SAN DIEGO — Soldiers often call plastic surgeon Adam Tattelbaum of Rockville, Md., seeking liposuction fast.
Some military members are turning to the surgical procedure to remove excess fat from their waists. It's all in an effort to pass the Pentagon's body fat test, which utilizes neck and waist measurements and can determine a person's prospects in the military.
“They come in panicked about being kicked out or getting a demerit that will hurt their chances at a promotion,” Tattelbaum said.
Many service members complain that the Defense Department's “tape test” method of estimating body fat weeds out not just flabby physiques but also bulkier, muscular builds.
Some fitness experts agree and have joined calls for revamping the military's fitness standards. They say the Pentagon's weight tables are outdated and do not reflect that Americans are now bigger, though not necessarily less healthy.
Defense officials say the test ensures that troops are ready for the rigors of combat.
At Offutt Air Force Base near Bellevue, 93 percent of military personnel pass the physical fitness test. That rate has not varied in recent years, according to Mark Geairn, director of fitness and sports at Offutt.
The test measures height, weight and waist circumference and also includes a 1-minute sit-up test, 1-minute pushup test and 1.5-mile run. The benchmarks vary depending on age and gender.
Squadrons perform a practice test 30 to 60 days before official testing. Fitness programs and nutrition counseling are available to those who are considered at-risk or have failed the exam.
Those who fail must retest within 90 days unless a medical condition prevents it. Airmen who fail four times within a two-year period can be discharged or fall in rank, though neither penalty is automatic.
Col. Thatcher Cardon, the 55th Wing's aerospace medicine squadron commander at Offutt, said that although no test is perfect, “virtually every time” someone complains about the process, that person is overweight. He said he has never worked with an airman who resorted to liposuction to meet the Air Force's physical fitness standards.
The military does not condone surgically altering one's body to pass the test, but liposuction is not banned.
The Pentagon insists that only a small fraction of service members who exceed body fat limits do well on fitness tests.
“We want everybody to succeed,” said Bill Moore, director of the Navy's Physical Readiness Program. “This isn't an organization that trains them and says 'Hey, get the heck out.' ”
The Defense Department uses neck and waist measurements rather than the body mass index, which is based on a height and weight and is widely used in the civilian world.
Those who fail are ordered to spend months in a vigorous exercise and nutrition program, which Marines have nicknamed the “pork chop platoon” or “doughnut brigade.”
Even if they later pass, failing the test once can halt promotions for years, service members say.
The number of soldiers booted for failing the test multiple times has jumped tenfold in the past five years, from 168 in 2008 to 1,815. In the Marine Corps, the figure nearly doubled, from 102 in 2010 to 186 in 2011, but dropped to 132 last year. The Air Force and Navy said they do not track discharges tied to the tape test.
Still, service members say they are under intense scrutiny as the military trims its ranks because of budget cuts and the winding down of the war in Afghanistan.
Dr. Michael Pasquale of Aloha Plastic Surgery in Honolulu said his military clientele has jumped by more than 30 percent since 2011, with about a half-dozen service members coming in every month.
“They have to worry about their careers,” the former soldier said. “With the military downsizing, it's putting more pressure on these guys.”
Military insurance covers liposuction only if it is deemed medically necessary, not if it is considered cosmetic — which would be the nature of any procedure used to pass the test. The cost of liposuction can exceed $6,000.
Some service members go on crash diets or use weights to beef up their necks so they're in proportion with a larger waist. Pasquale said liposuction works for those with the wrong genetics.
“I've actually had commanders recommend it” to soldiers, Pasquale said. “They'll deny that if you ask them, but they know some people are in really good shape and unfortunately are just built wrong.”
Jeffrey Stout, a sports science professor at the University of Central Florida, said the tape test describes the body's shape, not its composition, such as the percentage of body fat or the ratio of fat to muscle.
“I wouldn't want my career decided on that,” he said.
A more accurate method, he said, would be to use calipers to measure the thickness of skin on three parts of the body.
“That way these guys are not hurt by a bad measurement,” said Stout, who has researched the accuracy of different body composition measurements.
Air Force Gen. Mark Walsh noted only about 348 of 1.3 million airmen have failed the tape test but excelled otherwise.
Even so, his branch heeded the complaints and modified its fitness program last month. The Air Force obtained a waiver from the Pentagon so airmen who fail the tape test but pass fitness exams can be measured using the body mass index.
World-Herald staff writer Katy Healey contributed to this report.
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