MPCRN Projects - Obesity Prevention During Early Career

Each year the U.S. military discharges more than 1,200 first-time enlistees who have completed basic training before their contracts are complete because of unacceptable body weight. The cost of recruiting and training their replacements is estimated at $50,000 per person — or roughly $60 million a year. The cost-savings of retention are readily apparent, as are the obvious longitudinal benefits and cost savings to DoD related to longitudinal prevention of obesity. An effective prevention program to prevent overweight and obesity in the military is sorely needed. In the last decade, there has been a three-fold increase in the prevalence of overweight in the military raising concerns about the about the impact of overnutriton and subsequent weight gain on overall health, physical fitness, and military performance. The federal health care system incurs obesity-related financial burden past retirement or discharge from the military through Veteran’s Administration (VA) medical benefits. Estimates suggest that 80% of male and 60% of female veterans seen in the VA are overweight or obese. Therefore, prevention of excess weight gain among early career military could potentially alleviate serious health-related obesity problems and significantly reduce cost for both the DoD and VA.

The period following basic training is a time when young adults are at high-risk for gaining excessive weight. Dr. Eric Stice and colleagues have developed Project Health, an obesity prevention program involving participant-driven healthy lifestyle improvement plans designed to bring caloric intake and output into balance. Project Health also includes activities designed with a positive-gains based approach regarding unhealthy dietary and physical activity behaviors. Social psychology research has shown that humans strive to maintain consistency between their words and actions. Thus, this 6-hour intervention includes verbal and written exercises wherein participants discuss the costs of obesity, an unhealthy diet, and sedentary behaviors and the benefits of leanness, a healthy diet, and physical activity, which should increase the likelihood that they will make healthy behavior choices in the future. Project Health has significantly reduced risk for unhealthy increases in BMI in research with civilian young adults. The intervention effect sizes compare favorably to those from the most efficacious prevention programs that are more intensive. Given the time restrictions of active duty personnel and the cultural response toward being unfit in the military, Project Health may be especially well-suited to reduce excess weight gain in young adults following basic training. We propose to conduct a randomized effectiveness trial of Project Health (termed Project H.A.L.O. in proposed study) in the family medicine clinic at Ft Hood that serves newly enlisted personnel following basic training.

Location

Department of Family Medicine Madigan Army Medical Center