I 

117TH CONGRESS 

1ST SESSION H. R. 1309 

To amend title 10, United States Code, to provide for eating disorders 

treatment for members of the Armed Forces and certain dependents 

of members and former members of the uniformed services, and for 

other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 24, 2021 

Mr. MOULTON (for himself, Mr. KATKO, Ms. ESCOBAR, Mr. DEUTCH, Mr. 

FITZPATRICK, Mr. CROW, Ms. CHU, Mr. COURTNEY, Ms. MCCOLLUM, 

Mr. RYAN, Mrs. AXNE, Mr. CONNOLLY, Miss RICE of New York, Mr. 

PRICE of North Carolina, Mr. RUSH, Mr. NEGUSE, Ms. SCANLON, Ms. 

SHERRILL, Mr. FOSTER, Mr. KEATING, Ms. OMAR, Mr. CLEAVER, and 

Mr. LEVIN of California) introduced the following bill; which was referred 

to the Committee on Armed Services, and in addition to the Committee 

on Veterans’ Affairs, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL 

To amend title 10, United States Code, to provide for eating 

disorders treatment for members of the Armed Forces 

and certain dependents of members and former members 

of the uniformed services, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Supporting Eating dis3 orders Recovery through Vital Expansion Act’’ or the 

4 ‘‘SERVE Act’’. 

5 SEC. 2. EATING DISORDERS TREATMENT FOR CERTAIN 

6 MEMBERS OF THE ARMED FORCES AND DE7 PENDENTS. 

8 (a) FINDINGS.—Congress finds the following: 

9 (1) Eating disorders affect approximately 

10 30,000,000 Americans (or nine percent of the popu11 lation) during their lifetime, including individuals 

12 from every age, gender, body size, race, ethnicity, 

13 and socioeconomic status. 

14 (2) Eating disorders are severe, biologically 

15 based, mental illnesses caused by a complex inter16 action of genetic, biological, social, behavioral, and 

17 psychological factors. 

18 (3) Eating disorders result in the second high19 est case fatality rate of any mental illness, with one 

20 death occurring every 52 minutes as a direct result 

21 of an eating disorder due to serious medical co22 morbidities and suicide. 

23 (4) Untreated eating disorders cost the econ24 omy of the United States $64.70 billion annually, 

25 with families and individuals experiencing an eco26 nomic loss of $23.50 billion annually. 


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1 (5) A study from the Armed Forces Health 

2 Surveillance Branch found that diagnoses of eating 

3 disorders among military personnel increased by 26 

4 percent from 2013 to 2016. Although accurate esti5 mates are challenging due to underreporting, the 

6 prevalence of eating disorders in the military is two 

7 to three times higher than in the civilian population. 

8 (6) The Defense Health Board found that fe9 male members of the Armed Forces on active duty 

10 experience high rates of eating disorders, which can 

11 adversely affect their readiness and health. 

12 (7) Risk factors for eating disorders in the mili13 tary include pressure to maintain weight and fitness 

14 standards, trauma, sexual harassment, weight stig15 matization, and post-traumatic stress disorder. 

16 (8) Family members of members of the Armed 

17 Forces have a higher prevalence of eating disorders 

18 than the general population, with 21 percent of chil19 dren and 26 percent of spouses of members of the 

20 Armed Forces found at risk of developing an eating 

21 disorder. 

22 (9) Research demonstrates a strong correlation 

23 between a military spouse and their adolescent 

24 child’s risk for an eating disorder. Adolescent female 

25 military dependents are more likely to be at risk for 


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1 an eating disorder if their non-military parent is at 

2 risk for an eating disorder. 

3 (b) EATING DISORDERS TREATMENT FOR CERTAIN

4 DEPENDENTS.—Section 1079 of title 10, United States 

5 Code, is amended— 

6 (1) in subsection (a), by adding at the end the 

7 following new paragraph: 

8 ‘‘(18) Treatment for eating disorders may be 

9 provided in accordance with subsection (r).’’; and 

10 (2) by adding at the end the following new sub11 section: 

12 ‘‘(r)(1) The provision of health care services for an 

13 eating disorder under subsection (a)(18) shall include the 

14 following services: 

15 ‘‘(A) Inpatient services, including residential 

16 services. 

17 ‘‘(B) Outpatient services for in-person or tele18 health care, including partial hospitalization services 

19 and intensive outpatient services. 

20 ‘‘(2) A dependent may be provided health care serv21 ices for an eating disorder under subsection (a)(18) with22 out regard to— 

23 ‘‘(A) the age of the dependent, except with re24 spect to residential services under paragraph (1)(B), 

25 which may be provided only to a dependent who is 


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1 not eligible for hospital insurance benefits under 

2 part A of title XVIII of the Social Security Act (42 

3 U.S.C. 1395c et seq.); and 

4 ‘‘(B) whether the eating disorder is the primary 

5 or secondary diagnosis of the dependent. 

6 ‘‘(3) In this section, the term ‘eating disorder’ has 

7 the meaning given the term ‘feeding and eating disorders’ 

8 in the Diagnostic and Statistical Manual of Mental Dis9 orders, 5th Edition (or successor edition), published by the 

10 American Psychiatric Association.’’. 

11 (c) IDENTIFICATION AND TREATMENT OF EATING

12 DISORDERS FOR MEMBERS OF THE ARMED FORCES.— 

13 Section 1090 of title 10, United States Code, is amend14 ed— 

15 (1) by striking ‘‘The Secretary of Defense’’ and 

16 inserting the following: 

17 ‘‘(a) IDENTIFICATION AND TREATMENT OF EATING

18 DISORDERS AND DRUG AND ALCOHOL DEPENDENCE.— 

19 The Secretary of Defense’’; 

20 (2) by inserting ‘‘have an eating disorder or’’ 

21 before ‘‘are dependent on drugs or alcohol’’; and 

22 (3) by adding at the end the following new sub23 sections: 

24 ‘‘(b) FACILITIES AVAILABLE TO INDIVIDUALS WITH

25 EATING DISORDERS.—For purposes of this section, ‘necVerDate Sep 11 2014 22:59 Apr 01, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1309.IH H1309

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1 essary facilities’ described in subsection (a) shall include, 

2 with respect to individuals who have an eating disorder, 

3 facilities that provide the services specified in section 

4 1079(r)(1) of this title. 

5 ‘‘(c) EATING DISORDER DEFINED.—In this section, 

6 the term ‘eating disorder’ has the meaning given that term 

7 in section 1079(r)(3) of this title.’’. 

8 (d) CLINICAL PRACTICE GUIDELINES AND CRITERIA

9 RELATING TO EATING DISORDERS.— 

10 (1) GUIDELINES AND CRITERIA.—Not later 

11 than two years after the date of the enactment of 

12 this Act, the Secretary of Defense and the Secretary 

13 of Veterans Affairs shall jointly develop, publish, 

14 and disseminate clinical practice guidelines and cri15 teria for the identification and treatment of eating 

16 disorders. Such guidelines shall be consistent with 

17 generally accepted standards of care. 

18 (2) CONSULTATION.—In carrying out sub19 section (a), the Secretaries shall consult with, and 

20 incorporate into the guidelines and criteria developed 

21 under such subsection the recommendations and 

22 guidelines of, the following: 

23 (A) The Administrator of the Substance 

24 Abuse and Mental Health Services Administra25 tion. 


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1 (B) The Director of the Centers for Dis2 ease Control and Prevention. 

3 (C) The Director of the National Institute 

4 of Mental Health. 

5 (D) Nonprofit clinical specialty associa6 tions and any other organizations or associa7 tions determined relevant by the Secretaries. 

Æ 


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