25 October 2016

Top military doctor says trend toward overweight troops is troubling

October 20, 2016

The growing ranks of overweight troops is a worrisome trend and the Defense Department should look for ways to help today’s force live a healthier lifestyle, the Pentagon’s top health official said Thursday.

“I am concerned,” Vice Adm. Raquel Bono, director of the Defense Health Agency, told reporters on Thursday.

“Anything that attenuates or poses a challenge to our readiness or our health is something that I’m interested in,” she said.

But, Bono added, “We don’t have any kind of indication that this is impacting readiness.”

Recent military health data shows that about 7.8 percent of the force -- or about one in every 13 troops -- is clinically overweight, defined by a body mass index greater than 25.

That figure has roughly doubled during the past five years and is up fourfold since 2001, when about 1.6 percent of troops were diagnosed as clinically overweight.

Top Pentagon officials are rewriting the forcewide guidelines for body composition standards and the methods for officially evaluating it. For individual troops, a diagnosis of obesity can stall a career or lead to involuntary separation, making these policies are central to military life.

Some Pentagon officials worry that overweight troops pose a threat to combat readiness because they may not be able to move as quickly in ground combat and if they are wounded, it is more difficult for their buddies to pull them to safety.

“I’m glad that we're looking at it,” Bono said. “It gives us a chance to collectively, across the department, take a look and see what we can do to support our military members in their efforts to be more healthy, to maintain good body weight, to choose more nutritional options.”

The reasons for more overweight troops are similar to those in the civilian world, she said.

"We're kind of a microcosm. I think our level of activity has changed. I think our eating habits have changed. I think there are any number of reasons why that might be,” she said.

But the military community is unique because lifestyles are more easily controlled or influenced by the institution.

“The encouraging thing about this is, in the military we have opportunities to impact most of the things that we think are contributing to this -- in our dining facilities, in our chow halls, bringing in healthier food choices through [morale, welfare and recreation programs] and being able to provide more activities that engage people and get them off the couches," she said.

Military commanders can influence troops' eating and lifestyle habits. But, she said, they cannot force troops to become healthier.

“People still persist in certain behaviors," she said, despite aggressive education efforts.

“I don’t know what the right answer is, but I agree it’s a challenge and I don’t necessarily have a forcing function. I’m interested in finding out what might work in other areas,” she said.

The problem's scope shifts significantly depending on the service. 

The Army, for instance, reports that 10.5 percent of soldiers are overweight, up from 6.4 percent five years ago.

In the Air Force, 9 percent are overweight, more than double the 4.3 percent reported in 2011.

Navy doctors diagnosed 5.9 percent of the fleet with elevated body mass indices last year, up from 3.3 percent over the same five years.

Among Marines, the rate was 2.3 percent, up from 1.7 percent five years prior. 

Compared to the U.S. civilian population, the rate of overweight troops is far smaller. About 70 percent of the adult American population has a BMI above 25, meaning they are clinically overweight or obese, according to data from the U.S. Centers for Disease Control. 

Many health experts inside and outside the military criticize the body mass index as a flawed measurement tool because it does not evaluate body fat levels. Instead, BMI measures an individual’s height and weight to flag those who might have unhealthy levels of body fat.

It is often criticized as a blunt tool that wrongly identifies bodybuilders with heavy muscle mass as being fat while missing flabby and unfit people with lanky body types.

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