Too Fat To Fight?

Most of my regular readers know that I am an Air Force flight surgeon (TX Air National Guard) with a total combined active duty, reserve, and National Guard time of 23 years. I picked up a copy of the Air Force Times during my last visit to Holloman AFB as I was intrigued by the headline “New Rules to Pass PT Test”. The Air Force is updating the regulation regarding member fitness to bring the branch into compliance with the latest change from the Department of Defense (DoD).

Failure to pass the abdominal circumference tape test will result in a body mass index (BMI) calculation. Male members will be required to have a BMI of no greater than 26 while female members must be less than 36 per DoD regs. The official numbers that will be required for the Air Force weren’t available at the time of this article but cannot be greater than DoD standards.

Why the changes? Our military needs to be fit! The current Air Force motto: “Aim High… Fly, Fight, Win” requires a force composed of men and women that are fit to fight. High body fat content (high BMI) is detrimental to the goals of the Air Force. Our ejection seats were never designed to eject obese pilots. Our Air Support Operations Squadron (ASOS) members need to be able to move quickly on the ground. Our maintainers and technicians? Whether working on aircraft, ground equipment, or life support equipment, they need to be able to fit into not only the access hatches but the same uniforms that other Air Force members wear.

The United States military is well respected by other nations. Will we maintain our current level of respect (and ability to deter) if our members don’t maintain a professional military appearance? Not likely! Consider the playground bully who taunts the overweight/obese kid and then outruns the fight. A similar occurrence on the battlefield has much greater repercussions.

What about the effects of fat on health? We know that obesity decreases testosterone levels, decreases energy, increases fatigue, increases cholesterol, and increases the risk for heart disease, high blood pressure, diabetes, and sleep apnea. Wait a minute… I knew that carrying too much fat had detrimental effects on overall health, but testosterone?

Testosterone (T) is converted into estradiol by an enzyme called aromatase. Fat cells contain the greatest amount of aromatase. So… the more fat you have, the higher the aromatase level, the lower the T level (and higher estradiol level). Man boobs? Usually seen on guys carrying too much weight. Hot flashes and night sweats aren’t usually a big issue in big women due to the increased estradiol levels. Low libido in obese men and women is a given. Signs and symptoms of low T in men and women include the same symptoms associated with obesity with the addition of anxiety, depression, and loss of muscle, memory, and hair.

Military, dependent, retired, or civilian; maintaining a good fighting weight is critical for your health and well-being. Overweight, symptoms of low T, or both? Talk to your doc or flight surgeon about steps you can take to improve your health!

Aim High… Fly, Fight, Win!

Disclaimer: Dr Stephen Rath, MD, DABA is a board certified anesthesiologist, Air Force flight surgeon, FAA AME, paramedic, and pilot as well as the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. He considers it an honor to still be able to serve his country. Comments or questions? His email address is: