Obesity in the United States and Effects on Military Recruiting

Obesity in the United States and Effects on Military Recruiting

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December 22, 2020
Obesity in the United States and Effects on Military Recruiting
Background
Michigan, Mississippi, Oklahoma, South Carolina,
Congress has a sustained interest in maintaining capable
Tennessee, and West Virginia (see Figure 1). The Midwest
military forces. To this end, a population of healthy and
(34%) and the South (33%) were the two regions that
eligible recruits is important to sustain the military services
represented the highest prevalence of obesity.
and meet the annual requirements established by Congress.
Though many aspects of health are important, a 2016
Figure 1. Prevalence of Self-Reported Obesity among
Department of Defense (DOD) report found that obesity
U.S. Adults by State and Territory, 2019
was one of the main disqualifiers from joining U.S. military
service.
Obesity in the United States is not a new issue. A report
published in Health Economics in 2012 estimated that the
percentage of military-age adults ineligible for enlistment
because of excessive body fat more than doubled for men
and tripled for women during 1959-2008. Since 2008, the
percentage of obese youth has continued to increase. The
increasing proportion of obese American youth reduces the
pool of eligible military recruits. This trend may pose
particular challenges with recruiting highly-qualified
individuals to service in the U.S. Armed Forces.
Obesity in the United States
The U.S. Centers for Disease Control and Prevention

(CDC) defines obesity in children (2 to 19 years of age) as
Source: CDC, “Adult Obesity Prevalence Maps,” found at
those with a body mass index (BMI) at or above the 95th
percentile for BMI based on the child’s age and sex. For
https://www.cdc.gov/obesity/data/prevalence-maps.html.
Note: Data based on the Behavioral Risk Factor Surveil ance System
adults, CDC classifies obesity as those with a BMI of 30 or
(BRFSS), the world’s largest, on-going telephone health survey
greater. Though BMI—the ratio of weight in kilograms
system.
divided by height in meters squared— does not measure
body fat directly, it is strongly associated with direct
Military Recruiting Efforts
measurements of body fat and adverse health outcomes.
DOD Instruction 1304.26 establishes minimum physical
standards for recruitment and retention; the military
In 2017-2018, the most recent years for which CDC adult
services can also include additional requirements. Military
data are available, obesity prevalence—the proportion of
physical standards began in 1775. The military services
the population who have obesity in a given time period —
issued the first weight standards in 1887 for men and in
was 42% in adults (age 20 years or older). Among
1942 for women. The original function of these standards
adolescents (age 12 to 19 years old), obesity prevalence was
was to exclude underweight individuals. In recent decades,
21% in 2015-2016, the most recent years for which CDC
however, far more applicants for military service have been
childhood obesity data are available. These CDC estimates
found to be unfit for duty for being overweight.
are from National Health and Nutrition Examination Survey
(NHANES) data. NHANES consists of participant
Since the 1970s, disqualification from joining the military
interviews and physical examinations.
based on inability to meet established weight standards has
risen. A RAND Corporation analysis of the evolution of the
Obesity affects some populations more than others. For
all-volunteer force discusses increasing physical
example, in 2015-2016, obesity prevalence was 26% among
disqualification rates as the draft was being phased out in
Hispanic children and 22% among non-Hispanic Black
1972. The Services currently use a body composition test
children, compared to 14% in non-Hispanic White children.
based on height and weight to determine body fat
In adults, in 2017-2018, non-Hispanic Black adults had the
percentages. Alternatively, measurements at the waist and
highest prevalence of obesity (50%), followed by Hispanic
neck are also used to calculate body fat percentages in the
adults (45%), and non-Hispanic White adults (42%).
military.
Based on geographic location, adult obesity prevalence was
To meet annual personnel goals and fill entry-level
highest (greater than 35% of the overall U.S. population) in
positions, the military services recruit approximately
Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana,
175,000 new active duty enlisted servicemembers every
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Obesity in the United States and Effects on Military Recruiting
year. Military officers are recruited from and commissioned
military of over $1.2 billion annually in higher healthcare
while in the 18-24 age group; 11% are in this demographic,
spending and lower productivity. Lower levels of physical
while 47% of enlisted recruits come from this age group.
fitness have also been associated with increased risk of
Most military recruits self-identify as White (72%). The
injury during basic training. Historically, the IOM found
next largest group identifies as Black (18%) followed
that of the recruits who exceeded the weight-for-height
closely by Hispanic (17%) identification.
standards but subsequently entered the military because
they passed the standards later or received a waiver, 80%
The majority of military recruits are from the South,
left the military before completing their first term of
followed by the West, North Central and Northeast regions
enlistment but after the expenditure of training costs. An
(see Figure 2). As noted above, the Midwest and the South
updated analysis of the habits of recruits who were obese,
are currently the areas of the United States with the highest
but subsequently lost sufficient weight to meet standards,
prevalence of obesity (See Figure 1). Currently, 19% of
could further understanding of successful fitness programs.
U.S. adults ages 18-24 would not meet standards for
accession to the U.S. military due to obesity. Those who do
Reducing Risk of Obesity in the Recruitment
not meet body fat standards can join the armed forces if
Population
they reduce their body fat through diet and exercise.
Obesity is seen as a preventable disease; it could be a topic
for legislative consideration. Published recommendations to
Figure 2. Military Recruits by U.S. Region
address U.S. obesity include improved quality of and access
to food in schools, programs that address exercise and
eating habits of parents and children, school-based intensive
physical education classes, social support, and space for
physical activity in community settings. Some measures,
such as the Department of Defense Fresh Fruit and
Vegetable Program, a partnership with the U.S. Department
of Agriculture, are already in place to bring fresh foods to
U.S. schools. Interventions to improve nutrition and fitness
in youth may increase fitness to serve in the military.
Relevant Statutes and Policies
Chapters 31 and 33, Title 10, U.S. Code
DOD Instruction 1304.26, Qualification Standards for
Enlistment, Appointment, and Induction, October 26, 2018

CRS Products
Source: DOD, “Population Representation in the Military Services,
Fiscal Year 2018” at https://www.cna.org/pop-
CRS In Focus IF11147, Defense Primer: Active Duty Enlisted
rep/2018/appendixd/d_10.html
Recruiting, by Lawrence Kapp

CRS Report RL31297, Recruiting and Retention in the Active
Component Military: Are There Problems?, by Lawrence Kapp
Issues for Congress
Other Resources
The high and rising prevalence of obesity in the United
States represents a substantial obstacle for military
Cawley J & Maclean JC. Unfit for service: The implications of
recruitment. Obesity is one of the leading medical reasons
rising obesity for US Military Recruitment. Health Econ. 2012.
that young adults are disqualified from joining the military,
Nov; 21(11):1348-66.
and has been an issue for military recruitment for over 30
Koehlmoos TP, Banaag A, Madsen CK and Adirim T. Child
years. The impact of rising obesity rates on military
Health as a National Security Issue: Obesity and Behavioral Health
recruitment may depend on the number of military
Conditions Among Military Children. Health Aff. 2020 Oct;
members needed in the future. Two potential mitigating
39(10):1719-27.
factors in the future include a possible reduction in the
Mission:Readiness. Unhealthy and Unprepared. 2018. Found at
target number of qualified recruits and more formalized
http://www.strongnation.org
pre-recruitment programs that would help more people
Yamane GK. Obesity in civilian adults: Potential impact on
meet military requirements. With a downsized military, the
eligibility for U.S. military enlistment. Mil Med. 2007 Nov;
impact of rising obesity would likely diminish demand for
172(11):1160-5.
qualified recruits, as compared to conditions that would
require many additional recruits.

Why Obesity Matters to the Military
Erin Tompkins, Defense Health Fellow
A study by the Institute of Medicine (IOM, now the
National Academies of Medicine) describes a link between
IF11708
those with high weight and body fat and lower job
performance in some military occupations at cost to the

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Obesity in the United States and Effects on Military Recruiting

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