By Jim Gourley
Best Defense department of physical fitness and national security
Obesity and weight-related health conditions have become a prevalent concern to American policy in the last decade. National military leadership was also exposed to obesity's potential risks to national security with the release of the report "Too Fat to Fight" by Mission Readiness in 2010. The group's primary message is that a burgeoning population of overweight American children will drastically reduce an already diminished pool of viable candidates for military service in the next ten years. However, these reports indicate only the most general aspects of the problem and focus on projections of future implications. When the scope of the American obesity epidemic is examined specifically within the context of its impact on the armed forces, data shows clearly that the threat is not imminent, but existential.
At present, 62 percent of active duty military members over the age of 20 have a body mass index that falls into either the overweight or obese category. For personnel under the age of 20, the number stands at 35 percent. That is actually an improvement from a 2005 rate of 46 percent. These statistics are often challenged due to the disputable methods of calculating Body Mass Index (BMI). However, the 2011 Annual Summary of the Armed Forces Health Survey Center cites 21,185 medical diagnoses for overweight, obesity and hyperalimentation (overeating). Research also dispels service culture stigmas. No service is immune to overweight issues. Comparing the relative percentages of overweight/obese service members, the Navy is the fattest service at 62.7 percent, followed by the Army at 61 percent, the Air Force at 58.8 percent. The Marines register the fittest at 55.1 percent, still substantially more than half overweight. Closer examination shows that more than 12 percent of active duty service members in each service are obese. The Marines break the trend more significantly in this category with a 6.1 percent obesity rate.
The increase of girth in the military progressed at a linear rate between 1995 and 2005, but has remained fairly consistent since then. However, emerging data indicates that the overweight population may rise further in the next ten years if the military is to meet recruiting goals. A new study by the Trust for America's Health predicts that more than half of Americans in 39 states will be obese by 2030. This is disturbing enough, but it becomes even more troubling for the armed forces when individual state recruitment trends are compared to their childhood obesity rates. All ten states that contributed the most military inductees in 2010 have childhood obesity rates greater than 15 percent. Three of them (including Texas, which was second in total recruitment with over 15,000 new military members) exhibit rates between 20-25 percent. The preponderance of our young military members come from the most ponderous states.
The problem is not simply one of cosmetics or intangible metrics of combat performance. The costs of an unfit military carry a real-dollar value. A 2007 joint study by The Lewin Group and TRICARE management activity estimated that the Defense Department spends $1.1 billion annually on medical care for obesity and overweight conditions. This study included dependents and retirees who qualified for TRICARE Prime coverage. More restricted to the active duty component are the costs to manpower. The AFHSC report tallied 245 "bed days" for medical treatment directly linked to weight issues, and 4,555 service members were involuntarily separated for failing to meet weight standards in 2008. The recruiting and initial entry training costs alone represent a loss of $225 million. Adding in specific military job training, logistics, equipment and the cost of lost duty days brings the annual price tag of overweight service members to about $1.5 billion. That exceeds the military's budget for Predator drones in 2010. The military still fails to grasp the true scale of the problem so long as comorbidities of overweight and obesity remain unexamined. There were more than 42,000 service members affected by hypertension and another 5,700 by diabetes in 2011. Hypertension alone ranks in the top thirty conditions affecting active duty service members. Also overlooked is the expense of XXL chemical warfare suits and development of other plus-sized uniform items.
The military's response to the problem has been mixed. The Army provided waivers to 1,500 new recruits who failed to meet weight standards in 2007. The program remains in place but the numbers of waivers issued in subsequent years have not been published. The Navy had a similar program until 2010. The Air Force never offered such a program and the Marines actually tightened standards in the 2009-2011 time period. Trends suggest that weight standards are on a sliding scale driven largely by manpower requirements and retention problems in a wartime military.
Therein lies the greatest problem. It seems all but certain that American society will continue gaining weight over the next decade. In this regard, the military may be a kind of canary in the cave given its emphasized dependence on physical fitness for mission success. However, without an established position on the matter of physical fitness standards and given the likelihood that leaders at every level will themselves be at an unhealthy weight, it is possible that the military will experience substantial increases in operating costs and diminished capability in the next decade.
Jim Gourley is a Best Defense jolly good fellow.
Thomas E. Ricks covered the U.S. military for the Washington Post from 2000 through 2008.