Recently, Sgt. Rene Sesma resigned from the Army after being notified that if he didn't quit, the Army would fire him for being overweight.

Being fired for not meeting height and weight requirements happens a lot, said Sesma, “But, I was always working at it. If I was lazy and never worked at it, that would be different.”

In a job that depends on your fitness level and preparedness, Sesma said that although he was 10 to 15 pounds overweight on the Army's height and weight scale (for 5 feet 8 inches tall, his maximum weight should have been 181 pounds), he still scored well on his biyearly physical fitness assessments (PFA), which consist of a series of sit-ups, push-ups and a two-mile run. Sesma jogs three times a week and coaches baseball teams that two of his five children are on. At the age of 49, he ran his 2-mile test in 15:05.

“It's a challenge among ourselves,” he said about losing weight. “I still carry a little weight around my midsection, but I've run all my life.”

Just how common is Sesma's case? Tanja Linton, spokesperson for Fort Huachuca Army Post in Sierra Vista, AZ, said a soldier being fired for being overweight is a rare occurrence. Last year, a little over a dozen soldiers were let go at Fort Huachuca for being too heavy.

“No one wants to see a soldier be put out of the Army because of it. There's extensive Command involvement to work with a soldier. A readiness issue is really what it comes down to,” she said.

However, according to a report on military weight management by the Food and Nutrition Board (FNB) and the Institute of Medicine (IOM), which is a nonprofit, federally funded adviser to improve health, in 2002, 54 percent of the almost 1.4 million men and women on active duty in the Army, Navy, Marine Corps and Air Force were in danger of being assigned to a weight-control program, and some, like Sesma, may be at risk of separation from the service due to their weight. In 1999, more than 4,600 people were discharged for their weight. That number dropped to 1,400 in 2002. However, the report cautions that a large part of this decline was due to a change in the Navy's policy. That change no longer allows discharges for being overweight. Instead, those who fail to meet weight requirements can serve out their current term but cannot re-enlist.

“In the Navy, it's very hard to be put out for being overweight. You have to be in the over standards category for roughly two-and-a-half years to three years, but we're going to tighten that standard down,” said Lanny Boswell, a sports medicine researcher and physical training analyst for the Naval Training Service Command in Great Lakes, IL. “Being put out of the military is one of the last resorts.”

The 2002 report, Department of Defense Survey of Health-Related Behaviors, showed that while military personnel may be less obese and more fit than the general public, they are still far from meeting the government's Healthy People 2000 objectives. Measured by body mass index (BMI), 23.8 percent of the military under age 20 were overweight, 17.2 percent of those ages 20-25 were overweight, 27.1 percent ages 26-34 were overweight, and 31.4 percent ages 35 and older were deemed overweight.

The objective was for no more than 20 percent of the personnel to be overweight. Only the 20-25 age category met that requirement.

However, Boswell cautioned that research based on BMI may be misleading as many military members may have higher BMIs, but different body compositions than that of a civilian due to the physical nature of the job. Many in the military have high rates of muscle mass, which weighs more than fat, putting their BMI in the overweight category.

“Those numbers tend to get skewed, especially as members have been in the Navy for awhile. They are more fit than the general population,” he said. “A 32 [BMI in the Navy] is considerably leaner than a 32 [BMI] that's not in the Navy.”

Each branch of the service sets its own weight standards. According to the IOM report, most branches of the service typically have two sets of weight/fat standards. One is for potential recruits, and the other is an equivalent or more difficult set for those already admitted into the service. As in Sesma's case, both are usually a weight-for-height measurement that can be used to calculate BMI. Maximum allowable weights-for-heights vary across services. However in 2002, the Department of Defense (DOD) issued a policy that all branches would be tested based on BMI, and that no service could have a standard more stringent than a BMI of 25 or more liberal than a BMI of 27.5. Sesma's BMI was 29.

The DOD also requires service branches to use a single, validated equation based on abdominal and neck circumference and height for men and a different equation based on abdominal, neck and hip circumference for women to estimate body fat. For men, body fat standards cannot be more strict than 18 percent and not more liberal than 26 percent. For women, the numbers are 26 percent and 36 percent respectively, the report said.

Raw Recruits

Current military personnel aren't the only problem. New recruits come from the general population — a general population that is 64.5 percent overweight or obese (for those 20 years of age and older).

“The young men and women going into the military are bright and smart. However, because of the obesity epidemic, they're not in great physical condition,” said Wayne Westcott, fitness director at the South Shore YMCA in Quincy, MA.

The overweight civilian population affects the military in two ways, according to the IOM report. First, it confines the pool of people eligible for recruitment. Perhaps even more worrying is that almost 80 percent of recruits who exceed weight-for-height standards when they enter, end up leaving the military early. That's not good news considering the continuing conflicts abroad and the fact that the military is all volunteer.

Not only are new recruits heavier than the military would like, but many of them also have problems passing their physical fitness tests.

Former Navy Seal and fitness author, Stew Smith, said it's typical to have 50 to 55 percent of military recruits fail their initial fitness test. However, with training (and because the majority of recruits are 18 or 19 years old) most recruits can meet those standards within the first two months.

“The military is a very good cross section [of the population],” Smith said. “I'm just amazed that someone would show up at the Naval Academy — very smart, motivated and never failed anything in their life — but show up the first week and can't pass minimum [fitness] standards.”

Helping Hand

So once a recruit or military member is deemed overweight, how does he or she lose that weight? Some resort to over-exercising, under-eating and taking over-the-counter weight-loss drugs that promise fast results. Sesma said all of these methods are common for those battling their weight to meet standards.

A 1997 study showed that among about 700 nurses studied the prevalence of bulimia was 12.5 percent or six times that of the civilian population. Among about 1,400 Navy men studied, half of them across all ranks had an eating disorder. Two to four percent of those studied used diuretics, vomiting, diet pills, laxatives and fasting under normal conditions, but those behaviors increased to a prevalence of 14 or 15 percent during the time of weigh-ins and fitness testings.

Initially, Sesma was sent to a dietician for his weight, but when he turned 40, Sesma's weight became a bigger problem when a blood pressure medication caused water retention — resulting in added pounds. Like many in the service, he tried to lose the weight by jogging more and taking over-the-counter weight loss drugs. His lowest weight was 172 pounds where he felt “terrible,” he said.

“People said I was a walking skeleton, and it didn't feel right. [My weight] never got in the way of my job. It never affected my job or anything,” he said.

The military is aware of these problems and has programs to help personnel safely lose weight or prevent weight gain. The military also has pamphlets on the dangers of using unsafe weight-loss methods, such as diuretics.

One of the programs, Ship Shape, is a world-wide weight-management program for anyone in the Navy, especially those who exceed or are in danger of exceeding body composition standards. The program has been approved by the Bureau of Medicine and Surgery. Made up of eight sessions, Ship Shape gives active-duty personnel basic information about nutrition, stress management, exercise and behavior modification techniques to lower and maintain body weight and body fat percentage.

The Navy has studied putting healthier foods in its vending machines, changing offerings on menus at the food court, and identifying healthy choices at the commissary, said Sally Vickers, acting director of Ship Shape and public health educator.

“We're really looking at the entire environment — also, what physical activity facilities are available,” she said. “It's a total environmental approach to weight management.”

Other branches of the military have similar weight and fitness counseling programs (many are required when minimum standards are not met), and many times individual military fitness facilities will develop their own program targeted to their community.

The DOD is also looking into these issues. Last month the department began working on the 2005 Survey of Health-Related Behaviors among military personnel. The report will look at factors such as nutrition, exercise, weight, cholesterol and tobacco. The government is expected to release results in spring 2006.

“It's a political issue and a national strategic issue, and I think if we don't watch out, it could be a much bigger strategic issue than we thought,” Smith said.

Percent of Overweight Active-Duty Personnel

Army Navy Marine Corp Air Force Total
Under 20 19.0 37.5 21.4 22.8 23.8
20-25 17.1 21.4 12.9 16.3 17.2
26-34 29.3 31.7 18.9 23.3 27.1
35 or older 31.7 36.3 25.3 28.8 31.4

Note: Overweight based on BMI

Source: DOD Survey of Health Related Behaviors Among Military Personnel, 2002