The obesity rate in the U.S. continues to increase, and the military sees similar trends. As a result of the obesity epidemic, U.S. Army recruiters have struggled to meet quarterly and annual recruiting goals. The number of individuals qualified to serve continues to decrease, posing a direct threat to national security.
The Centers for Disease Control and Prevention reported in May that more than 2 in 5 American adults suffer from obesity, and just over a third of young adults ages 17–24 are too heavy to serve in the military.
In response to recruiting challenges in the early 2000s, the Army granted enlistment waivers for recruits with a body composition of up to 2% body fat over the accession standard if recruits could pass a physical endurance, motivation and strength assessment. This test was known as the Assessment of Recruit Motivation and Strength (ARMS) test.
Call to ARMS
Since 2009, the Army has continued to modify and expand implementation of the ARMS test. Facing recruitment challenges, ARMS 2.0 became a pilot program in August 2022 as part of the Future Soldier Preparatory Course at Fort Jackson, South Carolina, which gives prospective soldiers a window to reach basic training standards. The ARMS pilot program authorized 90-day conditional enlistment contracts for recruits with a body composition of 3% to 6% over the accession standard, in accordance with Army Regulation 40-501: Medical Services: Standards of Medical Fitness.
This past February, the program allowed for further expansion to authorize trainees with higher body fat percentages: up to 8% over the accession standard. Once trainees achieve the original ARMS standard of 1% to 2% over the Army accession standard, they can begin Basic Combat Training.
Soldiers who struggle with obesity may be labeled by Army leaders and other soldiers as unmotivated, incompetent and undisciplined. However, there are physiological, behavioral and environmental challenges for some that make it difficult to maintain weight loss. Long-term weight loss requires continuous effort toward mitigating persistent metabolic adaptations that work against ongoing weight-loss efforts. The long-standing pressure of “making weight” through discipline and increased physical activity over medical treatment can lead to unhealthy and counterproductive behaviors, such as disordered eating and diagnosable eating disorders.
According to an article titled “Trends in the Incidence of Eating Disorders Among Active Component Service Members, 2017 to 2021,” published in January 2023 by health.mil, the official website of the Military Health System, eating disorders among active-duty service members increased approximately 79% between 2017 and 2021. The strategies the military uses to care for service members with obesity should be rooted in evidence-based weight-management guidelines to produce the best outcomes. The holistic approach of the ARMS program is designed to adhere to these evidence-based principles and mitigate the risk of disordered eating or regression.
Healthy Approach
The ARMS program addresses each domain of Holistic Health and Fitness (H2F)—the Army’s approach to soldier and unit readiness that focuses on every aspect of wellness—to help trainees meet the body composition standard to attend Basic Combat Training in a healthy manner. Utilizing a holistic approach throughout the ARMS program promotes the lasting lifestyle changes necessary to maintain recruits’ progress beyond Initial Entry Training.
Trainees who enter the ARMS program at Fort Jackson are met by drill sergeants who have completed the Army’s H2F Integrator (formerly Master Fitness Trainer) and Master Resiliency Training courses. These deliberately selected drill sergeants are skilled, professional and resilient leaders focused on standards and performance that help create the identity of the American soldier. These leaders understand and model the importance of all five domains of H2F: physical, nutritional, mental, spiritual and sleep readiness.
The domains provide benefits for those in the ARMS program, as detailed below:
Physical: The goal of physical training in the ARMS program is to prepare trainees for Basic Combat Training without injury. Many trainees in the ARMS program previously lived a sedentary lifestyle, so it is imperative to deliberately progress them to an active lifestyle. In July 2023, Future Soldier Preparatory Course leaders responded by revising the physical training program in collaboration with brigade-level H2F strength coaches and physical therapists to ensure proper progression for training frequency, duration and intensity. The program includes strength training, endurance training, low-impact cardio, high-intensity circuit training, foam rolling, band stretches and Tactical Mobility and Active Recovery and Mindfulness, a mind-body exercise like yoga.
A key element of the ARMS training plan is a posture and run clinic administered to trainees by a physical therapist during the program’s first week. Physical therapists teach trainees proper biomechanics and movement patterns to enhance performance, prevent injuries and facilitate longevity in the military. Using this as a foundation, trainees follow a structured walk-to-run progression to help prevent and reduce the frequency of overuse injuries.
Nutritional: Nutritional readiness is a primary focus in the ARMS program because it is closely connected to the other domains of H2F. Proper nutrition promotes and is supported by optimal physical, mental, spiritual and sleep readiness. Standardized nutrition classes developed by registered dietitians help trainees learn about macronutrients, micronutrients, basic performance nutrition, food labels, the U.S. Department of Agriculture’s MyPlate model and the Army’s Go for Green food labeling system.
Additional resources are provided to assist in the trainees’ long-term success beyond Initial Entry Training. Some of these resources include:
• Defense Commissary Agency recipes and resources, available at www.commissaries.com/recipes/all-recipes
• Uniformed Services University’s Human Performance Resources by Champ warfighter nutrition guide at www.hprc-online.org/nutrition/warfighter-nutrition-guide
• Operation Supplement Safety, a DoD dietary supplement program, at www.opss.org
Drill sergeants and registered dietitians help trainees apply nutrition knowledge in military dining facilities through “plate coaching”—providing feedback to a trainee about their food choices at the dining facility. Furthermore, registered dietitians provide regular medical nutrition therapy for trainees identified with increased metabolic or cardiovascular risk. Registered dietitians are available to assist this program to ensure consistent and evidence-based nutrition information is provided.
Mental: What’s fed to the mind is as important as what’s fed to the body. Mental readiness is the ability to successfully adapt to risk and adversity. A range of factors like character, behavior, resilience, cognitive and social skills affects mental readiness. Drill sergeants in the ARMS program focus on these factors daily to improve trainee mental readiness. Body composition assessments occur weekly, which can be a difficult time for trainees who fail to meet Basic Combat Training standards. Following the results of body composition assessments, trainees receive cognitive skills training with a cognitive performance specialist, who can be thought of as a mental strength coach.
The goal is to help trainees bounce back from disappointment, strengthen mentally and provide lifelong cognitive skills. Training is accomplished through action-committed mindfulness, which is the practice of being disciplined to values and goals despite negative thoughts and feelings. Applying these mental and emotional skills improves performance and optimizes long-term health.
Spiritual: Spiritual readiness is vital to personnel no matter their background, philosophy or religion, and applies to both religious and nonreligious people. The unit chaplain briefs newly arrived ARMS trainees and remains available to them throughout the program. Trainees utilize spiritual journal prompts to promote personal reflection and enhance spiritual readiness. A key element of the trainee’s first 72 hours in the ARMS program includes the “what’s your why” reflection. Drill sergeants ask trainees to reflect on their purpose and why they decided to begin their journey in the Army. Trainees write their “why” on an index card that is displayed in the company area. Drill sergeants use the “why wall” as a source of inspiration and motivation on challenging days, reminding a trainee about why they wanted to join the Army.
Sleep: The focus of sleep in the ARMS program is the critical role it serves in physical and mental health. Sleep is important for learning, emotional regulation, decision-making, problem-solving, growth and tissue repair. Sleep also can improve mood and motivation, which can benefit trainee progression throughout the program. Additional studies have demonstrated a positive correlation between quality sleep and healthy body weight. Drill sergeants teach ARMS trainees healthy sleep habits that they can continue to employ beyond their time in the ARMS program to improve overall health, maintain a healthy body weight and reduce risk of injury and chronic pain.
As of mid-October, the ARMS program had a 95% graduation rate, with 6,868 graduates. Sixty-three percent of the trainees graduated in the first two weeks. While the data speaks for itself, it is important to recognize that the ARMS program is a controlled environment. Consequently, it is imperative for trainees to understand the importance of long-term lifestyle change through a holistic approach to sustain a healthy weight when they leave the controlled setting.
While it is too soon to report on the retention and long-term weight maintenance and readiness of ARMS 2.0 graduates, data beyond the ARMS program is beginning to emerge. As of early August, 94% of ARMS graduates completed Basic Combat Training, 97% completed Advanced Individual Training, and 87% completed one-station unit training.
Ensuring Well-Being
A comprehensive approach that includes medical professionals is key to fostering long-term change. It is well known that obesity is a risk factor for several chronic diseases, and obese individuals are at greater risk of sustaining injury. Proper medical oversight, support and routine involvement in the ARMS program are vital to ensure the safety and well-being of ARMS trainees. Medical professionals can provide interrelated, meticulous and continuous health care for the trainees to help prevent injury, ensure safe weight-loss practices and encourage sustainable lifestyle changes.
An ARMS graduate wrote on a September 2023 exit survey, “The [Future Soldier Preparatory Course] is a program that, in itself, demonstrates to each Trainee that the Army has not given up on them, so they cannot give up on themselves. Additionally, on top of the physical preparedness the program offers, each Trainee gains a head start to the Soldierization process. The … ARMS program was an incredible gift and an experience I will never forget.”
The Army’s H2F system promotes total health and well-being at the individual level and is a positive shift in Army culture. The established H2F principles are foundational for the ARMS program and promote lasting lifestyle changes necessary to maintain progress achieved in the program beyond Initial Entry Training.
The way the Army treats soldiers with obesity must reflect the principles outlined in Field Manual 7-22: Holistic Health and Fitness if Army leaders want to foster healthy outcomes, promote mission readiness, retain skilled professionals and maintain a lethal fighting force.
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Capt. Emily Rice is the commander of the Assessment of Recruit Motivation and Strength program, Future Soldier Preparatory Course, Company A, 1st Battalion, 61st Infantry Regiment, Fort Jackson, South Carolina. She is a registered dietitian, a certified specialist in sports dietetics, a certified strength and conditioning specialist and has a certificate of training in obesity for pediatrics and adults.