thedrifter
02-20-04, 12:59 PM
Issue Date: February 23, 2004
Planning for battle of the bulge
Obesity in military community targeted by DoD health officials
By Deborah Funk
Times staff writer
Citing America’s rising rate of obesity, defense health officials are studying how best to attack fat in service members, retirees and their families.
Experts say obesity is more unhealthy than even smoking because it puts people at risk for heart disease, diabetes, stroke, depression, osteoporosis, cancer, Alzheimer’s and other illnesses.
Today’s children may be the first generation of young people with a shorter life expectancy than their parents because of illnesses related to obesity, said Air Force Lt. Col. (Dr.) Joyce Grissom, medical director for the Tricare Management Activity.
A group of defense health officials is planning an offensive in the battle of the bulge that includes a medical, community and educational campaign. They’ll look at existing weight and fitness programs, determine what gaps exist and help identify the best strategies to address them. But whatever programs are put forward would be competing with other items in the defense health budget.
One initiative to be considered is a limited test project that would let Tricare pay for weight-management treatment before the problem reaches extreme levels that require bariatric surgery to lose weight. Bariatric, or stomach, surgery is the only weight treatment now authorized under Tricare. To qualify, patients must be at least 100 pounds overweight and have other serious health conditions or be at 200 percent of their ideal weight. This proposal would require a change in law.
In 2002, the military health system spent $15 million on 1,905 stomach surgeries, nine of them on active-duty members.
Another proposal is to bring a successful Department of Veterans Affairs program to select military hospitals and clinics. The program, Managing Overweight/Obesity in Veterans Everywhere, or MOVE!, provides a range of treatment that can include outpatient and inpatient services, weight-control drugs and bariatric surgery. Treatments vary, depending on what is available at each individual VA facility
No decisions have been made on these potential initiatives, and others could be considered.
“I’ve asked a group of people to look at all of our activities related to obesity prevention, treatment, the whole gamut,” said Dr. William Winkenwerder, assistant secretary of defense for health affairs.
Weighty problem
Some 64 percent of Americans are overweight and more than 30 percent are obese, according to the 1999-2000 National Health and Nutrition Examination Survey done by the Centers for Disease Control and Prevention.
Obese people have a very high, unhealthy amount of fat, usually determined using a weight-height ratio to measure body mass. Measuring the waist circumference is another means often used to help determine abdominal fat.
A November 2002 Defense Department instruction requires the services to create a maximum weight/height table to screen for body mass. But they also measure the circumference around different parts of the body, particularly the abdomen, to better determine fat, rather than relying on the body mass index’s calculations.
Each service has a program to help military members manage their weight. The programs vary but may include nutritional counseling, exercise, behavior modification, stress management or problem-solving skills, among other components, Grissom said.
About 16 percent of service members meet the body mass index for obesity, the military says, well below the national average. But some data indicate obesity rates among children, spouses and retirees in the military community are above the national average.
Among adults who are not on active duty but are enrolled in military clinics and hospitals, 34 percent are obese. For military family members aged 12 to 19 who are enrolled in military medical facilities, the figure is 19 percent. Those data come from a random sample of outpatient charts at military facilities in the continental United States.
A recent Old Dominion University survey of more than 100 Navy children aged 9 to 12 in the Hampton Roads, Va., area found that nearly 40 percent were obese.
To be sure, military officials have been taking steps to rein in troops’ waistbands for some time, to include encouraging exercise as part of the duty day.
Also, military dining facilities have cut salt and fat and increased fruits, vegetables and complex carbohydrates in their food. Calories in main-course selections were trimmed by as many as 100 to 300 calories.
Some installations also promote fitness walks and the use of stairs instead of elevators, for example.
Such multifaceted approaches, officials believe, are key to winning the fight against fat.
“This is a leadership issue, this is a command issue, this is a cultural issue,” Grissom said.
--------------------------------------------------------------------------------
FYI on BMI
The Body Mass Index is a measure of an adult’s body fat based on height and weight. BMI results fall into one of four categories:
•Underweight — BMI of less than 18.5.
•Normal weight — BMI of 18.5 to 24.9.
•Overweight — BMI of 25 to 29.9.
•Obese — BMI of 30 or more.
To find your BMI, visit the National Institutes of Health’s online BMI calculator at www.nhlbisupport.com/bmi/.
Source: National Institutes of Health
Sempers,
Roger
:marine:
Planning for battle of the bulge
Obesity in military community targeted by DoD health officials
By Deborah Funk
Times staff writer
Citing America’s rising rate of obesity, defense health officials are studying how best to attack fat in service members, retirees and their families.
Experts say obesity is more unhealthy than even smoking because it puts people at risk for heart disease, diabetes, stroke, depression, osteoporosis, cancer, Alzheimer’s and other illnesses.
Today’s children may be the first generation of young people with a shorter life expectancy than their parents because of illnesses related to obesity, said Air Force Lt. Col. (Dr.) Joyce Grissom, medical director for the Tricare Management Activity.
A group of defense health officials is planning an offensive in the battle of the bulge that includes a medical, community and educational campaign. They’ll look at existing weight and fitness programs, determine what gaps exist and help identify the best strategies to address them. But whatever programs are put forward would be competing with other items in the defense health budget.
One initiative to be considered is a limited test project that would let Tricare pay for weight-management treatment before the problem reaches extreme levels that require bariatric surgery to lose weight. Bariatric, or stomach, surgery is the only weight treatment now authorized under Tricare. To qualify, patients must be at least 100 pounds overweight and have other serious health conditions or be at 200 percent of their ideal weight. This proposal would require a change in law.
In 2002, the military health system spent $15 million on 1,905 stomach surgeries, nine of them on active-duty members.
Another proposal is to bring a successful Department of Veterans Affairs program to select military hospitals and clinics. The program, Managing Overweight/Obesity in Veterans Everywhere, or MOVE!, provides a range of treatment that can include outpatient and inpatient services, weight-control drugs and bariatric surgery. Treatments vary, depending on what is available at each individual VA facility
No decisions have been made on these potential initiatives, and others could be considered.
“I’ve asked a group of people to look at all of our activities related to obesity prevention, treatment, the whole gamut,” said Dr. William Winkenwerder, assistant secretary of defense for health affairs.
Weighty problem
Some 64 percent of Americans are overweight and more than 30 percent are obese, according to the 1999-2000 National Health and Nutrition Examination Survey done by the Centers for Disease Control and Prevention.
Obese people have a very high, unhealthy amount of fat, usually determined using a weight-height ratio to measure body mass. Measuring the waist circumference is another means often used to help determine abdominal fat.
A November 2002 Defense Department instruction requires the services to create a maximum weight/height table to screen for body mass. But they also measure the circumference around different parts of the body, particularly the abdomen, to better determine fat, rather than relying on the body mass index’s calculations.
Each service has a program to help military members manage their weight. The programs vary but may include nutritional counseling, exercise, behavior modification, stress management or problem-solving skills, among other components, Grissom said.
About 16 percent of service members meet the body mass index for obesity, the military says, well below the national average. But some data indicate obesity rates among children, spouses and retirees in the military community are above the national average.
Among adults who are not on active duty but are enrolled in military clinics and hospitals, 34 percent are obese. For military family members aged 12 to 19 who are enrolled in military medical facilities, the figure is 19 percent. Those data come from a random sample of outpatient charts at military facilities in the continental United States.
A recent Old Dominion University survey of more than 100 Navy children aged 9 to 12 in the Hampton Roads, Va., area found that nearly 40 percent were obese.
To be sure, military officials have been taking steps to rein in troops’ waistbands for some time, to include encouraging exercise as part of the duty day.
Also, military dining facilities have cut salt and fat and increased fruits, vegetables and complex carbohydrates in their food. Calories in main-course selections were trimmed by as many as 100 to 300 calories.
Some installations also promote fitness walks and the use of stairs instead of elevators, for example.
Such multifaceted approaches, officials believe, are key to winning the fight against fat.
“This is a leadership issue, this is a command issue, this is a cultural issue,” Grissom said.
--------------------------------------------------------------------------------
FYI on BMI
The Body Mass Index is a measure of an adult’s body fat based on height and weight. BMI results fall into one of four categories:
•Underweight — BMI of less than 18.5.
•Normal weight — BMI of 18.5 to 24.9.
•Overweight — BMI of 25 to 29.9.
•Obese — BMI of 30 or more.
To find your BMI, visit the National Institutes of Health’s online BMI calculator at www.nhlbisupport.com/bmi/.
Source: National Institutes of Health
Sempers,
Roger
:marine: