C–1. General
Overweight and obesity are significant military medical concerns because these conditions are associated with de-creased operational effectiveness.
In order to meet Army body fat standards and avoid losing their careers, Soldiers may resort to dangerous tactics.
This limits the body’s ability to function effectively and hinders physical and cognitive performance.
While some weight loss diets may be harmless, others could result in adverse effects that may compro-mise the health of the Soldier.
These diets usually fail in the end and may start a vicious cycle of weight loss and weight regain.
C–2. Leader responsibilities
Leaders must be aware of unsafe weight loss strategies and pay attention to clues that a Soldier might be engaged in unhealthy weight loss practices.
Soldiers suspected of engaging in harmful weight loss practices should be referred by the commander to their primary care manager for a medical evaluation.
A consultation with a registered dietitian, who can provide guidance in starting a safe and effective weight loss program, is also recommended.
C–3. Key components of a weight loss program
A healthful and safe weight loss program includes these key components:
a. Nutrition therapy
(1)
A weight loss of no more than 1 to 2 pounds per week is recommended.
The best weight loss plan will not be too difficult to follow.
It will also help an individual obtain and maintain his or her ideal weight and body fat in the recommended ranges and develop and/or maintain lean muscle tissue required for physical demands.
An energy intake that is 500 kcal less than estimated energy needs should achieve a weight loss of 1 to 2 pounds per week.
(2)
A healthful diet contains sensible portions of fruits, vegetables, grains, lean protein, and skim and/or low-fat dairy products.
In addition, it is recommended that foods and beverages consumed contain little or no added sugar, sodium, and solid fats.
Eating four to six small meals per day and not skipping meals, especially breakfast, is helpful for weight loss.
b. Increased physical activity
Physical activity should include aerobic activity, muscular strength and endurance, and flexibility activities.
Recommendations:
(1) To maintain a healthy weight
30 minutes of physical activity 5 to 7 times a week.
Bottom line up front: Stay active for a lifetime to keep weight off.
(2) Active weight loss
60 to 90 minutes of physical activity daily may be needed for weight loss.
Physical activity will enhance weight loss as long as the daily resting energy needs are met.
(3) Weight loss maintenance
30 to 60 minutes daily may be needed to prevent weight gain.
Physical activity is the best predictor of weight loss maintenance.
c. Behavior modification
Behavior change is the key to long-term weight management.
Specific strategies to change behavior such as self-monitoring, stress management, sleep-strategies, problem solving, planning, and prepar-ing are needed for successful weight loss and maintenance.
C–4. Unsafe weight loss strategies
a. Fasting or starvation
Crash dieting, fasting, or starvation reduces weight, but also slows down the body’s me-tabolism and forces the body to utilize lean muscle or organs for energy.
Prolonged fasting can lead to decrease in muscle endurance and loss of strength and power.
Coupled with fluid restriction, the dangers of dehydration are also a factor.
b. Water loss or forced dehydration
Since the body is 75 percent water, this is the easiest way to lose weight (2 cups water equals 2 pounds).
Most common practices to lose water weight include fluid restriction, exercising in hot and humid conditions, and the use of saunas, “sauna suits,” or diuretics.
Risks of dehydration include irritability, dizziness, fatigue, weakness, organ failure, and death.
c. Abuse of diuretics and/or laxatives
Used to reduce further the body of excess “weight.”
This method combines all the risks of dehydration and starvation by depriving the body of fluids and nutrition.
d. Vomiting and/or purging
May lead to dehydration and can be self-induced or with emetics (laxatives) that stimulate the response.
This method combines all the risk of dehydration and starvation by depriving the body of fluids and nutrition.
e. Use of diet or weight loss pills (appetite suppressants, metabolism boosters, fat burners)
(1)
These weight loss aids may contain chemicals that act like drugs.
Many of these supplements can be lethal, especially when taken before heightened physical activity.
Others may result in serious side effects like liver damage, kidney problems, heart failure, stroke, or extreme dehydration.
Supplements may have negative interactions with medications, other supplements, or existing medical conditions.
The supplement may not have been proven to have any effect on weight loss.
(2)
Unlike pharmaceutical products, manufacturers do not need to register dietary supplements with the Food and Drug Administration (FDA) or get FDA approval before producing or selling their products.
FDA cannot take action unless problems are reported after the supplement is marketed.
C–5. Unsafe diets
Be suspicious of diets that—
a.
Promise rapid weight loss.
b.
Allow unlimited quantities of only certain foods and/or are overly strict.
c.
Encourage unsafe practices such as fasting, use of diuretics and/or laxatives, or colon cleansing.
d.
Promote special dietary supplements of “diet” pills.
C–6. Eating disorders
An eating disorder is an illness that causes serious disturbances to a person’s food intake, such as eating extremely small amounts of food or severely overeating.
Eating disorders affect both men and women, and result from a variety of emotional, physical, and social issues such as depression, anxiety disorders, or substance abuse.
Although eating disorders may begin with a preoccupation with food and weight, they are more than just about food.
Leaders who suspect a Soldier of suffering from an eating disorder should submit a referral for medical evaluation.
a. Anorexia nervosa
A serious potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.
Individuals with anorexia nervosa see themselves as overweight even though they are clearly underweight.
Eating, food, and weight control become obsessions.
b. Bulimia nervosa
Characterized by a cycle of bingeing and compensatory behaviors such as self-induced vom-iting designed to undo or compensate for the effects of binge eating.
Bulimia nervosa is a serious, potentially life-threatening eating disorder.
c. Binge eating
Occurs when a person loses control over his or her eating.
Unlike bulimia nervosa, it is not fol-lowed by purging, excessive exercise, or fasting.
d. Eating disorders not otherwise specified
Eating disorders that include a combination of signs and symptoms but do not meet the full criteria for an eating disorder.
C–7. Resources
a.
USAPHC TG 358, The Army Weight Management Guide at https://phc.amedd.army.mil/phc%20re-source%20library/usaphc_tg_358_army_weight_management_guide.pdf#search=weight%20management provides a list of current nutrition and weight management resources.
b. De-mything diets
Diet books routinely top the bestseller lists and new fad diets frequently surface.
The follow-ing websites sort out the myths to increase understanding of which diets are reasonable and which should be avoided:
(1)
Academy of Nutrition and Dietetics at https://www.eatright.org/.
(2)
Weight Control Information Network at https://www.niddk.nih.gov/.
View web page “Weight Loss and Nutri-tion Myths-How Much do you Know?”
c. Weight loss programs
Weight Control Information Network at https://www.niddk.nih.gov/.
View web page “Choosing a Safe and Successful Weight Loss Program.”