Air Force

The Air Force Weight Management Program is described in Air Force Instruction 40-502 (1994) and implements Air Force Policy Directive 40-5 (1994), "Fitness and Weight Management." The Weight Management Program is the responsibility of each installation commander, with counseling and medical policies established by the deputy chief of staff for personnel, the surgeon general, and the Air Force Nutrition Committee. As in the Army, evaluation of weight and appearance, measurement of body fat, and assignment to the Weight Management Program is the responsibility of commanders and supervisors. All personnel are weighed, without notice, a minimum of every 12 months; 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 group or who appear to exceed body fat standards or who fail to present a "professional military appearance" undergo circumferential body fat measurement (see Air Force body fat standards in Appendix B). Those who exceed body fat standards receive medical evaluation; a 6-mo body fat standard adjustment may be made by the Medical Service if the person is deemed to be otherwise physically fit. Those personnel found to have no underlying causative condition or disease receive diet counseling and are entered into Phase I of the two-phase Weight Management Program and a 90-d exercise program by the unit commander. Such personnel are restricted from some travel; in addition, they are ineligible for education, permanent change of duty station, and promotion (AFI 40-502, 1994).

Phase I of the Weight Management Program is administered by the Nutrition Medicine Service, with counseling provided by authorized diet counselors, who are defined as registered dietitians, authorized diet therapists, or other health professionals authorized by the Major Command (MAJCOM) consultant dietitian (AFI 40-104, 1994). While initial and follow-up counseling are specified in Air Force Instruction 40-502 (1994), the actual counseling may be conducted for various lengths of time, including a one-time class, a 4-wk program, or a 16-wk program (a mandatory program of quarterly diet counseling has been discontinued); some of the programs include a fitness component (Personal communication, MAJ J. M. Spahn, Elmendorf AFB, Alaska, 1997). Counseling is based on Air Force Instruction 44-135 (1994), "Clinical Dietetics," which in turn is based on the American Dietetic Association's Manual of Clinical Dietetics (Personal communication, MAJ J. M. Spahn, Elmendorf AFB, Alaska, 1997). Class materials are updated quarterly. Counseling sessions or classes cover the content of Air Force Pamphlet 44-132 (1994), "Dietary Information for Weight Loss." This 57-page booklet includes basic instruction on nutrition, physiology, foods and low-fat food choices, sample menus, portion guides, methods to chart progress, behavioral modification strategies, and references. In addition, individuals enrolled in the Weight Management Program receive the booklet Air Force Pamphlet 44-133, ''Improving Eating Habits," and Air Force Pamphlet 44-125, "Good Eating: A Dieter's Guide," as well as a food diary and exercise log (AF Form 3529, 1993) to teach self-monitoring of food intake and exercise.

Individuals who complete Phase I of the program are enrolled in Phase II, a 6-mo observation period during which they are weighed monthly. This is followed by a 1-y probationary period, during which personnel can be weighed at any time. Personnel are encouraged at all times to return to the nutrition clinic for individual counseling and quarterly follow-up classes. Those who repeatedly fail to make satisfactory progress (defined as a decrease of at least 1 percent body

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