Coming to grips with BMI

Some service branches take a fresh look at body composition assessment methods, but weight still a focal point.

The U.S. Army and other branches of the military are taking a fresh look at how they measure body composition to determine if it is accurately associated with performance.

The U.S. Department of Defense instruction 1308.3 mandates that each service branch carry out physical fitness and body fat programs and procedures. In general, the military establishes minimum physical standards for recruitment and retention by measuring body fat based on height and weight tests or based on measurements at the neck and waist. Body composition is calculated using the body mass index (BMI).

The standards are not easy to meet. Right now, according to a Dec. 22, 2020, Congressional Research Service report, “19% of U.S. adults ages 18-24 would not meet standards for accession to the U.S. military due to obesity.”

However, some experts consider BMI-based body composition calculations to be a problematic way to measure body fat overall, gauge healthy weight ranges among and between racial and ethnic groups, or predict health outcomes in general. (See a rundown of the BMI issue at https://www.insider.com/is-bmi-accurate.)

Many of the military’s body composition programs haven’t been updated since the 1940s, when society looked very different, said Katrina Velasquez, a lobbyist with the nonprofit Eating Disorders Coalition. The average American — and service member — is taller with more muscle mass.

Velasquez: Weight-based body composition programs are harmful and stigmatizing

BMI testing is not only an inaccurate measure of health, “it’s actually pretty harmful,” Velasquez said, because it can trigger eating disorders in service members predisposed to develop one.

She said research shows that the service member population is developing eating disorders at a higher rate than the general population, which is roughly 9%. The military has few treatment options for this mental illness, she added.

Velasquez said she’s heard from numerous service members who’ve engaged in unhealthy behaviors to “make weight.” These include eating almost nothing ahead of weigh-ins, wearing plastic to sweat off pounds or taking laxatives. The body composition programs also often layer on stigmatizing and stressful elements such as announcing weights out loud in group settings or separating out or threatening to fire service members who don’t make weight, she said.

Certain service branches look at new assessment methods

The following studies or policy changes suggest that some service branches are open to considering changes to body composition programs:

Army: The U.S. Army on Oct. 18 launched the first evaluation in 30 years of its body composition test, examining its association with physical fitness to determine if changes are needed to regulatory guidance, training and instructional programs, or to the mechanics of the program. The U.S. Army Center for Initial Military Training and the U.S. Army Institute of Environmental Medicine are conducting the research.

Sgt. Major of the Army Michael Grinston kicked off the study at Fort Bragg by taking the test, which uses four techniques to assess body composition: 1) standard AR 600-9 tape test, 2) dual-energy X-ray absorptiometry (DXA), 3) three-dimensional total body scanning and 4) bioelectrical impedance analysis. Researchers are looking at body size and composition and comparing them to soldiers’ most recent physical fitness score and to dates and types of injuries. For females, the study is reviewing the number and dates of pregnancies, delivery methods, and first postpartum physical fitness score and Army Body Composition Program record. Army officials said initial findings should be out in December, but that final data will be ready in six to nine months.

Marine Corps: The U.S. Marine Corps’ (USMC) Human Performance Office is collaborating with the Army Research Institute of Environmental Medicine to study body composition using various methods to assess fat mass, lean mass and bone mineral density. The review aims to determine whether the USMC’s policies and standards balance “health, performance, fitness and appearance.” According to a USMC study webpage, the Quantico-based study, which began in June 2021 and extends through the second quarter of 2022, will inform the future of body composition standards in the Marine Corps.

Navy: The Navy’s body composition assessment protocols, dated April 2021, don’t appear to be under review. (See the guide at https://www.mynavyhr.navy.mil/Portals/55/Support/21stCenturySailor/Physical/Guide%204-Body%20Composition%20Assessment-BCA-APR%202021.pdf?ver=UXBxbuAy0713JcZBkRRy2g%3d%3d.)

Air Force: The U.S. Air Force recently removed waist measurement as a scored component of its soon-to-be-revamped physical fitness test, and distributed those points across three main fitness categories. However, Air Force officials said that waists may still be measured as part of a body composition assessment that was set to start again this fall, according to a May 26 news release. Officials said details would be released at a later date.

Velasquez contended that the military does not need to use weight at all in health assessments. Instead, service members’ fitness could be measured through calculations of metabolic rates, blood pressure or other vital signs.

“From our perspective at the Eating Disorders Coalition, actually having a focus on hitting a certain weight is still going to be triggering into an eating disorder,” Velasquez said.

Learn more

Review the Army’s news release on its study, dated Oct. 18, 2021: https://www.dvidshub.net/news/407457/us-army-evaluate-relationship-between-body-composition-and-physical-fitness.

Review the Army Body Composition Program guidelines, dated Aug. 16, 2019: https://www.armyresilience.army.mil/ard/images/pdf/Policy/AR%20600-9%20The%20Army%20Body%20Composition%20Program.pdf.

Review the USMC study webpage: https://www.fitness.marines.mil/Body-Composition-and-Resources/Body-Composition-Study/Marine-Corps-Base-Quantico-Body-Composition-Study.

Review the Air Force’s news release on its fitness assessment alternatives, dated July 2, 2021: https://www.afpc.af.mil/News/Article-Display/Article/2681139/air-force-releases-cardio-and-strength-fitness-assessment-alternatives-new-onli.

Read the Congressional Research Service report, “Obesity in the United States and Effects on Military Recruiting,” dated Dec. 22, 2020: https://fas.org/sgp/crs/natsec/IF11708.pdf.

I am the OP.

When I was in the Corps, and for several years after, I weighed 196 +/- 2 pounds, and for my height that put me at 25.2 BMI - the low end of over weight (not obese). Later in age I weighed 210 +/- 2 pounds and placed in a body composition competition. That put my BMI at 27.0. Again, overweight. Today? my BMI is at 32.1 (obese). 6 months ago it was at 29.9 (borderline obese) when I went on a heart med. The weight gain has been atrocious and a 75% calorie intake plus working out was not bringing it down at all.

I do not expect to ever be in the so called Healthy range on the BMI. I was up until I went to boot camp. Since then - never again will I see that unless I get seriously sick - and I mean very, very, very sick.

I do not trust the BMI as a standard indicator. My heart doc has said NOTHING about weight. My stress test came back normal with a good recovery rate - before the BP was down in the normal range. And now, on the Keto diet these last 16 or so days, my BP is starting to get too low. I am almost out of the obese BMI range and am hoping to be back to 210 pounds within the next 4-8 months.

So - all I was trying to say at the beginning is when my BMI says I am over weight, I am at my fittest.