A majority of weight-loss supplements sold online at a discount to service members and tested by Defense Department researchers are mislabeled -- and some contain substances banned for consumption by troops, a new analysis has found.

The researchers, who looked into whether service members are at risk for ingesting unsafe products, tested 30 weight-loss supplements available online and in stores to determine whether they contained the ingredients listed on their labels or had any hidden additives.

They found that 24 listed ingredients that weren't actually in them, seven had additives that weren't listed as ingredients, and one-third had substances found on the Defense Department's Prohibited Dietary Supplement Ingredients List, according to the study, published online Wednesday by the journal JAMA Network Open^[1].

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All the products were also rated as "risky" when assessed against the Defense Department's Operation Supplement Safety^[3] scorecard, according to the report. The research was done by the Uniformed Services University of the Health Sciences and the Henry M. Jackson Foundation for the Advancement of Military Medicine.

Service members must maintain their weight and fitness levels as a professional requirement, making them a lucrative target for the $43.9 billion U.S. weight-loss supplement industry.

Mislabeled or dangerous supplements, however, can pose a risk to troops, endangering their health, careers and financial well-being, the researchers noted.

"The predatory marketing to service members and low quality of dietary supplements promoted for weight loss pose a threat to military members and the public," wrote the authors, led by Cindy Crawford, a senior research associate with the Henry M. Jackson Foundation.

The rate of obesity among U.S. troops rose by 13.3% from 2020 to 2021, while diagnoses of pre-diabetes and Type 2 diabetes among service members also increased -- the latter, the risk of which increases greatly with poor dietary habits, was up 25% since 2018, according to data published in March 2023^[4] by the Defense Health Agency.

Given the pressure troops face to maintain fitness, they may be more likely to turn to dietary supplements, "mistakenly believing that dietary supplements have been declared safe and effective by the Food and Drug Administration if they are available for purchase in stores and online," according to the study.

The Food and Drug Administration requires supplements to have labels listing them as dietary supplements; the name and place of the manufacturer; ingredients; and the contents of the product.

By analyzing the chemical makeup of the products via liquid chromatography-mass spectrometry, the researchers found that many were adulterated or did not contain ingredients that were listed on their labels, such as raspberry ketones, hoodia or other extracts that claim to promote weight loss.

A few even contained DMAA, a synthetic ingredient banned by the FDA in 2013. Touted as a fat-burner, DMAA is known to elevate blood pressure and can cause health problems such as shortness of breath or heart attacks.

The Defense Department launched Operation Supplement Safety in 2012 to educate the military community about dietary supplements and the potential health risks of ingredients. The program's website^[5] provides extensive resources on supplements and contains a list of substances banned by the Defense Department.

The researchers noted that more education is needed among health professionals and service members to address supplement safety. According to the authors, the results of their study
"require solutions."

"These issues present clear health risks for all consumers," they wrote.

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The U.S. Supreme Court has decided not to hear a case involving 39 military chaplains who say they continue to face recrimination for refusing to get the COVID-19 vaccine for religious reasons.

In an announcement Monday of the cases the court has selected to hear next year, the justices denied the chaplains' petition to review last year's dismissal of the case by the U.S. Court of Appeals for the Fourth Circuit.

The appellate court ruled that the Defense Department's decision in January 2023 to rescind the vaccine mandate rendered the chaplains' case moot.

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In their petition, the chaplains said they needed the court to consider the case to protect them and their First Amendment rights. They argued that many continue to have bad marks in their fitness reports that influence assignments and promotions.

"These chaplains' careers are dead men walking, direct consequences of filing [religious accommodation requests]," the petition stated.

According to court documents, the chaplains filed the lawsuit "when it became obvious" that the Defense Department was denying religious accommodation requests. They claimed that since the mandate was dropped, the Defense Department has made false claims that all adverse actions have been removed from the personnel files of those who had asked for a religious exemption.

With the Supreme Court's decision not to hear the case, the Fourth Circuit Court of Appeals ruling stands, an affirmation of the lower court's finding that renders the case, Israel Alvarado et. al. v. Austin, moot.

At least 50 service members previously sued the Defense Department over its vaccine mandate, alleging that the services and the Pentagon had violated their right to religious freedom for "categorically denying" their request for religious exemptions from the COVID-19 vaccine.

In one case involving several Navy SEALs^[2], a district court judge quashed the Navy's ability to punish^[3] the sailors for refusing the vaccine order, a ruling which was upheld by the Fifth Circuit Court of Appeals but later rejected by the U.S. Supreme Court^[4].

The Defense Department was later ordered to pay $1.8 million in legal fees as settlement^[5] for two lawsuits over the mandate.

The Defense Department began requiring service members to get the COVID-19 vaccine in August 2021. More than 2 million troops and nearly 350,000 Defense Department civilian employees received the vaccines, two of which used emerging technology -- messenger RNA -- to teach a recipient's immune system to replicate the spike protein found on the COVID-19 virus and destroy it.

More than 17,000 service members refused to take the vaccine, with some citing concerns over the new technology and others saying they objected on religious grounds, noting that the widely available vaccines from Moderna, Pfizer and Johnson & Johnson were tested using cell lines derived from fetal tissue obtained from abortions decades ago.

Roughly 8,400 troops were discharged, including 3,717 Marines, 2,041 Navy^[6] sailors, 1,841 Army^[7] soldiers, and 834 Air Force^[8] and Space Force^[9] members, and more than 1,000 service members received religious exemptions before the mandate was dropped.

A total of 690 service members, dependents and civilian Defense Department employees died from COVID-19 between the start of the pandemic in early 2020 and Dec. 8, 2022, the date the DoD stopped publishing updates of its COVID-related deaths.

Nearly 1.2 million Americans have died and more than 7 million deaths have occurred worldwide as a result of the virus, first detected in China in late 2019.

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