Analysis of weight and associated health consequences of the active duty staff at a major Naval medical center.

OBJECTIVE The purpose of this study was to analyze the prevalence of overweight and obesity among active duty staff members at one the Navy's largest medical centers, in an effort to clarify the relationship between weight, physical fitness, health care utilization patterns, and health care costs. METHODS Data obtained from the Physical Readiness Information Management System were linked with health care utilization data obtained from the Military Health System Management Analysis and Reporting Tool. This information was applied to the National Heart, Lung, and Blood Institute risk-stratification criteria to clarify the roles overweight and obesity play as factors contributing to increased health risk, comorbid conditions, and health care costs in this military health care setting. RESULTS At least 53% of the active duty staff members (1,755 of 3,306) at this medical center were either overweight or obese, based on body mass index (BMI). Three hundred fifty-one personnel did not have body composition analyses recorded. Using the Navy's current system, only 149 personnel were identified as being "out of standards" and 2,806 personnel were considered to be "within standards." Remarkably, the within-standards group included 241 personnel with obese BMIs and 1,365 personnel with overweight BMIs. The National Heart, Lung, and Blood Institute risk-stratification criteria identified 445 personnel as having increased risk of premature death, based on their BMIs and other risk factors. The Navy's current program resulted in 296 (445 minus 149) missed opportunities to provide weight loss intervention when it is most effective, in the early stages of weight gain. CONCLUSION The system currently used by the U.S. Navy to characterize personnel by weight ignores opportunities to identify and to treat high-risk personnel and provides neither a consistent nor an evidence-based model for early intervention and treatment of high-weight personnel at risk for increased morbidity, loss of productivity, and associated increased medical costs.