referred to weight control programs. It was agreed by those contacted that enforcement of the weight standards by referring individuals to weight control programs was entirely at the discretion of unit commanders and supervisors and was done on an individual basis.

Regarding outcome analysis, no data were available on the rate of success or recidivism of the weight control programs except for a small study of Navy personnel. Trent and Stevens (1995) compared the 6-wk, 6-mo, and 12-mo outcome of patients enrolled in programs at approximately 20 different command sites and found that although maintenance of weight loss at 12 months was higher than civilian studies have reported, absolute loss was small. Interpretation of the results is complicated by the fact that the study compared personnel enrolled in three program levels. Whereas the most intense Level III (a 6-wk in-patient program) has since been abolished, the current program is most similar to the former Level II program. In addition, attrition was significant, and there was no control group. Nevertheless, based on their results, the authors recommended changing the Navy's approach to treatment of overweight, including adoption of a long-term, supportive, behaviorally based "aftercare" program.

The 1992 Institute of Medicine (IOM) report, Body Composition and Physical Performance, recommended examining data compiled by the Army Medical Remedial Enlistment Program database to evaluate long-term health outcome and performance of program participants, as well as to perform a cost-benefit analysis of the program; however, these data were not available. The numbers of active-duty enlisted women separated from service in fiscal year 1996 for failure to adhere to the body composition standards are listed in Table 4-1. The Air Force was the only branch of service that separated female commissioned officers in fiscal year 1996 for failing to adhere to weight standards. Five women were separated, all between 26 and 40 years of age; three were minorities. According to one Air Force dietitian, the DoD is developing a software program to collect outcome data on weight reduction programs (Personal communication, MAJ Joanne M. Spahn, Elmendorf AFB, Alaska, 1997). At present, this software is being tested.