Obesity in the army: prevalence, correlates and prediction
2014-09-17T08:32:42Z (GMT) by
The emergence of obesity as a distinct disease could have far reaching consequences for an organisation where optimum health and physical fitness are required for personnel to perform their occupational roles effectively. The aim of this thesis is to increase our understanding of the prevalence, correlates and predictors of obesity in the British Army. Systematic review indicated a smaller body of knowledge in respect of the treatment and correlates of obesity in military populations. Successful treatment interventions incorporated exercise, healthy eating information, behavioural modification, self-monitoring, relapse prevention, structured follow-up and were supported by trained personnel. The major significant correlates of obesity were being enlisted personnel, male, ≥35 years of age, African-American / Hispanic ethnicity, and married (with spouse present). The review highlighted the deficit in knowledge concerning treatment, and correlates of obesity in military populations. The trend of escalating obesity has prompted some armed forces to report obesity trends and prevalence, the findings of which suggest that obesity is a growing concern in the armed services. A study based on the secondary analysis of data covering 50,000 British Army soldiers indicated that according to BMI, 56.7% of the study population were overweight and of those individuals 12% were obese. When waist circumference data were added to the BMI data, the results indicate that females displayed a higher percentage of risk of obesity related ill-health (a combination of BMI and waist circumference) than males (30.4% and 24% respectively). Further analysis suggested that age, marital status, rank and military employment category were significant correlates of obesity. Additionally, obesity and increased risk of obesity related-ill-health were linked to higher failure and lower attendance on British Army physical tests. Data suggested older army personnel (>30) had a higher pass rate, but a lower attendance rate. The final analysis of all available variables suggested physical test outcome, age, medical status and enlisted status were the most significant predictors of obesity. A final study based on a different study population (n=1124) from the high readiness component of the UK based British Army sought to identify relationships between health behaviours that were not supportive of healthy weight and to understand the predictive influence of individual and collective behaviour in relation to obesity and the risk of obesity related ill-health in military personnel. The investigation used a health behaviour questionnaire to assess health behaviours that might influence weight status. Final analysis of this highly active population suggested, restrained eating, food preparation in the working week, injury status, age, sedentary behaviour, leisure-time physical activity engagement and type of motivation for exercise were the most significant factors. This thesis highlights the lack of knowledge, and gives evidence to support the impact of obesity on individual health and collective occupational capability. Obesity is a complex multifaceted disease where no single causal route predominates. However, the identification of potential causal and predictive relationships will aid in the prevention and treatment of obesity in the British Army.