Monday, November 07, 2016

The Canadian Armed Forces Need Help On Obesity

Today's anonymous guest post is a letter I received a few weeks ago from a member of Canada's armed forces who wanted to fill me in on how obesity is being handled with our soldiers. The letter speaks to the fact that doctors and dietitians are not uniformly trained or capable of providing helpful, or thoughtful, advice, and that despite all evidence to the contrary, that the way to deal with obesity is at once simple and easy.
Good Morning Dr. Freedhoff,

Please let me start by thanking you for your efforts on promoting bariatric health (I own your book and subscribe to your blog).

It took me some time to work up the courage to write you on the issue surrounding obesity in the Canadian Armed Forces (CAF) as we are not meant to air our dirty laundry in public. However, I thought you might be interested in some of the recent media attention surrounding obesity in the CAF and how the issue is dealt with in our organization.

First, please note that I am obese. I weigh approximately 230lbs and am 5’7". I am active (running, cycling) and do not have any issues meeting the minimum fitness standards in the CAF. I would describe myself as someone who is carrying extra fat (read not a body builder).

This article (along with a couple of variants) have been getting media attention inside my organization of late and the issue of obesity is something that the organization wants to address (adding weight and waist circumference measurements to our fitness testing routine, introducing incentives to motivate members to improve their fitness scoring, and general fitness promotion). The article discuses more stringent fitness standards for a deployment when, in fact, the battle fitness test is a more specific assessment (marching with a “heavy” pack, fireman’s carry, etc.).

I was provided with some advice on how to lose weight from the CAF health services organization:
  • Establish a starting weight (i.e. 230 lbs), and by the next week aim to be at 229. If by the next week I am not at 229, do not eat until I am. Repeat as required until I achieve goal weight (Medical Officer)
  • Restrict calories (especially carbohydrates) in the evening (Medical Officer)
  • After reviewing my food log (that didn’t contain ice cream) I was advised to reduce caloric intake by eating a bowl of ice cream each night instead of a full pint (Dietitian).
Needless to say, there is a negative connotation with being obese in the CAF. It is my opinion that the organization could find better ways to support its members in their efforts. As an example, at my most recent medical appointment I was happy to find that I had lost 15lbs over the past year (largely due to increased activity) but I was told that it was probably just water, not fat and that there was much more work to do to reduce my BMI to a healthy level.

As someone who is struggling to improve my fitness/health, it is fairly obvious that my organization does not understand the complexity of the issue they are trying to address. I appreciate your efforts to promote bariatric health and to advocate for obese/overweight people.
Here's hoping that over time, the military, and everyone else, starts to wrap their heads around the straightforward fact that scales (or BMIs) don't measure the presence or absence of health, and that the truism of "eat less, move more" is no more helpful to obesity than "buy low, sell high" is to wealth.