Reprinted from Eating Disorders Review
January/February 2009 Volume 20, Number 4
©2009 Gürze Books
Obesity is rising among the general population, and is also a major concern among military veterans. In 2005, one study reported that 68.3% of women veterans and 73% of male veterans had body mass indexes (BMIs) greater than 25 kg/m2, and that 38% of women veterans and 33% of male veterans had BMIs greater than 30 kg/m2 (J Preventive Med 2005; 28:291). As Chery Smith and colleagues at the University of Minnesota learned in a recent study, post-service eating patterns and obesity originate in military service (Appetite 2009; 52:280).
To get to the bottom of the increase in post-service obesity and high BMIs, the authors conducted 11 focus group discussions with U.S. veterans who served between World War II and the Iraqi War. About half were Vietnam Veterans and the majority had served in Vietnam or in the Gulf wars. Sixty-one male and three female veterans participated. The mean BMI for the group was 30.5 kg/m2. Thirty-five percent were overweight, 47% were obese, and 3% were classified as excessively obese.
What led to their obesity?
Changes in eating behavior during military service appeared to impact veterans’ weight status both in the service and afterward. Many participants reported learning to eat rapidly during boot camp, which then became a survival mechanism to pack in calories when confronted with stressful situations. Others reported having to eat fast to survive during conflict. Many of the veterans believed the high-carbohydrate, high-fat diet they ate during their service led them to choose unhealthy diets after they left the service. Many others reported overeating when food was scarce. A change in activity patterns was also common—they slowed down after leaving the service but continued to eat the same foods in the same amounts as before.
After leaving the service, many veterans reported having food cravings, binge- eating episodes and/or nighttime eating patterns, hiding food, or having a preference for sweets. The authors believed that these behaviors led the veterans to overeat, gain excessive weight and become obese. This preoccupation with food and having cravings for certain food was similar to patterns reported among prisoners of war and survivors of the Holocaust.
The authors stressed that military service has health consequences after discharge, including risk of obesity and substance abuse. Consistent with their findings, others have reported substance use or abuse originating either during or after being in the service. In 2005, Haddock et al. reported a high rate of starting smoking among nonsmokers entering basic training.
The authors note that much needs to be learned about ways in which clinicians can help veterans change harmful behaviors that lead to obesity. Servicemen and women face huge challenges upon their return to the U.S. They are often released from their tour or service without housing, employment, or marriage counseling in place. Others return with a history of food insecurity and behavioral eating changes, as well as struggles with posttraumatic stress syndrome. Obesity may be just one of their many challenges.