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BMI & OSA: New Hurdles To Jump Thru For Medical Certification
Since I fit the profile of the profiling that is about to start by the FAA's aeromedical group, check out this news:
http://www.avweb.com/avwebflash/news...s220978-1.html Notice that the new policy has no limiter. Might as well have said that all pilots will be required to be tested and treated for OSA! "Once we have appropriately dealt with every airman examinee who has a BMI of 40 or greater, we will gradually expand the testing pool by going to lower BMI measurements until we have identified and assured treatment for every airman with OSA." To identify and assure treatment for every airman with OSA means that all pilots will eventually have to be evaluated. There are millions of people out there with normal BMI's that have OSA. Ask most any sleep doctor and they will tell you that OSA is a risk factor for obesity not the other way around. Where do they get these people? Starting soon at a AME near you, have a BMI higher than 40 (soon to be lowered per the policy letter)? Well guess what, you just earned a trip to the sleep doctor for a bunch of time consuming and expensive test! Here is a BMI calculator for those that may be interested: http://www.nhlbi.nih.gov/guidelines/...MI/bmicalc.htm |
Unbelievable. I am amazed everyday with more regulations and ways they think they can "fix" anything. Cradle to grave protecting me from myself.
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I'm even more amazed that medical professionals give ANY credibility to BMI.
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FYI, OSA = Obstructive Sleep Apnea.
If you have OSA it can be serious, and I've heard stories of people who had it, got it treated, and experienced an astonishing new vitality from the better sleep they were enjoying. However the treatment is an obnoxious breathing mask thing with attendant gizmotronic box which provides a slightly elevated pressure to your mouth and nose, preventing the apnea and thus the constant stop/start breathing which is so harmful. I went into a store that provides these gadgets and everyone was obese...seems a fundamentally better treatment would be a serious plan to lose weight. |
So it sounds like those that "all sleep apnea victims" will have to pay for their AME and a sleep specialist.
Then he wants to go after anyone with an extra 20 to 30 pounds on them. Hasn't he looked at the average age of pilots today? Almost everyone over 30 years old has an extra 20 to 30 pounds on them. It sounds like they are not going to regulate us out of the air but do it via our medicals. Once they find out all the pilots have dropped their 3rd class medicals and switched to LSA what are they going to do? This it total BS! Sounds to me like they aren't going to drop the 3rd class medical. |
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Like most things there are tons of incorrect assumptions and just plain wrong information floating around. My sleep Dr. that has almost 30 years treating sleep disorders and many other highly regarded professionals in the field claim that OSA is a major risk factor for developing obesity related issues and that most people that have it are born with it. OSA is like heart disease, it does not care if you are obese or not. (OSA is also a huge risk factor for developing heart disease, seems like a trend here) |
BMI Woes
My company requires blood work for our health insurance plan. You have to pass three out of four values to get the lowest rate (Blood Pressure, Blood Sugar, Cholesterol, BMI). I nailed them all, except BMI. I am way to high.
In the last year I have dropped 40 pounds and my BMI has dropped from 35 down to 30. That's still to high for my company insurance plan. If this FAA medical requirement goes through, it may be to high for them as well. I am tired of other people telling me I am fat. I choose my lifestyle. It's my choice to loose the weight or not. Period. |
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I am not against people getting checked for OSA if they have a reason to believe they have it, I am against this type of rule making that profiles certain individuals without just cause and I am also against new rules that have no limits. This is the first rule that targets pilots that are overweight. Where is this going to lead? |
BMI of 40
According to the calculator, for someone 6ft 2in, that equates to a weight of 315lbs. Ideal weight for the same height is around 180 - 210. So this is more about 100 pounds overweight not 20 to 30 lbs. There are many other issues to be worried about at that weight. Something other than OSA will make the medical tough to keep. There already was a requirement to test for OSA if your neck size was greater than 18 inches.
I do not say this lightly. In 6 months I dopped 100 lbs this year through just controlling my consumption and working out . Talk about improved vitality! And the aircraft has gained 100 lbs of useful load without any mods. The human body is amazing on how it can correct itself if treated properly. |
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While you should be very proud of your accomplishment at losing weight, the real challenge is keeping it off long term. I hope you can beat the statistical data that shows that on average those that are of a starting BMI of 30 or more typically fail to keep lost weight off long term. I sure hope you are the exception. I do not wish obesity on anyone. Great job! Quote:
There is a suggestion to be tested in the AIM for BMI's greater than 30 or neck sizes over 17" in men. This is not a requirement however to get issues a medical, only a suggestion. |
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Crazy point, using the simple method of height and weight LAbron James is overweight, who's going to tell him that. A calculator that does not measure your waist at the belly button is useless. The military and the YMCA use a more complex formula that has a greater accuracy. I hope the latter is used.
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Straight from the FAA's 2013 Guide for Aviation Medical Examiners: Formula: weight (lb) / [height (in)]2 x 703 Calculate BMI by dividing weight in pounds (lbs) by height in inches (in) squared and multiplying by a conversion factor of 703. Example: Weight = 150 lbs, Height = 5'5" (65") Calculation: [150 ? (65)2] x 703 = 24.96 |
I read it on a T shirt. "Were the FAA were not happy till your Unhappy!":eek:
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Where are the incidents that would have been prevented by this measure?
I thought so. |
Beware...
BMI does not account for the age, gender or muscle mass of the individual. It is a simpleton’s “one size fits all” metric that has zero medical diagnostic value. To use BMI as a single criterion for mandated OSA screening is completely disconnected from fact-based medical science, which tells us that it is politically motivated. Others can opine on the FAA’s true agenda in this case, but we’re seeing an alarming increase in “non-science-based science” trotted out by government agencies as the basis for new rules and regulations that limit citizen’s freedoms and liberties. BS indeed!!
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I thought it said . .
"Once we have appropriately dealt with every airman examinee
who has a BMI of 40 or greater, we will gradually expand the testing pool by going to lower BMI measurements until we have identified and assured treatment for every airman." Well, too bad all medical records are at the IRS now, it makes it harder to cheat. My former employer had a program to "gently influence" us to be more healthy to lower health care costs. When it began, I reported way overweight and high blood pressure. Over the next 10 years, each 6 months I reported improvements in weight, BP, and diet until it finally reached my real numbers. I always got glowing (form) letters saying how proud they were for my improvements. |
"Once we have appropriately dealt with every airman examinee
who has a BMI of 40 or greater, we will gradually expand the testing pool by going to lower BMI measurements until we have identified and assured treatment for every airman with OSA." The use of the words "testing pool" almost sounds like they want a large group of folks who get regular, standard medical exams to prove out a theory. I sort of wonder who the "they" is that would want this experiment.... |
Dont know if it will do any good or not, but I did send EAA and AOPA a note about this.
"The newly released FAA **** about checking BMI--------------this needs to be stopped immediately or sooner. This is a condemnation based solely on conjecture not fact. Profiling at its ugliest." |
AOPA is already on it.
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thread note
Doug, this thread was deleted by one of the mods as "not RV related".
I hate to undelete a thread but I believe this is a subject that effects hundreds of RV pilots and who knows how many non-RV pilots. This is a huge development in our medical certification. Please override my override if you see fit. :) |
Interesting reading below. I wonder if a case could be made that the FAA is violating some federal law/regulation such as ADA, or EEOC or HIPAA etc??
http://www.diversityinc.com/diversit...ity-says-eeoc/ http://www.psmag.com/health/obesity-...th-care-60619/ http://www.hhs.gov/ocr/privacy/index.html |
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While the initial BMI limit set for this discrimination/profiling may not effect that many, the other statements made in that memo should be scaring the majority of RV pilots. This is just the beginning and who knows where this will end. Many folks may be shocked to find that their BMI falls within the proposed lower limits that are being discussed. The memo states that they plan to find all pilots that have undiagnosed OSA. It goes on to say that 30% of people with a BMI > than 30 have OSA. This tells me that to meet their goal they will eventually have to lower the BMI requiring an evaluation to the sub 30 BMI range. I would bet that the % of the pilot population with a BMI of 25-30 is a huge number. AOPA said this "In 2011, the FAA identified 124,973 airmen who are considered obese" My gut feeling is that only a small percentage of those are part 121/135 pilots. My guess is that the majority of em are folks just like us.... |
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(rant about FAA and medical certification typed then deleted to avoid straying into politics...) |
Cost
It is my understanding these sleep studies cost many thousands of dollars and one or more sleep overs at the doctors office wiired up like Frankenstein. Can you imagine going through this annually on your special issuance medical?
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AOPA asks FAA to suspend implementation
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The FAA is casting a wide net. You may have to spend a couple thousand dollars to determine your sleep apnea score. Should you fail that test, you?ll place an expensive mask on your face every night for a couple of weeks before you become so frustrated with the device that you sell it for a loss on ebay. Furthermore, while body fat is a contributing factor to sleep apnea, Body Mass Index is not a true indicator of body fat. So the FAA is using criteria that doesn?t does not directly correlate to a health problem, to solve an aviation problem that apparently doesn?t exist. Besides the cost, it may take a lot of RVs and their pilots out of the sky. http://www.aopa.org/News-and-Video/A...aspx?CMP=ADV:1 |
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Insurance company's
Insurance company's are the driving force behind the data.I've been to the doctors office a few times this year and BMI is a new block up in the corner of pre exam form filled out by the assistant along with LDL/HDL ratio,Blood pressure,presenting complaint. Four points
1. Everything is paperless but still compartmentalized within a health care system.Be careful about what you present to your doctor,ask to talk to him off the record before your visit about your FAA concerns.have a list of medications that are and are not approved before they enter something in the record that will red flag your file. Arrive 15 minuets early,check in,sit in a chair and meditate,I use this time to communicate with my maker.Get your blood pressure as low as can,relax for a least 10 minuets before they take your pressure. 2. Now you know what the standards are,start working towards them.There is no point in "Dieing to keep your medical!" Big Corporations have already determined if your over the age of 56 your of no use to them anymore and you can expire of natural causes without affecting the statistics.It's hard to lose weight as the same big corporations supply processed food that is slowly killing us all. Eat better & Eat less. stay active...you know the drill. 3. Adapt a new mind set. I have the Bee Gees "Stayin' Alive" downloaded to my mp3,comes on when I'm out walking. 4. Support VAF/EAA/AOPA. Write letters when requested for less then $125 a year they are our only voices in Washington. Oh yea get a subscription to Kit Planes.... It's never been better.IMHO:) |
I think the Federal Air Surgeon, Mr. Fred Tilton, is way overstepping his authority by unilaterally imposing a "policy" change with such far reaching impact. If this is something that he feels so strongly about, it should be a regulatory change proposal to FAR Part 67 (Medical Standards) that requires a NPRM process so it can be properly vetted, justified by some basis of facts, discussed, amended and/or probably rejected. I would imagine all the alphabet groups like EAA and AOPA will at the least pursue this avenue.
Areas like this is where AOPA and EAA can do their most good. |
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Dear Mr. Starkey, Thank you for your email. We agree with you 150% and will aggressively fight any implementation of the proposal. Please see the lead article on the AOPA website for more information. http://www.aopa.org/News-and-Video/A...aspx?CMP=ADV:1 The FAA continues to evaluate our petition for an exemption to the 3rd class medical requirement for what we term ?recreational flying.? Mark met recently with FAA Administrator Huerta to keep the pressure on them to make a decision soon. We are also exploring legislative avenues that would accomplish the same end goal. All the best, Patrick Timmerman AOPA |
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The above linked fatality is the subject of Peter Garrison's excellent analysis in his monthly column in FLYING magazine this month (December issue). |
Why worry?
Anyone with a BMI over 40 wouldn't fit in a RV.
Seriously though, a BMI over 40 is grossly unhealthy. It isn't "fat", it's morbidly obese. Maybe OSA isn't a significant problem in aviation, but it is a serious problem. Perhaps instead of claiming another FAA conspiracy theory, we should view this as a wake-up call for improving our lifestyle and health. Jim BMI 24.7 Weight peaked at 211 and I'm now down to 195. 185 is my goal. |
I know a pilot...
Who has OSA who when asking his AME back in the 90's about it received this sage advice. He asked the pilot: "have you ever fallen asleep while flying?" The pilot responded: "no". So the AME, now deceased, said to the pilot: "keep your OSA to yourself". This pilot held a commercial, MEI rating with over 2100 hours of safe PIC time. BTW the AME was also a pilot with an instrument rating.
My personal situation is such with CAD (coronary artery disease) that I am subject to an annual physical, stress test like Brantel, and cardiac evaluation. So I sold my partner my RV7, bought the RV1 MockingBird, and will go light sport. :rolleyes: |
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BMI
As someone who has been in the health and fitness field for many years (and competes in fitness and figure competitions), I have to chime in with the rest that BMI is one of the least accurate measurements of someone's health and fitness available. With a body fat percentage of close to 20% in my off season, my BMI score still lists me as OVERWEIGHT.
Unnecessary, uncalled for, and unbelievably inaccurate. |
The flip side
Many of the previous posts make valid points about what appears to be a precipitous and perhaps overreaching policy. On the other hand, a male of average height with a BMI of 40 is approximately 100 lbs. overweight; morbidly obese. Most will have obstructive sleep apnea, and many will also be hypertensive and diabetic. If that describes you, I understand that you want to continue to fly, whether or not it is prudent. Would you want to be a passenger of such a pilot?
Several posters have commented on the shortcomings of the BMI. It is actually a reasonably good screening tool, even though it does not distinguish between an increase in fat versus muscle. The occasional power lifter or body builder packing an extra 50-100 lbs. of muscle is at nearly as much health risk as an individual carrying an equivalent amount of fat. The extra pounds put added stress on heart and lungs, either way. Very few people in this country with a BMI of 40 are not obese. Flame suit on! Jim Berry RV-10 |
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