Despite the popular beefcake image, some 70 percent of firefighters are overweight or obese with few receiving weight-loss advice during yearly visits to the doctor, researchers said Thursday.

“Obesity is a major threat to firefighter health and safety,” the researchers wrote in Preventing Chronic Disease, a journal published by the Centers for Disease Control and Prevention. The new study also finds that most firefighting deaths may be attributed not to smoke inhalation or collapsing buildings but to cardiovascular events on the job. Those heart-related fatalities are linked directly to diet and exercise, with the latter found lacking around the firehouse.

“There are a lot of firefighters who are in great shape," researcher Rena Sue Day told The Los Angeles Times. Yet most of the firefighting workforce, even those who lift weights, could stand to lose the “spare tire” in the middle. "Bigger doesn’t always mean stronger, there’s a difference between fitness and being big."

Among 1,002 men who worked as firefighters during 2011-2012, 96 percent had visited a health care provider within the past year. However, 69 percent said they’d received no weight-loss advice from their clinicians. “Something has to be done,” Day said. “It’s really a missed opportunity and that’s the important message.”

Younger firefighters were least likely to receive weight-loss information, unless they were egregiously overweight or obese — suggesting doctors viewed youthful age as insulating factor against cardiovascular events, at home or on the job. Moreover, many fire departments lack health and wellness programs, leaving firefighters on their own with a weight bench and not much more.

Patrick Morrison, assistant to the president of the International Assn. of Firefighters for health and safety, agreed with the researchers on the value of clinical advice to health and wellness. "I found [the study] to be quite a surprise, because that’s not what we’re seeing" in fire departments that have wellness programs,” he told The Times. "The sit-down consultation means so much" in a physical exam.

The researchers said they hope to encourage more doctors to dispense weight-loss advice to overweight and obese, particularly those at risk  — like firefighters. “We need to get these 20 year-olds who are overweight and obese and begin there,” she said.

Interestingly, the researchers noted that many salaried firefighters living at the firehouse develop good culinary skills, often cooking for their bachelor brothers. Aside from messages about healthy eating, she said, firefighters should receive advice on exercise.

Source: Wilkinson, Michelle Lynn, Brown, Austin Lane, Poston, Walker Seward Carlos, et al. Physician Weight Recommendations for Overweight and Obese Firefighters. United States. 2011-2012. Preventing Chronic Disease. 2014.