It's difficult enough to eat right and stay healthy when there are lots of food choices and plenty of time for exercise in your life. But in the military, this isn't always the case. Soldiers often face long hours and limited healthy food selections. Chicken and dumpling MRE, anyone? Moreover, for those prone to obesity through genetics or a lifetime of unhealthy habits, it can not only be difficult to stay in shape while in the military, but also to "make tape," which can have serious repercussions on their military careers.

Beginning this summer, the Department of Family Medicine at Madigan Army Medical Center on Joint Base Lewis-McChord is conducting a weight-gain prevention program study that will help officer and enlisted soldiers at risk for weight gain address concerns before they become problematic.

Funded by the Uniformed Services University and completely voluntary, the program, entitled Project Fit4Duty, will address concerns specific to soldiers, "such as finding healthy foods on base, PT, dealing with injuries, eating the right foods and getting enough sleep," explained Elena Spieker, PhD, the medical psychologist in charge of the project.

"It's not a nutrition education program," she clarified, "because unfortunately, the research shows that nutrition education just doesn't work ... It's a participant-driven program that offers support to soldiers in order for them to make behavior changes that work in their lives."

The study will target first-term Army soldiers at their first duty station, and volunteers are still needed. "After initial training, soldiers typically move to a more sedentary position on base and are more likely to gain weight, which sets them up for problems," Spieker said.

"We are looking for soldiers in the healthy weight or overweight (Body Mass Index) range who are motivated to get information and work with us to find a way to make behavior changes for the rest of their lives."

Making tape

The Army doesn't take obesity in its soldiers lightly. According to the Army Body Composition Program (Army Regulation 600-9), "Soldiers must maintain a high level of physical readiness in order to meet mission requirements. Body composition is one indicator of physical readiness that is associated with an individual's fitness, endurance and overall health. Individuals with desirable body fat percentages generally exhibit increased muscular strength and endurance, are less likely to sustain injury from weight bearing activity, and are more likely to perform at an optimal level."

All soldiers are subject to a bi-annual (or more frequently, if their commander requires it) weigh-in, and standards must be met. For example, a 6-foot (72-inch) tall male between the ages of 21 and 27 can weigh no more than 195 pounds, and a 5-foot, 6-inch (66-inch) female can weigh no more than 156. Those who exceed the weight limit undergo a "tape test" to determine their body fat percentages.

Soldiers who exceed the Army's body fat standard (22 percent for males age 21 to 27 and 32 percent for females) are flagged, enrolled in the Army Body Composition Program (previously known as the Army Weight Control Program), and given six months to "make tape." During this time, the soldiers can't be promoted, will not be assigned to command positions and are not authorized to attend professional military schools.

Clearly, obesity has a real impact on soldiers' military careers, and those who can't lose the weight will eventually be subject to involuntary separation from service.

The Madigan study seeks to prevent weight issues before they become a problem. Adopted from a similar successful civilian weight gain prevention program, Project Fit4Duty is perfect for "people who are proactive and want to solve a problem before it starts," Spieker said.

One of the criteria for the study is that the soldier is at risk for weight gain, which is indicated by a previous weight problem or family members who struggle with obesity.

"This is most people," Spieker said. And since the program is voluntary, Spieker is optimistic.

"You won't get good effects from a study like this if you get soldiers who are forced to do it," she noted. "We want soldiers who are motivated because they want results for themselves."

The study involves an initial assessment, including baseline height and weight measurements, followed by a series of six group sessions in which participants will "discuss different topics central to maintaining a healthy weight in the military," Spieker said. This will be followed by another assessment at eight weeks, and follow up assessments at one and two years.

Program organizers still need several active-duty Army soldiers to take part in the study. Participants must be at least 18 years old and on their first military assignment.

"The ultimate goal is to equip first-term enlistees with the tools that they need to prevent problems before they start," Spieker said. "This isn't weight loss. We're not doing something the military is already offering for soldiers to lose weight once the problem happens. We want to prevent the problem before it starts."

For more information or to sign up for the study, contact the study coordinator, Dawn Bates, at 908.306.2769 or email fit4dutystudy@gmail.com.