JULY 1, 2025 – Secretary of Defense Pete Hegseth issued a directive on March 12, 2025, describing the start of a “rapid” cross-force review of changes in physical fitness and body composition standards since Jan. 1, 2015. The secretary followed up on this order on April 24, 2025, signing a memorandum directing a 30-day review of medical conditions that disqualify individuals from joining the military—calling for applicants to “be physically and mentally able to perform their duties under the harshest of conditions without risk to themselves or others,” Hegseth said in a video posted on Department of Defense social media accounts.
As the DOD reviews these requirements, the focus on service member fitness is emerging at the forefront—and experts in the Military Health System offer advice on potential solutions.
“Each military service has different operational requirements, and it is important to understand those differences,” said Dr. Donald Shell, director of the Disease Prevention, Disease Management, and Population Health Policy and Oversight program in the Office of the Assistant Secretary of Defense for Health Affairs.
“’Overweight’ does not necessarily equal ‘overfat,’ particularly on the individual level. Two individuals that have the same weight and height may have different types of mass (for example, muscle vs. fat) and exhibit different levels of physical performance and different levels of health risks,” Shell said at a federal health symposium in spring 2025 where he discussed obesity in the military.
“It is important that standards are linked to substantiated health standards, common tasks, or military occupational specialty (MOS)-specific task criteria,” Shell said.
Fitness Policies are a ‘Frame’ to Build On
“Military service fitness tests, at minimum, address the primary physical fitness components of cardiorespiratory endurance, muscular strength, muscular endurance, and body composition for all military service applications. For career fields, where it is deemed necessary to ensure adequate skill, performance, and safety, the military services promote physical fitness programs that incorporate occupationally specific physical fitness requirements,” Shell said.
“Physical readiness standards are based on scientific research and establish both health-based criteria and operational physical performance-based criteria for physical fitness. Physical fitness and body composition testing programs promote readiness by emphasizing necessary physical capabilities, minimizing injuries, and meeting military service-specific operational mission requirements,” he explained.
“It is important that DOD standards are linked to substantiated health standards, common tasks, or MOS-specific task criteria,” Shell said. “Standards exist to promote physical readiness and motivate healthy fitness behaviors. For instance, higher muscle mass and high performance is preferred over poor nutrition and unhealthy habits.”
Announced on April 25, 2025, the U.S. Army updated its fitness test to strengthen readiness and lethality. Phased implementation of the Army Fitness Test began June 1, 2025, with new scoring standards for active duty soldiers in 21 combat military occupational specialties taking effect on January 1, 2026. The five-event test will be “sex-neutral and age-normed.”
Muscle and Bone Injuries Are Top Reason for Mission Absence
Musculoskeletal injuries, such as sprained knees or torn ligaments, affect military readiness, unit cohesion, rank progression, and other facets required of a deployment-ready force. “There is a consistent association in the literature between obesity and musculoskeletal injuries,” Shell noted. The military has documented that these injuries remain the No. 1 reason service members are held back from missions or suffer permanent disability. For example, active duty soldiers experienced more than 3.6 million musculoskeletal injuries over a 9-year period from 2008 to 2017.
The DOD Instruction 1308.03 on physical fitness and body composition added muscle and bone-related injury monitoring across the military in March 2022. This information gives the DOD the ability to measure and correlate injuries with failure and pass rates for body composition and physical fitness, Shell explained.
Obesity and the Military
Just as in the civilian world, increased muscle and bone-injury rates are tied to the epidemic of obesity, according to Shell. Estimates from the Centers for Disease Control and Prevention indicate that obesity-related conditions cost the U.S. healthcare system nearly $173 billion a year. For the DOD, the per-year average increase in cost for obesity is estimated at $540 per person, which includes paying for diseases and conditions related to obesity, like heart diseases, high-blood pressure, and diabetes.
Shell said that in the March 2025 issue of “Lancet,” a leading weekly peer-reviewed medical journal, a special commission’s review of global obesity identified diagnostic criteria of clinical obesity in adults, adolescents, and children, which include recurrent or chronic severe knee pain, reduced range of motion, and limitations of mobility. This is not only a challenge for recruitment, but can significantly impact retention, readiness, and one’s ability to be worldwide deployable.
Recognizing that weight can change over time due to age or duty stations, all service branches have programs service members can use to lose weight and improve their fitness through lifestyle changes and diet and exercise. There are also initiatives aimed at helping potential recruits get in shape before they join, such as the U.S. Army’s Future Soldier Preparatory Course.
Nutrition and Exercise are ‘Foundation’ of Fitness
Physical fitness and optimum body weight composition should be based on a “foundation” of heart healthy exercise and nutrition, according to 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 service member fitness and heart health.
“Lifestyle modification is relatively straightforward. It’s exactly what you would expect: Move more, eat less, and sleep well,” Franzos said.
Most service members should “really be doing three to four days in the gym [focusing on] large-muscle groups to maintain their strength.” This helps “maintain the muscle on the bones, but also the bones themselves,” because you want to “avoid osteoporosis, or thinning out of the bones.”
Aerobic exercise maintains heart health and should include “150 to 300 minutes of moderate activity that makes you breath heavy, but you can still carry on a conversation. If you push to a level of exertion where you can’t talk, or vigorous activity, then the target is half that of moderate,” said Franzos. “It can even include walking if you walk briskly.”
“The best exercise is what you do and what you enjoy, and what you see results from. You don’t have to follow specific routines,” he added. “You have to follow something that you’ll habituate to, and you’ll do regularly.”
It’s important to remember food is fuel for the warfighter, said Franzos. “You have to recognize those times that you’re giving to yourself some grace, you’re giving yourself … cheesecake … but also recognize that the bulk of the time you’ve got to really focus on healthy eating to ensure that you stay fit for the fight.”
Losing weight is hard to begin with, Franzos said. “Generally, when we put people on calorie-counting diets and put a lot of other physical effort in, we’re seeing no more than 3–5% weight loss. And, oftentimes, that weight loss isn’t maintained over time.”
Instead, he suggested staying fit, not fat, in the first place by cooking at home or in the barracks rather than eating out. Eating this way is “going to be better for your physical performance, because you’re going to be able to control a lot of the macronutrients that are coming into your body, so that you minimize the bad fats and maximize the good proteins to perform better.”
Story by Janet A. Aker
Office of the Assistant Secretary of Defense for Health Affairs/Military Health System