Previous military physical and body standards have been rewritten for men and women.
All our military branches have physical fitness and body composition requirements for men and women. Recently the Department of Defense completely overhauled the requirements for physical fitness and body composition for men and women. By increasing maximums for body composition, all branches of the military can now allow service members to gain muscle mass to meet physical fitness requirements.
US active-duty servicewomen have a higher prevalence of eating disorders than civilian women, while military men demonstrate a comparable prevalence to civilian men. Among active military populations, approximately 5% to 8% of women and 0.1% of men are diagnosed with an eating disorder. Comparatively, the lifetime prevalence of individual eating disorders among civilians ranges from 0.9% to 4.9% for women and 0.3% to 4.0% for men (Int J Eat Disord. 2015. 48:1057).
The Medical Surveillance Monthly Report (MSMR) describes annual incidence rates of anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders not otherwise specified (OSFED) by gender among active service members from 2013 through 2017.
The Report demonstrated that an incidence rate of any eating disorder was 2.7 cases per 10,000 patient-years, and the servicewomen’s incidence rate was more than 11 times that of men (MSMR. 2018. 25:18.) Veteran women in a primary care setting with binge eating disorder had a greater frequency of obesity, depression, post-traumatic stress disorder (PTSD), mood disorders, sleep disorders, hypertension, chronic pain, and lipid disorders than men. Eating disorder symptoms were significantly associated with PTSD and symptoms of depression, as well as lifetime incidence of intimate partner violence.
A study shows different results
The results of a year-long study of active-duty service women has shown no association between the body standards demanded by individual branches of the services and eating disorders diagnoses (J Eat Disord. 2024. 12:29).
Dr. Jessica Korona-Bailey and her colleagues at the Center for Health Services Research, Uniformed Services University of the Health Sciences, and the Jackson Foundation for the Advancement of Military Medicine, Inc, both in Bethesda, MD, used the MHS Data Repository (MDR) to identify 161,209 women whose body mass indexes (BMIs, mg/kg2) exceeded the maximum BMI service-specific standards for 2018-2019.
Dr. Korona-Bailey and her colleagues then conducted a cross-sectional study of active-duty servicewomen 18 years of age and older in the Army, Air Force, Navy and Marine Corps, from 2018 to 2019. More than a third of the women (38.3%) had higher-than-normal BMIs, while 61.7% had a BMI lower than normal, and 21.0% had a borderline BMI based on the most recent BMI in their medical record.
The authors also identified 765 (0.5%) active-duty servicewomen diagnosed with an eating disorder. The diagnosis of binge eating disorder (BED) or OSFED was the most frequently occurring diagnosis (100%), followed by AN (19.1%), and BN (2.7%). The majority of the women (50.2%) were 18 to 24 years of age, White (62.3%), unmarried (65.8%), and had healthy BMIs (39.0%). The borderline service-specific BMI standard category accounted for 14.6% of eating disorder diagnoses. For service-specific factors, the majority of women with an eating disorder were in the Army (34.0%) and had a junior enlisted rank (48.8%).
New BMI Standards for Military
In recent years, the Air Force and Army have adjusted body composition measurements for their admission tests. The new BMI standard for Air Force recruits, for example, is a maximum of 27.5.
In the Air Force, the BMI standard ranges from 17.5 to 27.5; among prospective Army entrants, the percentage of body fat can’t be more than 30% to 36% in women, compared to 20% to 26% among men. In the Navy, applicants must have a BMI of at least 19; however, those with BMIs under 19 are not necessarily ineligible for entrance, and can undergo an additional review from medical officers to determine their overall health. Additionally, in the Army and Marines Corps, soldiers and Marines who score at a certain level on physical fitness tests are exempt from assessment of body composition.
Looking Professional
Each of the military service branches has instituted BMI standards to ensure a force that looks both professional and can physically perform their duties. From fiscal year 2018-2019, BMI standards for the Army ranged from 25.0 to 26.0 and varied with age. The Air Force has a BMI standard of 27.5. The Navy has a BMI standard that varies from 25.0 to 27.5, varying with height, and the Marine Corps has a single standard of 25.9.
The authors found that 38.3% of servicewomen had a BMI exceeding their service-specific maximum standard. In general, women who were older (35 years to 44 years of age), Black, and had a senior rank had BMIs above the service standards. The highest prevalence of eating disorder diagnosis for each category was in women who were White, unmarried, serving in the Army, and of junior enlisted rank. No association was found between a borderline service-specific BMI and a diagnosis of an eating disorder.
The authors found that underweight servicewomen were at greatest risk of developing or having a current eating disorder. Overall, the prevalence of eating disorders was low in this study: 0.5%, compared to some studies showing prevalence ranges of 2% to 13.5% in civilian populations. The authors reported that there seemed to be no association between body composition standards set by the individual services and eating disorders diagnoses among active-duty servicewomen.
