Advocates urge Austin to act on active duty obesity ‘epidemic’

The military must take swift, decisive action to address obesity in the ranks, according to a new letter sent to Defense Secretary Lloyd Austin Wednesday by a group of more than 50 individuals and organizations, including 21 retired senior military leaders.

The letter, spearheaded by the American Security Project, urges defense leaders to strike at the core of the problem on five fronts related to prevention, identification and treatment of obesity in the military.

“This crisis has far-reaching impacts on readiness and retention,” wrote the group, which also includes health experts and advocacy organizations.

The missive follows a study released by the organization last year showing that more than two-thirds of active duty members are overweight or obese. About 1 out of 5 active duty members meet the clinical standard for obesity.

“Despite incredible leaps in medical and nutrition science, obesity and its comorbid conditions in the U.S. armed forces remain heavily stigmatized and underprioritized,” the letter said.

In spite of the need for adequate medical treatment for obesity, care is often inaccessible for military service members living with the disease, the American Security Project said in a release announcing the letter.

“Military regulations continue to rely on value judgments from commanders, and not consultations with medical experts, to determine whether and how a soldier receives treatment for obesity,” the nonpartisan national security forum said in the release.

According to the letter, systemic issues are preventing individuals with obesity from getting access to “evidence-based treatments including behavioral therapy, anti-obesity medications and bariatric surgery.”

Instead, the services “promote voluntary, willpower-based ‘wellness’ programs followed by forced enrollment in rigorous weight-loss programs associated with disordered eating, weight gain and even bone and muscle loss,” according to the American Security Project. “As a result, military obesity rates across active duty alone have more than doubled over 10 years, with experts claiming the current state of military obesity treatment is more than 15 years behind current science.”

“Musculoskeletal injuries, heart disease, Type 2 diabetes, liver disease and other comorbid conditions are rising in tandem with body composition trends,” the letter added.

The letter recommended:

• A full review of DOD guidelines for identification and treatment of obesity, including statistics on treatment approvals, denials and appeals for existing treatment options;
• A system-wide recognition of obesity as a chronic disease that can be treated while in service, provided the service member’s performance standards are being met;
• Cost-effective, comprehensive policies for obesity prevention;
• Effective early interventions for overweight and obesity for service members, including Guard and Reserve members.
• Greater access to credentialed food and nutrition practitioners and the full continuum of evidence-based treatments in consultation with medical professionals.

In a 2022 report, the Centers for Disease Control and Prevention found that 19% of active duty service members were obese, up from 16% in 2015. The report said DOD spends about $1.5 billion a year in obesity-related health care costs for current and former service members and their families, as well as costs to replace unfit personnel.

The CDC said it is working with other groups, including the National Association for Chronic Disease Directors, to address obesity by finding ways to help prevent risky behaviors among troops and their families and by educating DOD providers, such as clinicians and those in family programs, to connect troops with national and state public health resources.

Among the 21 retired senior officers who signed the letter are retired Air Force Gen. Merrill McPeak, former chief of staff of the Air Force; retired Navy Vice Adm. Kevin Green, former deputy chief of naval operations; retired Army Lt. Gen. Daniel Christman, former superintendent of the U.S. Military Academy; retired Marine Corps Brig. Gen. Stephen Cheney, former inspector general of the Marine Corps; and retired Vice Adm. Lee Gunn, former inspector general of the Navy.

Other signatories include the Obesity Action Coalition, the Obesity Care Advocacy Network, YMCA of the USA, American Society for Nutrition, the National Hispanic Medical Association, the Endocrine Society and the American Diabetes Association.