical Practice Criteria and Guidelines on the 
     Identification and Treatment of Eating Disorders.--
       (1) In general.-- Not later than two years after the date 
     of the enactment of this Act, the Secretary of Defense and 
     the Secretary of Veterans Affairs, in consultation with 
     specialized stakeholders, shall jointly develop, publish, and 
     disseminate clinical practice criteria and guidelines on the 
     identification and treatment of eating disorders.
       (2) Inclusion of recommendations and guidelines.--The 
     criteria and guidelines developed, published, and 
     disseminated under paragraph (1) shall include--
       (A) recommendations and guidelines established by, and any 
     guidance from, the Substance Abuse and Mental Health Services 
     Administration, the Centers for Disease Control and 
     Prevention, and the National Institute of Mental Health; and
       (B) clinical practice guidelines developed by specialized 
     nonprofit professional associations.
       (e) Effective Date.--This section and the amendments made 
     by this section shall take effect on October 1, 2022.
                                 ______