Sleep Apnea, Obesity, And Military Recruiting Shortfalls

By Eric Gang

The obesity epidemic in the United States is not only a health crisis. It is now compromising the nation’s defense. As the number of overweight individuals continues to rise, the US military faces significant challenges in meeting its recruiting goals. This alarming trend is also concerning for military veterans and the cost of veterans’ healthcare. Veterans are not only facing obesity but also an increased risk of developing sleep apnea—a costly condition.

The Army garnered 55,000 new recruits in 2023, markedly short of its 65,000 fiscal year goal. In 2022, all branches of the U.S. military failed to meet recruiting goals, reporting record lows unmatched since 1973. According to a recent Defense Department Qualified Military Available Study, just 23% of the nation’s youth are eligible to serve without a waiver.

The close association between obesity and post-traumatic stress disorder (PTSD) means U.S. veterans are more susceptible to sleep apnea. Studies show that veterans are three times more likely to receive a PTSD diagnosis than civilians. Nearly 70% of Vietnam veterans and 69% of Iraq and Afghanistan veterans show coexisting PTSD and sleep apnea.

The impact of sleep apnea on obese patients is profound, both physically and financially. These individuals often must bear the burden of expensive treatments such as Continuous Positive Airway Pressure (CPAP) machines, surgery, and weight loss drugs. Paying thousands of dollars annually for these treatments is not only financially draining but also adds to the overall health-related expenses.

In addition to the financial toll, sleep apnea is a disabling condition that affects many aspects of a person’s life, including their ability to maintain employment. Poor concentration, lethargy, insomnia, and other related health problems make it extremely challenging for veterans with sleep apnea to perform their duties effectively. Consequently, many veterans find it difficult to sustain employment, leading to further economic and social challenges.

To alleviate these financial burdens, veterans can receive various sleep apnea ratings from the Department of Veterans Affairs (VA). Currently, veterans can receive a 100% sleep apnea rating, a 50%, 30%, or even a 0% rating, depending on severity. Recognizing the impact of this disorder, the VA has recently proposed modernizing the sleep apnea rating criteria to ensure veterans receive the appropriate support and compensation. Updated criteria would apply medical developments to base sleep apnea evaluation on responsiveness to treatment. VA has stated that this approach aims to align the rating criteria more closely with the intended purpose of the rating schedule.

To combat this issue of recruiting shortfalls, the Army has attempted to lift the requisite BMI and is now employing dual-energy X-ray absorptiometry scans or bioelectrical impedance analysis to help determine whether a potential recruit is officially overweight. The Army is also planning significant changes to its recruitment strategies, recently announcing plans to create a new recruiting-dedicated enlisted occupational specialty and expanding its target demographic to higher socioeconomic regions. However, these changes alone may not suffice.

Improving the overall health and fitness of the population should be a priority, not just for military purposes but for the well-being of the entire nation. Investments in education are crucial, focusing on the quality and availability of programs that promote healthy living. Effective communication with the younger generation, especially those from higher economic sectors, is essential to instill the importance of a healthy lifestyle from an early age.

Furthermore, implementing initiatives such as physical activity and recreation programs, subsidized staple foods, and food programs offering pre-prepared meals can help individuals make healthier choices. Additional assistance, such as nutritional education and counseling, can further support those struggling with obesity and related conditions.

Revising public policies to prioritize the health and well-being of the population can have far-reaching effects, not just on military recruiting but on the overall strength and resilience of the nation. Steps must be taken to combat the obesity epidemic, reduce the incidence of sleep apnea among veterans, and ensure a healthier, fit, and slim population.

The detrimental effects of obesity, sleep apnea, and PTSD on military recruiting cannot be ignored. The link between obesity and sleep apnea among veterans is concerning and demands immediate attention. By addressing these issues through improved education, communication, and support systems, we can work towards a healthier and more capable military force. Simultaneously, these efforts will benefit the entire population, leaving a lasting impact on the nation’s defense and well-being.

Eric Gang is the managing attorney and founder of Gang & Associates (, where he specializes in veterans’ disability law, representing veterans with complex VA claims and appeals involving PTSD, sleep apnea, and related conditions. He can be reached at [email protected].