Caring for Those Who Have Borne the Battle

One year after the official end of World War I, President Woodrow Wilson commemorated the first Armistice Day to show “solemn pride in the heroism of those who died in the country’s service and with gratitude for the victory.” It would be some decades later before the day was made a legal holiday throughout the United States; and, to recognize service members from other wars and mobilizations, the name was changed to Veterans Day in 1954.

There are more than 17 million veterans in the United States today, and though their population is declining, the number of service-connected disabilities, that is, physical or cognitive health issues that were incurred or aggravated during service, is on the rise. Although obesity is not considered a disability, several related diseases and conditions are, including chronic heart disease, hypertension, type 2 diabetes, respiratory issues, sleep apnea and insomnia.

As with the general population, the number of veterans with overweight and obesity has increased steadily over the years, and 78 percent of Veterans fall within these categories, according to the Department of Veterans Affairs. Unlike the greater population, however, obesity affects more male than female veterans.

One reason veterans gain weight is because they are no longer required to adhere to the same strict physical fitness standards they did while on active duty. As with many people, lack of time, fear of injury and feeling socially awkward are among the reasons why veterans skip their workouts.  In addition, a study by the Wounded Warrior Project revealed that the transition from the military back to civilian life and the absence of camaraderie, along with depression and sleep stress also impacts weight gain.

Further, Post-Traumatic Stress Disorder (PTSD) is linked to obesity. Research finds that beyond the physical conditions identified above, military members and veterans with obesity were more likely to have depression and PTSD and to report more life stressors and worries compared to other participants of normal weight.

To address these issues, the Veterans Health Administration convened a conference on weight management in 2016 to evaluate evidence supporting behavioral, pharmacological and surgical weight loss interventions. While all three intervention types are available, emphasis traditionally has been on behavioral approaches, specifically their ‘MOVE! Weight Management Program.’ Recommendations from the conference included a more integrated framework that considers all three levels and ensures that resources are available to coordinate integrated weight management care systemwide.

Because of their unique experiences and circumstances, any weight loss approach for veterans should evaluate cognitive as well as physical readiness. Activities such as swimming or walking are low impact and can be done alone or with others. Working with a physical therapist or personal trainer is another option that provides structure and individualized focus specific to Veteran’s needs.

We salute all who have served, and thank you for your service.