The primary purpose of fitness and body composition standards in the U.S. Armed Forces has always been to select individuals best suited to the physical demands of military service, based on the assumption that proper body weight and composition supports good health, physical fitness, and appropriate military appearance.

The current epidemic of overweight and obesity in the United States affects the military services. The pool of available recruits is reduced because of failure to meet body composition standards for entry into the services and a high percentage of individuals exceeding military weight-for-height standards at the time of entry into the service leave the military before completing their term of enlistment.

To aid in developing strategies for prevention and remediation of overweight in military personnel, the U.S. Army Medical Research and Materiel Command requested the Committee on Military Nutrition Research to review the scientific evidence for: factors that influence body weight, optimal components of a weight loss and weight maintenance program, and the role of gender, age, and ethnicity in weight management.

Contents

• THE NATIONAL ACADEMIES
• SUBCOMMITTEE ON MILITARY WEIGHT MANAGEMENT
• COMMITTEE ON MILITARY NUTRITION RESEARCH
• FOOD AND NUTRITION BOARD
• Reviewers
• Preface
• Executive Summary
• 1. Background and Context of the Overweight Problem
  • THE CURRENT NATIONAL SITUATION
  • UNIQUENESS OF THE MILITARY ENVIRONMENT
  • PREVIOUS RECOMMENDATIONS ON BODY FAT AND FITNESS
  • THE CURRENT TASK
  • SUMMARY
• 2. Military Standards for Fitness, Weight, and Body Composition
  • INTRODUCTION
  • FITNESS VERSUS FATNESS
  • WEIGHT STANDARDS FOR ACCESSION AND RETENTION
  • THE IMPACT OF WEIGHT AND BODY-FAT STANDARDS
  • MEETING THE WEIGHT AND BODY-FAT STANDARDS
  • WEIGHT-MANAGEMENT PROGRAMS
  • SUMMARY
• 3. Factors That Influence Body Weight
  • DEVELOPMENTAL DETERMINANTS
  • GENETIC DETERMINANTS
  • AGE
  • RACE/ETHNICITY
  • PHYSICAL ACTIVITY
  • FOOD
  • PHYSIOLOGICAL FACTORS
  • ENVIRONMENTAL FACTORS
  • SOCIAL FACTORS
  • SUMMARY
• 4. Weight-Loss and Maintenance Strategies
  • INTRODUCTION
  • PHYSICAL ACTIVITY
  • BEHAVIOR AND LIFESTYLE MODIFICATION
  • DIET
  • SUPPORT SYSTEMS
  • PRESCRIPTION AND OVER-THE-COUNTER DRUGS AND SUPPLEMENTS
  • FUTURE DRUGS FOR THE TREATMENT OF OBESITY
  • SURGERY
  • THE USE OF STRUCTURED MAINTENANCE PROGRAMS
  • PUBLIC POLICY MEASURES
  • SUMMARY
• 5. Response to the Military's Questions
  • QUESTION 1
  • QUESTION 2
  • QUESTION 3
  • QUESTION 4
  • QUESTION 5
  • QUESTION 6
  • QUESTION 7
• 6. Programmatic and Research Recommendations
  • PREVENTION
  • ASSESSMENT
  • TREATMENT
  • PROGRAM EVALUATION
  • TRAINING
  • RESEARCH RECOMMENDATIONS
  • OTHER AREAS FOR RESEARCH
• References
• A Workshop Agenda and Abstracts
• B Biographical Sketches of the Workshop Speakers
• C Biographical Sketches of the Subcommittee on Military Weight Management
• D Acronyms

Support for this project was provided by U.S. Army Medical Research and Materiel Command through contract no. DAMD17-99-1-9478. The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick, MD 21702-5014, is the awarding and administering acquisition office. The views presented in this report are those of the Subcommittee on Military Weight Management and are not necessarily those of the funding agency.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.