A recent study published in The Journal of Nutrition found that in young, physically active service members the medical burden of being overweight or obesity is substantial.
Obesity is associated with a wide range of medical conditions and has reached epidemic proportions in the United States. Active-duty service members are no exception. Several US military studies indicate that body mass index (BMI), a population screening tool for evaluating overweight and obesity, has steadily increased among active-duty service members. The Armed Forces Health Surveillance Division of the US Defense Health Agency (DHA) maintains the Defense Medical Surveillance System (DMSS), which contains comprehensive data from medical visits by service members to their health care providers. Although a few studies have examined selected medical conditions in relation to BMI in the military, none have examined the relationship between BMI and a broad range of clinically diagnosed medical conditions in service members.
To comprehensively address this knowledge gap, Dr. Joseph Knapik (Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine) and colleagues examined the relationship between BMI and a broad range of clinically diagnosed medical conditions in a large cohort of young, physically active service members. A stratified random sample of service members completed an online questionnaire reporting their height, weight, and demographic/lifestyle characteristics. Medical conditions for 6 months before questionnaire completion were obtained from a comprehensive military electronic medical surveillance system and grouped into 39 clinically diagnosed medical conditions. The prevalence among medical conditions was compared among normal weight, overweight, and obese service members.
After adjusting for demographic/lifestyle characteristics, higher BMI was associated with higher odds of a diagnosed medical condition in 30 of 39 standard categories of clinically diagnosed medical conditions. The clinically diagnosed medical conditions with the largest odds ratios when comparing obese to normal weight service members were: endocrine/nutritional/metabolic diseases; nervous system diseases; circulatory system diseases; musculoskeletal system diseases; and mental/behavioral disorders. Compared with normal weight service members, overweight or obese service members had an overall higher number of clinically diagnosed medical conditions (1.8 vs. 2.0 and 2.5, respectively).
In this young, physically active population, higher BMI was associated with a host of medical conditions. This study demonstrates the need for the US Department of Defense to provide nutrition education to ease the medical burden of obesity, which is substantial among US service members. The findings of this study are also likely to apply to the young, health civilian population.
Knapik JJ, Farina EK, Steelman RA, Trone DW, Lieberman HR. The Medical Burden of Obesity and Overweight in the US Military: Association of BMI with Clinically Diagnosed Medical Conditions in United States Military Service Members. The Journal of Nutrition, Volume 153, Issue 10, October 2023, Pages 2951-2967, doi.org/10.1016/j.tjnut.2023.08.023.
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