Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA.
Department of Endocrinology, Eisenhower Army Medical Center, Fort Gordon, GA 30905, USA.
Mil Med. 2022 Jul 1;187(7-8):e948-e954. doi: 10.1093/milmed/usab292.
The overall rate of obesity is rising in the USA; this is also reflected in the military population. It is important that providers appropriately diagnose obesity and discuss treatment options with their patients.The purpose of this study was to investigate diagnosis of obesity compared to documented body mass index (BMI) in the military health system.
Institutional review board approval was obtained by the 59th Medical Wing (Lackland Air Force Base, Texas) as an exempt study. This study included active duty military service members aged 18-65 years who sought outpatient care at a military treatment facility from September 2013 to August 2018 with a weight within the range of 31.8-226.8 kg and height between 121.9 and 215.9 cm. Data were collected from the Clinical Data Repository vitals and M2 encounter data to determine the percentage of each sub-population with a diagnosis of obesity according to BMI (≥30 kg/m2) and International Classification of Diseases diagnosis codes.
Using BMI, 19.2% of female and 26.8% of male service members can be diagnosed with obesity; however, only 42.2% and 35.1%, respectively, with a BMI ≥30 was diagnosed as such. This discrepancy was consistent among all service branches and BMI ranges.
This study demonstrates that obesity is underdiagnosed compared to BMI. This may result in insufficient resources being provided to patients to reduce weight. Further investigation is warranted to identify causes of underdiagnosis and potential barriers to diagnosis.
美国的肥胖总体发生率正在上升；这一现象在军人中也有所体现。医疗服务提供者恰当地诊断肥胖并与患者讨论治疗方案非常重要。本研究旨在调查与文献记载的体重指数（BMI）相比，军人健康系统中肥胖的诊断情况。
第 59 医疗联队（得克萨斯州拉克兰空军基地）获得机构审查委员会批准，将本研究作为豁免研究。该研究纳入 2013 年 9 月至 2018 年 8 月期间在军人治疗机构接受门诊治疗、体重在 31.8-226.8kg 之间且身高在 121.9-215.9cm 之间的 18-65 岁现役军人。从临床数据存储库生命体征和 M2 就诊数据中收集数据，以确定根据 BMI（≥30kg/m2）和国际疾病分类诊断代码诊断为肥胖的各亚人群比例。
根据 BMI，19.2%的女性和 26.8%的男性军人可被诊断为肥胖；然而，仅有 42.2%和 35.1%的 BMI≥30 的军人被诊断为肥胖。这一差异在所有军种和 BMI 范围内均存在。
本研究表明，与 BMI 相比，肥胖的诊断不足。这可能导致向患者提供的减肥资源不足。需要进一步调查以确定诊断不足的原因和潜在的诊断障碍。
