Weight Loss Before Basic Combat Training and Musculoskeletal Injuries Among U.S. Army Trainees: The ARMI Study

Abstract

Objective

To investigate the association between weight loss before joining the U.S. Army and rates of musculoskeletal injury (MSKI) during physically demanding Basic Combat Training (BCT).

Methods

Self-reported weight loss was collected on 3168 Army trainees who were followed through electronic medical records for diagnosis of any and region-specific MSKI. Cox regression models were stratified by sex and COVID-19 pandemic and adjusted for age, height, maximum-ever BMI, race/ethnicity, smoking history, prior physical activity, and history of injury.

Results

A total of 829 trainees (26.16%) reported losing weight to enter the Army with mean (SD) weight loss of 9.06 (8.62) kg, most commonly through exercise (83.72%). Trainees who lost weight to enter the Army had lower rates of any (HR: 0.86; 95% CI: 0.74, 0.99) and lower extremity (HR: 0.84; 95% CI: 0.72, 0.98) MSKI during BCT compared to trainees who did not lose weight. Rate of weight loss (mean [SD]: 1.27 [1.06] kg/week) was not associated with any or region-specific MSKI.

Conclusions

Results indicate that losing excess weight before military training may minimize injuries during training and the relatively gradual rate of weight loss in these trainees did not pose a higher risk of injury.