Trends in the prevalence of obesity among U.S. active component service members and civilians, 2013-2023

Trends in obesity among U.S. active component service members (ACSMs) and civilians are relevant to military recruitment and retention, as excess body weight is a common disqualification for military service. This study utilized measured height and weight data from the Military Health System Data Repository for ACSMs (cumulative n=12,262,745) and the National Health and Nutrition Examination Survey for civilians ages 17-62 years (cumulative n=19,334). Accounting for the design of each data source, the prevalence of obesity (body mass index≥30 kg/m2) and body mass index (BMI) distributions were calculated. Joinpoint software and polynomial regression regression were used to assess trends over time. From 2013 through 2023, obesity prevalence increased among ACSMs, from 14.7% to 24.2%. Although obesity rates among civilians were consistently higher, this gap narrowed over the course of the decade. The same pattern was seen in young men (ages 17-24 years). Civilians have greater proportions within the highest classes of BMI than ACSMs. Persistently high obesity prevalence among ACSMs overall and in young men, particularly since 2019, may affect military recruitment, retention, and ultimately, strength and readiness. From 2013 through 2023, the prevalence of obesity increased significantly among U.S. ACSMs, 2019 to 2023 in particular, while prevalence among civilians remained consistently high. The pattern of obesity is especially relevant in young men, the largest source of potential and newly accessed military recruits.