If U.S. military personnel fail to comply with body composition standards, they are referred to a remedial weight management program. All military weight control program regulations implement Department of Defense (DoD) Directive 1308.1 (1981), which established a weight control program for all services. Each branch of the military has its own weight loss program, based on scientifically and medically accepted approaches for decreasing energy intake and increasing energy expenditure. Personnel participate in these programs until a weight within military standards is achieved.
The Army Weight Control Program is the responsibility of the deputy chief of staff for personnel, with counseling and medical policies established by the surgeon general. Evaluation of weight and appearance, measurement of body fat, and assignment to the weight control program are the responsibility of commanders and supervisors. All personnel are weighed a minimum of every 6 months (at the time of the physical fitness test [PFT]); additional weighings and body fat measures are at the discretion of the commander or supervisor. Personnel who exceed the screening table weight maximum for their height, gender, and age undergo circumferential body fat measurement (see Army body fat standards in Appendix B). Those who exceed body fat standards receive medical evaluation; those found to have no underlying causative disease are entered into the weight control program by the unit commander, and their personnel records are flagged (this notation carries implications for travel, education, permanent change of duty station, and promotion). They must receive nutrition counseling (one visit with a counselor) and are required to meet a weight loss goal of 3 to 8 lb per month (AR 600-9, 1986).
The nutrition counseling component of the Army Weight Control Program is provided by "qualified health care personnel," according to Army Regulation 600-9 (1986). Depending on the availability of such personnel, the counseling may be provided by registered dietitians, dietetic technicians, physicians' assistants, nurses, or physicians. Beyond the initial visit, there is no requirement regarding the number of visits, and an unlimited number of follow-up visits is permitted (Personal communication, LTC J. P. Warber, U.S. Army Research Institute of Environmental Medicine, Natick, Mass., 1997). The educational materials and counseling provided appear to vary from one facility to another (Personal communication, C. Baker-Fulco and LTC J. P. Warber, U.S. Army Research Institute of Environmental Medicine, Natick, Mass.; A. D. Cline, Pennington Biomedical Research Center, Baton Rouge, La., 1997). A general nutrition and weight management guide that emphasizes lower-fat food choices, sample menus, and advice on lifestyle and behavioral modification strategies appears as an appendix to Army Regulation 600-9, and may serve as a reference for Army health care personnel to provide counseling to personnel enrolled in weight control programs.
Progress of personnel in the Weight Control Program is monitored on a monthly basis and evaluated at 6 months. Failure to show satisfactory progress for 2 consecutive months or at the 6-mo point may result in additional medical evaluation and ultimately separation from the Army.