A Comparison of Obesity Prevalence: Military Health System and United States Populations, 2009-2012

Authors
Eilerman, P. A. Herzog, C. M. Luce, B. K. Chao, S. Y. Walker, S. M. Zarzabal, L. A. Carnahan, D. H.
Publication year
2014
Citation Title
A comparison of obesity prevalence: Military health system and United States populations, 2009-2012.
Journal Name
Military Medicine
Journal Volume
179
Issue Number
5
Page Numbers
462-470
DOI
10.7205/MILMED-D-13-00430
Summary
This descriptive report, for 2009-2012, compares the prevalence of overweight and obese children and adults in the Military Health System (MHS) population to rates of the general U.S. population. Among children (between ages 2 and 17), trends show reductions in both groups, but that the prevalence for MHS children was significantly lower than the general U.S. population. Among adults, non-Active Duty participants had stable and comparable results in the overweight and obesity categories to their peers in the general population, but interestingly, Active Duty members were more likely to be overweight and less likely to be obese than the general U.S. population. However, both the MHS population and the general U.S. populations still had too many children and adults in the overweight and obesity categories.
Key Findings
Compared to the U.S. population by gender and age, MHS children generally had lower overweight and obesity prevalence.
MHS Active Duty adults had higher overweight and lower obesity prevalence compared to the U.S. population.
Non-Active Duty MHS adults had rates of overweight and obesity generally comperable to the U.S. population.
Implications for Program Leaders
Educate Service members and their families about preventing the health risks associated with being overweight or obese
Engage older Service members in workshops that provide strategies for increasing long-term health
Provide workshops in which Service members and their famlies learn skills (e.g., cooking, meal planning, physical activities) to support their physical well-being
Implications for Policy Makers
Continue to support programs that aim to prevent obesity while helping Service members maintain adequate military readiness
Promote the development of programs that encourage habits and behaviors that lead to long-term health
Encourage collaboration among DoD and community-based programs that offer recreational activities or events to military families to promote physical activity and reduce to risk of obesity
Methods
Participants' Body Mass Indexes (BMIs), as reported in medical records, were used to categorize individuals as overweight or obese.
Children were considered overweight if their BMIs were between the 85th and 95th percentile and obese if their BMIs were above the 95th percentile.
Adults were considered overweight if their BMIs were between 25.0 and 30.0 and obese if their BMIs were greater than 30.0.
Participants
The MHS population in the study included 2.2 million individuals per year; 60% were men, 22% were children, and 42% were Active Duty Service members.
MHS child population was 52% boys with an average age of approximately nine years old.
No ethnic/racial, socio-economic, income, education level, or deployment stage information was reported.
Limitations
This study reported prevalence of overweight and obesity; it did not investigate any predictors or possible interventions.
Because obesity is a disqualifying condition for entry into U.S. military service, the Active Duty population may contain an artificially low percentage of obese individuals.
BMI has been shown to misrepresent muscular adults as overweight due to the increased weight of muscle tissue compared to fat tissue.
Avenues for Future Research
Explore MHS demographic subgroups to identify relevant risk factors and potentially modifiable health behaviors for overweight and obese individuals
Investigate the differences in overweight and obese prevalence in military subgroups in order to guide program development and implementation
Replicate this study using more preferred methods of measuring being overweight and/or obese (body fat percentage or waist circumference)
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Population Focus
Military Component
Abstract
Overweight and obesity prevalence has increased over the past 30 years. Few studies have looked at the enrolled Military Health System (MHS) population (2,2 million per year). This descriptive study examined trends in overweight and obesity in both children and adults from fiscal years 2009 to 2012 and compared them to the U,S, population. Prevalence in MHS children decreased over time for overweight (14,2-13,8%) and obesity (11,7-10,9%), Active duty adults showed an increase in overweight prevalence (52,7-53,4%) and a decrease in obesity prevalence (18,9-18,3%), For nonactive duty, both overweight and obesity prevalence remained relatively unchanged around 33%, For both children and adults, overweight and obesity prevalence increased with age, except for obesity in the nonactive duty >65 subgroup. When compared to the United States by gender and age, MHS children generally had a lower overweight and obesity prevalence, active duty adults had higher overweight and lower obesity prevalence, and nonactive duty adults had comparable overweight and obesity prevalence, except for obesity in both men in the 40 to 59 subgroup and women in >60 subgroup. More research on the MHS population is needed to identify risk factors and modifiable health behaviors that could defeat the disease of obesity.
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