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Introduction

Obesity and overweight pose significant challenges to the armed forces in the United States, affecting service members (including active duty, guard, and reserve components), veterans, retirees, and their families and communities. The consequences of obesity and overweight in the armed forces influence various aspects of their operations that are critical to national security, including recruitment, retention, resilience, readiness, and retirement.

A workshop titled Understanding and Overcoming the Challenge of Obesity and Overweight in the Armed Forces was held on May 7, 2018, in Washington, DC.¹ The workshop was convened by the Roundtable on Obesity Solutions, which is part of the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine. The goals of the workshop were to examine the challenges posed by obesity and overweight for the armed forces and explore opportunities to overcome these challenges. The workshop’s full Statement of Task is in Box 1-1.²

Bill Purcell, currently with Farmer Purcell White & Lassiter, PLLC, and former mayor of Nashville, Tennessee, welcomed participants with an

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¹ The workshop planning committee’s role was limited to planning the workshop, and this Proceedings of a Workshop was prepared by the workshop rapporteur as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.

² The workshop agenda, presentations, and other materials are available at http://www.nationalacademies.org/hmd/Activities/Nutrition/ObesitySolutions/2018-MAY-07.aspx (accessed July 13, 2018).

overview of the roundtable. He explained that the roundtable, established in 2014, engages leaders from multiple sectors to help solve the nation’s obesity crisis. Through meetings, public workshops, background papers, and ad hoc convening activities, it fosters an ongoing dialogue about critical and emerging issues in obesity prevention and treatment. It also provides a trusted venue for inspiring, developing, and examining multisector collaborations as well as policy, environmental, and behavioral initiatives that will increase physical activity, reduce sedentary behavior, and improve the healthfulness of foods and beverages to reduce the prevalence and adverse consequences of obesity and its related health disparities.

Purcell then introduced the workshop by remarking on the aptness of its topic in relation to the history of the National Academies. It was in the midst of the Civil War in 1863, he informed the audience, that President Lincoln signed the Act of Incorporation establishing the National Academy of Sciences (NAS). The NAS’s dominant purpose was service to the nation, he continued, and at the request of President Wilson, it expanded during World War I to keep pace with the demand for advice regarding military preparedness. Subsequent executive orders have affirmed the importance of the NAS and further broadened its charter (NASEM, 2018).

Following Purcell’s remarks, Bernadette Marriott, professor at the Medical University of South Carolina and chair of the workshop planning

committee, took the podium to outline the workshop’s five sessions. She added to Purcell’s historical overview by noting that the Roundtable on Obesity Solutions is an activity of the National Academies’ Food and Nutrition Board (FNB), whose organization in 1940 was spearheaded by the Council on National Defense. Also in 1940, she said, President Franklin D. Roosevelt established the National Defense Research Council, which asked the new FNB in 1941 to develop recommended dietary allowances to inform the feeding of American troops in the field. Since then, she observed, the FNB has continued to partner with the U.S. military on research related to many aspects of diet, nutrition, and health.

ORGANIZATION OF THIS PROCEEDINGS

This proceedings follows the order of the workshop agenda (see Appendix A), chronicling its five sessions in individual chapters. Chapter 2 examines how obesity and overweight are measured in the armed forces and how the problem of obesity and overweight affects recruitment, retention, resilience, and readiness. Chapter 3 then details service-specific issues related to obesity and overweight. Chapter 4 highlights innovative strategies for addressing obesity and overweight through improved nutrition, physical activity, and stress management. Chapter 5 describes perspectives from outside of the armed forces on approaches to preventing and treating obesity and overweight. Finally, Chapter 6 summarizes the last session of the workshop, during which the moderators of the preceding four sessions reflected on the speakers’ presentations and discussed the challenges and opportunities entailed in overcoming the concerns posed by obesity and overweight among the armed forces, military families, and their communities, including potential cross-sector opportunities. The acronyms and abbreviations used throughout this proceedings are listed in Appendix B, supplemental abstracts related to information presented in the workshop’s third session appear in Appendix C, and the biographies of the speakers and planning committee members are included in Appendix D.

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