[Juvenile obesity and fitness for military service]

In a prospective-catamnestic study among 21,978 19-20-year-old Swiss males at the time of military recruitment, a total of 412 (2.6%) obese young men were registered during the years of 1979-1981 for medical follow-up. They were matched for comparison with a group of 318 normal weight controls and studied for discharge rate from military service as well as rate and type of medical problems. After median follow-up of 3 years (basic military training and at least 1 annual repetition course) the obese group showed a discharge rate of 9% (37/412), 3.6 times higher than the normal weight group (2.5%, 8/318; p less than 0.001). There was no correlation between the extent of overweight and discharge rate within the obese group of young males. However, considerable differences for discharge rates showed up between military incorporations/functions (with values for the normal weight group in parenthesis). "Low-risk" incorporation subgroups for obese servicemen were: kitchen/logistics 2.7% (11.5%) and drivers 5.2% (2.6%), possibly due to overlap of professional and military functions. "High-risk" incorporation subgroups for obese servicemen were: medical corps/air defense 14.8% (0%) and artillery/technical functions 14.1% (2.7%), with infantry 7.8% (2.7%) in an intermediate position. The result of the gymnastic training test at military recruitment correlated best with the discharge rate from military service. The distribution of medical reasons (diagnoses) did not differ basically between obese and normal weight young servicemen. Diseases of the spine/joints and feet with 46% (37.5%) ranked first, followed by psychological problems with 22% (37.5%) and cardiovascular and other diseases with 8% (0%). Illness was the cause of discharge from military service in 7% (29/412) of the obese group compared to 1.6% (5/318) in the normal weight group (p less than 0.001), while the respective values for accident-derived discharges (1.9% vs 0.9%) showed no statistically significant difference. Impairment of fitness for military service due to minor medical problems, as well as median days at military infirmary (1.4 vs 1.6 days) and dispensation from physical exercise (0.7% vs 0.7%), were not more frequent in the obese cohort. In nearly one third of medically discharged servicemen the relevant diagnosis was already present at military recruitment. The chances of military promotion for obese servicemen were comparable to those of their normal weight peers, at least during the time interval studied.(ABSTRACT TRUNCATED AT 400 WORDS)