© Army Times
Soldiers are dangerously starving themselves, gobbling diet pills and laxatives - even going under the knife in costly liposuction surgery - all to meet the Army's weight standards and avoid losing their careers.
"Liposuction saved my career - laxatives and starvation before an [Army Physical Fitness Test] sustains my career," a soldier told Army Times in an e-mail. "I for one can attest that soldiers are using liposuction, laxatives and starvation to meet height and weight standards. I did, do and still do," wrote the soldier, a medium helicopter repairer.
"Six years ago, I spent $4,500 on liposuction while on [permanent change of station] leave. As a crew member, our mission is to keep those aircraft in the air, and time for PT is not available," he wrote. "I was blessed with a very slow metabolism and an insatiable appetite."
His attitude is not uncommon. Health experts say the number of soldiers using extreme weight-loss methods may closely resemble results of a recent study by two officers attending the Naval Post Graduate School. The study found that nearly one in three Marines have gone to such measures to lose weight. The Army doesn't keep data on the likely numbers of soldiers taking these risks, but dozens of soldiers responded to a question from Army Times, many saying they use starvation, dehydration, pills or laxatives, and some have used - or are considering using - liposuction.
Additionally, more than a third of men in uniform do not meet height and weight standards, according to a separate 2009 report, "Military Services Fitness Database: Development of a Computerized Physical Fitness and Weight Management Database for the U.S. Army."
Soldiers know they will face the dreaded "tape" if they exceed height/weight standards. The tape measurements are used to determine body fat percentage, with limits set by age group and gender.
Soldiers are afraid of those limits, knowing that if they cross that line they won't be promotable. Further, they cannot be assigned to leadership positions and they are not authorized to attend professional military schools. Their career is over if they don't make satisfactory weight loss in two months - typically six to 16 pounds.
The danger to careers is real.
About 24,000 soldiers were discharged between 1992 and 2007 for failure to comply with weight standards outlined in Army Regulation 600-9, according to the 2009 Military Services Fitness Database report, which was published in the journal Military Medicine. In comparison, the Army discharged less than a tenth of that number - 2,342 soldiers - for failing the physical fitness test between 1999 and 2007.
To save their careers, some soldiers turn to excessive, unnatural and unhealthy measures.
'Disgusting and dangerous'
With 35 percent of male soldiers failing the weight standards, and 6 percent of men and women exceeding body fat standards, according to the 2009 report, how many of them will turn to extreme solutions is hard to say, as empirical data on this practice does not exist - a fact bemoaned by the medical experts with whom Army Times spoke.
"I don't think we have a clear understanding how widespread this problem is," said Col. George Dilly, Medical Command's chief dietician and a consultant to the Army surgeon general.
"Soldiers are hiding the fact they are doing this because they don't want the problem exposed."Dilly said the typical scenario is well known. As a soldier approaches his semi-annual weigh-in, he may use diuretics and laxatives to reduce fluid and lower his weight. But this can be a deadly decision, Dilly said, because it causes dehydration, and the loss of essential electrolytes can lead to cardiac arrest. Worse yet, this approach has no effect on the individual's body fat.
"This is not a long-term strategy," he said. "In fact, it's a very dangerous short-term strategy."
Second Lt. Lane Stover knows this all too well. The 5-foot-4-inch quartermaster said she went to extreme measures to keep the weight off.
"When I ate more than I thought I should, I would purge, and punish myself by heading to the gym or out on a late-night run," she said in an e-mail to Army Times. "I would often take laxatives, in excess of the prescribed amount, and knew exactly how long it would take for them to go into effect. It was a disgusting and dangerous practice that I thought would help me. I saw field exercises as an opportunity to lose weight. I refused to eat MREs and hardly drank water in an effort to shed pounds. Under the stresses of an FTX, no one really noticed these behaviors."Stover said she entered therapy and went to support groups to fix her problem, but said one problem remains.
"When I went to Airborne school, I tried to survive the rigors of training on salad, water, and determination. It definitely wasn't enough. I gave in and ate more, but just enough to keep from passing out during training. ... A year later, I tried the same thing at the Leadership Development Assessment Course and nearly became a heat casualty in the field more than once."
"My behaviors aren't the only problem. The Army's weight standard is," she said. "Until the Army takes a closer look at the weight regulations and methods for determining body fat, soldiers will resort to extreme measures to ensure they are within their weight requirements."The fact that soldiers are taking these steps is no secret among the rank and file.
"I have been on a roller coaster of gains and losses for half my military career," said one lieutenant colonel. "I have considered lipo, and I have certainly starved myself, dieted on only bread and water, or other similar extreme diets to make weight or tape. ... And it is no secret to any leader in the military what some soldiers will do to conform to standards that have been set."
Alejandra Lewis said she had taken laxatives and starved herself "a couple of times" in preparation for the PT test. She said the problem was not her weight, but the way the Army measures body fat.
"Every person has a different shape of body; not everyone is the same," she wrote to Army Times. "When I joined the military I went down 80 pounds starving myself and [using] laxatives. I had to do it because even though I had met weight, I have thick thighs. The tape measure said I was over, so I had to lose even more weight just to meet the standards. They need to change it because it isn't fair."
One noncommissioned officer said a friend used his inheritance to pay for abdominal liposuction when his career was in jeopardy, while he instead opted for a liquid-only diet with ephedrine supplements, which have since been banned.
The fact that soldiers are taking these steps is no secret in the cosmetic-surgery community.
CWO 2 Melissa Gash, based at Fort Riley, Kan., said she recently saw a poster for liposuction at the post gym.
"The bottom of the poster clearly states that advertisement does not mean endorsement, but the fact that material like that is even allowed on post, and more specifically where soldiers go to get fit, is inappropriate," she said. "It gives the soldier the false impression that liposuction should even be an option. Americans are all about fast results and immediate gratification. Whatever happened to working hard to accomplish a goal and feeling the satisfaction after earning what you set your sights on?"
Army Times also found liposuction ads in numerous base newspapers, including those at Fort Benning, Ga.; Fort Campbell, Ky.; and Fort Hood, Texas. Many offered financing and 10 percent off with a military ID.
But military health professionals say troops should not believe all the hype - and should be aware of the risks involved.
"We want soldiers to look right," said Dr. Thomas Williams, a retired colonel who heads the Army Physical Fitness Research Institute. "But they also need to feel right and perform right, and you can't get that from a pill or a procedure."
Battle of the bulge
Military leaders and health professionals are working to get, and keep, soldiers healthy. The formula is nothing new. Though they expressed it with far more medical elegance, the bottom line is this: Eat less junk and exercise more.
Lt. Gen. Mark Hertling, deputy commanding general for initial military training, stands at the forefront. Improvements to Physical Readiness Training were the first of three steps he has taken to strengthen the overall health and well-being of soldiers.
The second element is the Soldier Athlete initiative. The goal is to train the soldier to eat and drink healthier items that not only prepare him for strenuous physical activity, but also fuel him throughout the endeavor and aid in his recovery afterward.
The third element would be the forthcoming recommendations for new PT tests. If adopted, they will mark the first change to the test since it was introduced in 1980.
The formula works, according to Williams, whose organization tries to help individuals understand how nutrition, fitness and mindset can help you stay fit for the fight.
And their efforts are paying off.
Before changes at the Sergeants Major Academy in 2005, one to two students were dying from cardiac arrest in each class. Since APFRI came onboard, no student has died, Williams said. He attributes this to a keen understanding and aggressive reduction of risk factors. The program is now offered at the U.S. Army War College and the Command and General Staff College.
"We now have a stronger force, but it does not understand the impact of nutrition," he said.
Williams pointed to war-college students as proof. In the mid-'80s, the average student could lift only 85 percent of his body weight. Today, the average student can lift 25 percent more than his body weight - but soldiers still fight the battle of the bulge.
A key reason is the fact that a soldier will gain one pound for every 3,500 extra calories he takes in. For example, if you burn 2,000 calories per day, but eat 2,500 calories per day, you will put on a pound every week. It's what Williams calls "energy differential." And that is why the average American is 25 pounds overweight by the time he or she hits 45.
Unpredictable eating patterns will add to that girth, too. If you skip breakfast, your body will start breaking down lean muscle mass after 90 minutes to keep a constant supply of glucose. Your metabolism will slow down and your body will be under stress. Thinking it is in a low-food environment, your body will store more fat in the abdominal area. At dinner you are famished, and then you take in the bulk of your calories, which must be - you guessed it - stored. Because you did this, you will probably skip breakfast the next day - leading you further into this vicious cycle.
Adding to the dilemma, every 10 pounds you add requires an extra mile of capillaries to get blood to the tissues, adversely affecting your heart health.
To reverse the curse, Williams recommends "just-in-time nutrition and distribution." If you eat what you need when you need it, you won't store the excess that leads some people to get liposuction. You can start by cutting 150 calories from your daily diet and increasing your daily expenditure by 150 calories, he said. This can be done with a brisk 30-minute walk.
"Eating right, sleeping right and exercising right really does make for a better and more effective soldier," he said.
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