FALLS CHURCH, Va/ –

Dear Doc,

I’m adhering to my military branch’s instructions on keeping physically fit and eating nutritiously, but I’m having trouble getting rid of some excess pounds from my last duty station, where I mostly sat at a desk. How can I lose those pounds in a healthy way?

Sincerely,

U.S. Air Force Major G. Luke Gagon

To achieve optimum body weight composition (your fit-to-fat ratio) you’ll need to commit to regular exercise and a nutritious diet. Should these lifestyle changes not result in reaching your fitness goals, you may consider discussing weight-loss treatment options with your healthcare provider, including medications that may be appropriate for your specific medical needs and TRICARE coverage.

That’s the message from Dr. Marc Alaric Franzos, a cardiologist at the Uniformed Services University in Bethesda, Maryland. He emphasizes regular physical activity and a heart-healthy Mediterranean-style diet for maximum physical fitness and overall health.

“Lifestyle modification is relatively straightforward. It's exactly what you would expect—move more, eat less, and sleep well,” Franzos said. Ideally, service members should aim for cardiovascular health that includes “at least 150 minutes, maybe up to 300 minutes of moderate exertion, aerobic activity per week,” said Franzos. “If you're doing vigorous exercise where you're getting up into heart rate zones above 85% [of maximum], you can actually cut it down to 75 to 150 minutes per week, but ultimately that means you're still moving quite a bit, and that's a minimum.”

“Regular, vigorous exercise where you can’t carry on a conversation can be hard to maintain session-to-session, so most of your effort should be in the moderate zones.” Franzos. “It can even include walking if you walk briskly.” This weight-bearing exercise helps “maintain the muscle on the bones, but also the bones themselves,” because you want to “avoid osteoporosis, or thinning out of the bones.”

“Diet can be used for comfort, it can be used for celebration, it can be used for friendship, but it's also important to recognize that it's fuel,” for the warfighter, said Franzos.

The trouble with losing weight is keeping it off

Losing excess weight is hard to begin with, but so is keeping it off, Franzos said.

When lifestyle modifications don't achieve desired results, MHS beneficiaries who struggle with weight loss should discuss treatment options with their healthcare providers. Treatment approaches may include medications that are appropriate for their specific medical conditions and covered under their TRICARE benefit. Coverage for weight management medications varies based on medical indication and TRICARE enrollment status.

"Healthcare providers are best positioned to evaluate individual patient needs and determine appropriate treatment options, including newer medications that may be available," Franzos noted. "Traditional weight-loss medicines have typically achieved modest results, with some newer treatments showing improved effectiveness when combined with lifestyle changes."

‘Trust in your Military Health System’ and don’t go in alone

Franzos cautioned strongly against service members or other beneficiaries ordering medications via mail or from outside the U.S., especially as alternatives to proper medical supervision or because of concerns about treatment access.

“It's just too easy to order something mail order and end up getting a product that may not even contain any GLP-1ra,” Franzos said, but instead, “it may contain other substances which could be very hazardous to your health.”

“I would tell our service members to have trust in your Military Health System, and make an appointment with your primary care doctor, to discuss options and determine if it’s a good option for you.” Military sports medicine and obesity medicine specialists are also available, he noted.

“We've taken a lot of effort to learn about it and ensure that we can give proper counseling, proper guidance, and monitor for the adverse effects that may come up from these medications,” Franzo said.

“But I guarantee you that the first thing out of your doctor’s mouth is going to be, ‘Let me talk to you about lifestyle modification,’ and they're going to reinforce that, and they're going to want you to prove to them that you've taken genuine efforts on that front for about three to six months.”

Thanks to Dr. Franzos for his guidance on how to lose weight safely, be physically fit, and stay heart healthy at the same time.

Major, now is the time to get your weight checked and look for other possible causes of weight gain besides inactivity and unhealthy foods.

For more information, check out these resources, and remember, stay safe out there. We want you and your teammates to stay fit and in fighting shape.