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Abstract

PURPOSE: U.S. Air Force Reserve Officer Training Corps (AFROTC) cadets face unique military preparedness pressures that may heighten risk for negative body image and maladaptive eating behaviors. Such behavioral and body image concerns can meaningfully undermine health, performance, and readiness, yet remain underexplored relative to physical outcomes in pre-military populations. This study examined longitudinal changes in body composition and physical fitness assessment (PFA) scores alongside various psychosocial factors across a 12-week S&C program in AFROTC cadets. METHODS: Forty-six AFROTC cadets (21 F, 25 M; age: 20±3y; BMI: 24.0±3.9kg/m²; BF%: 26.1±8.2%) completed the Supporting Tactical Athletes for Readiness (STAR) Program. Assessments at baseline and post-intervention included body composition, PFA scores, cardiometabolic health, eating behaviors, depression, and attitudinal and perceptual body image via DXA, validated questionnaires, and 3D digital appearance adjustment. RESULTS: Following the intervention, cadets demonstrated broad improvements in physical and cardiometabolic health, including higher PFA scores (p<0.001), lower abdominal body fat percentage (p=0.035), improved blood pressure (p=0.009), lipids (p=0.021), and resting heart rate (p<0.001), and increases in lean soft tissue and bone mineral outcomes (all p≤0.045). In contrast, depression worsened overall (p<0.001) with pronounced increases among underclassmen and female upperclassmen (all p≤0.038). Body image perceptions remained directionally consistent across time, with cadets desiring smaller ideal body sizes (all p<0.001) and perceiving external pressure for leanness from potential partners and cadre members (all p<0.001). Greater BF%, particularly truncal BF%, was associated with more negative body image attitudes (all p≤0.036), especially for males. Eating behavior changes varied by academic classification and sex, where eating restraint declined in upperclassmen but increased in underclassmen (all p≤0.033), while changes in uncontrolled and emotional eating were differentially associated with abdominal adiposity and cardiometabolic health risk. Notably, improvements in strength and aerobic performance were linked to both favorable (e.g., improved mood, body area satisfaction) and unfavorable (e.g., greater overweight preoccupation, increased depression) changes in eating and body image behaviors. CONCLUSION: A 12-week S&C program elicited robust improvements in fitness and cardiometabolic health in AFROTC cadets, but these physical improvements were accompanied by various, and in some cases, adverse changes in eating behaviors, body image, and depression. These findings highlight a disconnect between physical readiness and psychosocial well-being, particularly among underclassman and female cadets. Integrating body image and eating behavior-informed monitoring and education into pre-military training may be necessary to optimize both performance and long-term health.

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