This application is in response to PAR-12-048, """"""""Prevention and Treatment of Obesity, Diabetes, and Chronic Kidney Disease in Military Populations"""""""". Active U.S. military personnel have mirrored the marked civilian increased prevalence in obesity. A survey conducted in 2005 reported that 61% of men and 39% of women serving in the active component of the U.S. military had a body mass index that classified them as overweight (Body Mass Index [BMI] >25 kg/m2) and 12% of active service members were obese (BMI>30 kg/m2), up from less than 5% in 1995. Given that the national epidemic of obesity continues, one would expect those prevalence rates to be even higher today. While the Announcement highlights the advantages of conducting research in military populations, there are also many logistical, practical, chain-of-command, philosophical, and other challenges that impede health promotion and other research in the military. Fortunately, our research team has a long history of conducting health promotion/disease prevention in the military and has a military liaison (Wayne Talcott, Ph.D., Col, USAF [retired]) who helps ensure the effective day to day running of our multiple projects. The key to successful research in the military is to address significant health promotion issues (e.g., smoking, alcohol abuse, obesity) that are (a) costly to the military;and (b) most importantly, impediments to military readiness (which is the ability to do one's job in either combat or non-combat situations). Given that obesity is an impediment to military readiness (a vital concern for the military), the need for obesity interventions in this high risk population and the dearth of research on obesity treatments in the U.S. Military, we propose the following specific aims: 1) To translate and tailo the Look Ahead weight loss intervention to the overweight/obese active duty U.S. Military population, while accommodating the lifestyle and environment that is unique to military members; (2) To randomize 520 participants to either the Look Ahead Intensive Lifestyle Intervention (ILI) versus a Diet and Physical Activity Education (Diet/PA Ed) condition. The Diet/PA Ed condition of this Look Ahead translation is not a placebo control group but an active information group that stresses nutrition, exercise and support (similar to the Diet Support and Education control group in the original Look AHEAD trial). (3) To evaluate the long term (one year) efficacy of the Look Ahead weight loss intervention in this population. The results of the intervention if successful will be easily disseminated to the entire U.S. Military as this project s designed to overcome the barriers and exploit the facilitators for weight loss that are unique to a military population. It will also better inform translation of the Look Ahead Rx in civilian populations as well.

Public Health Relevance

Obesity treatments are needed in the U.S. Military. If effective, this study will provide huge public health impact to the obesity epidemic in this high risk population.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
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Special Emphasis Panel (ZRG1-PSE-B (50))
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Kuczmarski, Robert J
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University of Tennessee Health Science Center
Public Health & Prev Medicine
Schools of Medicine
United States
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Fahey, Margaret C; Hare, Marion E; Talcott, Gerald W et al. (2018) Characteristics Associated With Participation in a Behavioral Weight Loss Randomized Control Trial in the U.S. Military. Mil Med :
Fahey, Margaret C; Klesges, Robert C; Kocak, Mehmet et al. (2018) Changes in the Perceptions of Self-weighing Across Time in a Behavioral Weight Loss Intervention. Obesity (Silver Spring) 26:1566-1575
Krukowski, Rebecca A; Hare, Marion E; Talcott, Gerald W et al. (2018) Dissemination of the Look AHEAD Intensive Lifestyle Intervention in the United States Military: A Randomized Controlled Trial. Obesity (Silver Spring) 26:1558-1565
Maclin-Akinyemi, Courtney; Krukowski, Rebecca A; Kocak, Mehmet et al. (2017) Motivations for Weight Loss Among Active Duty Military Personnel. Mil Med 182:e1816-e1823
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Krukowski, Rebecca A; Hare, Marion E; Talcott, Gerald W et al. (2015) Dissemination of the Look AHEAD intensive lifestyle intervention in the United States Air Force: study rationale, design and methods. Contemp Clin Trials 40:232-9
Rollo, Megan E; Hutchesson, Melinda J; Burrows, Tracy L et al. (2015) Video Consultations and Virtual Nutrition Care for Weight Management. J Acad Nutr Diet 115:1213-25