Selected weight management interventions for military populations in the United States: a narrative report

Murray, Jessica; Aboul‐Enein, Basil H.; Bernstein, Joshua; Kruk, Joanna

doi:10.1177/0260106017704797

Cited by 11 publications

(3 citation statements)

References 23 publications

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“…The effectiveness of the weight loss interventions was also found to be significant largely in active-duty military personnel but not in veterans. These findings indicate that weight management interventions in the military population are effective, updating previous research [20,65,89]. Most of the included interventions were based on behavior change strategies adopting a comprehensive approach with different therapeutic goals, combining lifestyle modification with diet and nutritional changes and physical activity therapy, in line with previous evidence [20].…”

Section: Discussionsupporting

confidence: 82%

Randomized Controlled Trials to Treat Obesity in Military Populations: A Systematic Review and Meta-Analysis

Gravina,

Keeler,

Akkese

et al. 2023

Nutrients

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In recent years, overweight and obesity have reached an alarmingly high incidence and prevalence worldwide; they have also been steadily increasing in military populations. Military personnel, as an occupational group, are often exposed to stressful and harmful environments that represent a risk factor for disordered eating, with major repercussions on both physical and mental health. This study aims to explore the effectiveness of weight loss interventions and assess the significance of current obesity treatments for these populations. Three online databases (PubMed, PsycInfo, and Web of Science) were screened to identify randomized controlled trials (RCTs) aiming to treat obesity in active-duty military personnel and veterans. Random-effects meta-analyses were conducted for body weight (BW) and body mass index (BMI) values, both longitudinally comparing treatment groups from pre-to-post intervention and cross-sectionally comparing the treatment group to controls at the end of the intervention. A total of 21 studies were included: 16 cross-sectional (BW: n = 15; BMI: n = 12) and 16 longitudinal (BW: n = 15; BMI: n = 12) studies were meta-analyzed, and 5 studies were narratively synthesized. A significant small overall BW and BMI reduction from baseline to post-intervention was observed (BW: g = −0.10; p = 0.015; BMI: g = −0.32; p < 0.001), together with a decreased BMI (g = −0.16; p = 0.001) and nominally lower BW (g = −0.08; p = 0.178) in the intervention group compared to controls at the post-intervention time-point. Despite limitations, such as the heterogeneity across the included interventions and the follow-up duration, our findings highlight how current weight loss interventions are effective in terms of BW and BMI reductions in military populations and how a comprehensive approach with multiple therapeutic goals should be taken during the intervention.

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Section: Discussionsupporting

confidence: 82%

Randomized Controlled Trials to Treat Obesity in Military Populations: A Systematic Review and Meta-Analysis

Gravina,

Keeler,

Akkese

et al. 2023

Nutrients

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“…Conversely, a review of 8 lifestyle programs in military populations showed that most did not result in significant weight loss at 6 months post-intervention. 13 However, a recent study comparing counselor initiated and self-paced adaptations of the LookAHEAD Intensive Lifestyle Intervention program in AD personnel showed that both interventions produced significant weight loss and decrease in abdominal circumference. 14…”

Section: Purposementioning

confidence: 99%

Effectiveness of Lifestyle Interventions in an Active Duty Air Force Population

et al. 2021

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Purpose: To examine the effectiveness of 3 lifestyle intervention programs in an active duty military population. Design: Experimental design with stratified random assignment to 1 of 3 intervention groups. Measures were taken at baseline, 3 months and 6 months. Setting: A Military Treatment Facility in the western U.S. Subjects/Intervention: 122 active duty service members were enrolled and randomly assigned to 1 of 3 lifestyle intervention programs: the Diabetes Prevention Program-Group Lifestyle Balance (DPP-GLB), the Better Body Better Life (BBBL) program or the Fitness Improvement Program (FIP). Measures: weight, abdominal circumference, lipid and HbA1c levels, physical activity, and well-being as measured by the RAND SF-36 questionnaire. Analysis: Statistical analyses were performed to assess changes over time. Results: 83 participants completed the study (BBBL N = 23, FIP N = 30, DPP-GLB N = 30). The DPP-GLB participants had statistically significant decreases in weight (-3.1 pounds, p = .01) and abdominal circumference (-0.9 inches; p = .01) over time. HbA1c was also significantly lower in this group at 6 months compared to baseline ( p = .036). There were no statistically significant changes in weight, abdominal circumference, or HbA1c in the FIP or BBBL groups. No significant changes were observed in lipids in any of the groups. Conclusion: Results from this study indicate that the DPP-GLB program may be effective in reducing weight, abdominal circumference, and HbA1c in an active duty U.S. military population.

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“…Research on the determinants of eating behaviors in military populations appears to be limited to topics such as sociodemographic characteristics of overweight and obesity within military populations (e.g., Hruby et al, 2015; Sanderson et al, 2014); the role of nutritional supplements and the composition and delivery of ration packs for training and combat missions (Crombie et al, 2013; Tassone & Baker, 2017). Eating behaviors have been examined as part of large-scale interventions to combat overweight and obesity that rely on a limited number of tools such as cognitive behavioral counseling, education and are based on minimal use of theory for program development, implementation, and evaluation (Murray et al, 2017). To date, only a handful of studies (e.g., Carins et al, 2016; Carins & Rundle-Thiele, 2014a; 2014b; Kullen et al, 2016) have examined the determinants of eating behaviors or tested and evaluated programs that aim to improve eating behaviors in military populations specifically.…”

Section: Background and Literaturementioning

confidence: 99%

Eating Behaviors in Australian Military Personnel: Constructing a System of Interest for a Social Marketing Intervention

Anibaldi

Carins

Rundle‐Thiele

2020

Social Marketing Quarterly

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Background: Eating behaviors are complex and have particular significance for military personnel who require sound nutrition to support health and physical fitness for job performance. Policies and guidelines for the provision of nutritionally appropriate food/drink on base and in the field do exist; however, many military personnel have poor dietary habits, and these habits are evident early in their career. Social marketing could assist in changing unhealthy eating behaviors of personnel through implementation of feasible interventions co-created with stakeholders that are valued by Australian Defence Force (ADF) personnel. : The article reports the first phase of a systemic co-inquiry into unhealthy eating behaviors of military personnel. This study aimed to gain an initial framing of the problem situation and thus hypothesize a “system of interest” in which to conduct future work. Research questions What components (e.g., ideas, objects, attributes, activities) are perceived to be relevant for eating behaviors in military personnel? Do interrelationships and interconnections among components suggest how unhealthy eating behaviors may emerge? Are there places that suggest viable leverage points as opportunities for changing unhealthy eating behaviors through delivery of offerings that ADF personnel value? Program Design/Approach: This study was part of a systemic inquiry approach. Methods: Data for the study included document analysis and 14 semi-structured depth interviews with ADF stakeholders. Data were thematically analyzed to construct a system of interest in which to explore how eating behaviors emerge among personnel and ADF-controlled leverage points that can be used to increase healthy eating for ADF personnel through social marketing intervention. Results: The data analysis identified alternative systems of interest in which to explore how eating behaviors emerge among personnel. Demand and supply side leverage points were identified. On the supply side, the encouragement of patronage through menu innovation, investment in facilities, cooking skills training, and auditing provision were opportunities for social marketing intervention. On the demand side, education and training coupled with communications that challenge cultural and regulatory norms and link to military values were areas that programs seeking to increase healthy eating in ADF personnel could focus on. Importance to the Social Marketing Field: As an approach for addressing “wicked” problems, the application of systems thinking in social marketing has privileged an ontological concept of system as a metaphor for reality. This approach assists in expanding the focus of change beyond the individual to include factors in social, economic, and policy environments. By using systems thinking as an epistemological device, this article offers an approach that may be applied to overcome practical and philosophical limitations in the application of systems thinking. Recommendations for Research or Practice: Research on alternative methods for applying systems thinking is recommended to strengthen the potential of system approaches in the field of social marketing. Limitations: This study is part of a broader program, and its findings on the problem of unhealthy eating behaviors in ADF are preliminary. Limitations specific to the study include the possibility of “reductionism” in stakeholder identification and self-selection bias in participation.

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Selected weight management interventions for military populations in the United States: a narrative report

Cited by 11 publications

References 23 publications

Randomized Controlled Trials to Treat Obesity in Military Populations: A Systematic Review and Meta-Analysis

Randomized Controlled Trials to Treat Obesity in Military Populations: A Systematic Review and Meta-Analysis

Effectiveness of Lifestyle Interventions in an Active Duty Air Force Population

Eating Behaviors in Australian Military Personnel: Constructing a System of Interest for a Social Marketing Intervention

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