BMI could trigger additional scrutiny with proposed policy

The FAA is targeting pilots (and controllers) with a “proposed obstructive sleep apnea (OSA) policy.” Pilots and controllers with a Body Mass Index (calculate yours here) with 40 and higher, will be the initial target.

Federal Air Surgeon Fred Tilton wrote in recent medical bulletin those pilots “will have to be evaluated by a physician who is a board certified sleep specialist.” Those diagnosed with OSA must be treated before they acquire a medical certificate, Tilton wrote.

Tilton’s bulletin continued, “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.”

My BMI is 31.6. Thus, I’m obese according to the calculator.

“The FAA has failed to demonstrate the justification for this proposed new policy when it comes to general aviation,” said Rob Hackman, vice president for regulatory affairs for the Aircraft Owners and Pilots Association. “We object to the FAA’s apparent decision to make this policy without any sort of public comment period. The FAA is already staggering under the load of reviewing tens of thousands of medical applications from pilots working through the agency’s special issuance process. This new policy could add thousands of applications to that process, increasing wait times and delaying the FAA’s handling and issuing of medicals, thus preventing pilots from flying.”

AOPA will reportedly ask the FAA to suspend the implementation of the policy indefinitely because:

  • The general aviation accident data does not support the new policy;
  • No public comment period was offered;
  • The policy will significantly add to the existing FAA medical certification backlog.

I wonder if this is what FAA Administrator Michael Huerta had in mind when he said the FAA and industry must come together? From my perspective, this seems to be a solution seeking a problem. 


  1. brett hawkins says

    In addition to being an MD, Tilton has a master of public health degree. People in that field specialize in one-size-fits-all.

    The medical profession in general is working hard to push more people into “treatment” by lowering the arbitrary threshholds for various conditions (e.g. hypertension). Tilton’s comments about establishing and then lowering a BMI threshhold for mandatory OSA treatment is a prime example of this trend. Perhaps docs, who work notoriously long hours and make life-and-death decisions, should all be screened for OSA annually as a condition of licensing?

    I agree with those who argue that the FAA should stick to the many recognized flight safety problems and keep its nose out of the public health biz. One good way to promote flight safety is to increase proficiency, and that comes from encouraging pilots to climb into their cockpits, not yanking them out because some docs are uncomfortable around heavy folks. Unless, of course, the real goal is to end private flying as we know it.

  2. Jeff Aryan says

    Who does this guy think he is. Just because he went to 8-12 years of a specialized school (medicine) and they give him a title of Doctor does that mean he has the right to arbitrarily say “I’m god” and this is what you will do. Answer: No way, Jose. Who is this guy and who does he think he is ?
    Myself and millions more have been to specialized schools and we don’t pretend to play god. Being a medical doctor is a fine profession. But it’s not all knowing and bowing down to their whims just because it says “Doctor” beside his name. The job of a doctor is to heal, not issue edicts. Yes, they can advise not to do certain activities and maintain certain style and habits, but that’s all.
    This is a bigger fundamental issue of our way of life. The way we live life in this country. Heck, look at other countries trying to control their people. It doesn’t work.

  3. Ed Watson says

    Gentlemen and women, As per usual this is an admirable idea but as usual rather than trying educate the pilot community about the subject we must remember that this is less about aviation safety and more and more about CONTROL. As with almost any gubmint “job” their job is to come up with regulations so show they are doing SOMETHING, good or bad is not relevant. If it were the approach would be to educate not regulate. My dad used to say you can lead a horse to water but you can’t make him drink. So very true.

    • Mike says

      The old sarcastic saying applies… ‘We’re from the government and we’re here to help you.’

      Just more & more nanny state, mandated nanny state. And this one will lead to a further decline in GA.

    • Richard Warner says

      Also, Ed, if several congressmen contact them, they are basicly ignored. These bureaucrats who are unelected by the people are ruling us and our elected representatives seem to be powerless to stop them. I’m so sick & tired of all of this increasing dictatorship by unelected idiots.

  4. Jeff says

    BMI is in of itself a joke. My Dr. told me so. BMI does not take into account the difference between muscle and fat. According to the scale I would have to weight what I did in 10th grade high school to be “normal”. BS. If I weighed 186# and not an ounce of fat I would be considered overweight. BMI to be used in this way is just wrong.
    The FAA in all their infinite wisdom is like most regulatory bodies, they regulate, and when through, regulate some more. After all it is their job to regulate. If they spent 10% of the time they use to come up with new regulations to actually help aviation, it would be a far better and safer sky.
    Like the new ATP regulations. 1500 hours, 1500 hours of what? Sitting next to some student pilot in a 25 year old 172 doing touch and goes by the hour? But because it came out of an accident no one argued against it and the reality it probably won’t help anything.
    So now some guy with a medical degree will decide our collective fates? BMI of 40 today, 28 tomorrow?

  5. Mike says

    FAA motto: We’re not happy until you’re unhappy.

    Federal Air Surgeon Fred Tilton’s bulletin continued, “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.” By that time there won’t be many pilots left flying.

    My BMI is 29.1 which is okay now but if they keep lowering the standard it won’t be, and I know several pilots who likely are higher than that.

    I had already made the decision not to renew my medical next year due to the high cost and hassle of the hoops/tests, which 5 doctors (2 of them are pilots also) have said are unnecessary overkill, they make me jump through every year to keep my SI. And on top of the cost and hassle I have to sit effectively grounded for 6-8 weeks every year before they approve my SI even though I send them everything they want in order weeks before my medical is up!

  6. Mike H says

    What a bunch of bureaucratic baloney! Here we are trying, with historical justification, to get the FAA to allow driver’s license medicals for pilots flying standard GA airplanes (the same as LSA has been doing successfully for the last 8 years without medical related accidents) and now this, which takes things in the exact opposite direction. I will actively resist any such attempts and am glad to hear that AOPA is objecting. I hope the other alphabet groups make a strong response and I will be anxious to submit my thoughts to the FAA. As the article says, this truly is a solution looking for a problem!

  7. John Wesley says

    Actually, on this one, they may actually be doing us a favor. Three years ago a good friend of mine had a massive heart attack, he was diabetic and had hypertension, while he was in the hospital they did a sleep study and diagnosed OSA. Within a year of starting treatment his bloodpressure and blood sugar were almost normal. He urged me to get tested, found I had it as well. 2 years later I feel better than I have felt in years, i sleep well through the night and dont keep my wife, the dog and the neighbors up with my snoring. It does not interfere with my second class medical and may have ensured a longer healthier life.

    So as much as it pains me to agree with anyone at the FAA on anything, this time I must.

    • Joseph says

      I think the difference is being forced into a test. I think we would all be ok with the doctor advising us to get the test if we were in the upper numbers. Maybe forcing the test for 1st and 2nd class medicals if you had hypertension, a high body fat percentage, and a few other symptoms then recommend a sleep study. My issue with it is BMI doesn’t work for people that exercise a lot it really only paints a picture of body fat/obesity if you have a median body type.

  8. Will says

    This is not about safety but about making money. I have a bmi of 26.8, but have a neck of 17.5 due to weightlifting. I guess I’d better stop exercising to help get my neck size down to comply!

    • Joseph says

      I think it was BMI AND neck size and not BMI OR neck size. I also have 17 inch neck and a BMI of 28.4 I’m 6’1″ tall so proportionally most people don’t see me as grossly overweight, though I should lose a few pounds but I don’t think I would look right at 180lbs which would give me the target BMI. I think this is a terrible idea but if they are dead set on doing it it should be based on true body fat percentage not on BMI which has many flaws. It almost sounds like he wants to do a study on BMI related to OSA finding the max BMI in which OSA becomes statistically insignificant, a study that has its merits but not one someone should be forced into based on career and or hobby.

  9. Richard says

    Well, after flying accident and violation free for the past 60 years and 26,000 hours, the FAA has finally found a way to eliminate me from the joy of flight. I am heavy. I have always been heavy and it hasn’t affected my ability to fly whether in an airliner cockpit of in the various light planes I have had from a J-3 to my present Cessna 180. They ought to do away with the 3rd class medical instead, but that would mean they would lose the ability to rule us. Instead of fostoring aviation, they intend to kill it. We in General Aviation are nothing but a thorn in their side.

    • Greg W says

      It may be time to go back to that J-3 and fly as a sport pilot. If you fly for yourself and are not pursuing an airline/corporate type gig S.P. is great. A classic like the Cub is a little small but Champs have a good size cabin and if it can be afforded the new LSA are as big or bigger than a C-172 cruise about the same speed and have all that neat “glass” that’s not in the windows. I do not mean to downplay the intrusion by the feds into something that has not been a problem. I just am trying to say it is more important than ever to work the edges of the system and match our machines more closely to the need.

  10. Steve says

    As I was saying, your medical history with your doctor would need to factor in before the ame who only sees you every few years would be allowed to have you get tested. This is not a positive proposal by the FAA and will only force more people out of flying, if for no other reason than fear.

  11. Steve says

    The extra burden on the system will be unbelievable. People I know who have to have extra tests or reports submitted to get their medicals renewed have to start the process months before the medical is due andthe reports only update their status. They feel that the FAA should look to see if there is a change rather than it appearing as if the review starts all over again. You would think with computer technology as it stands today, the computer could quickly do a comparison and provide instant analysis of problematic changes or just the same status as before. With this, many healthy people will go through needless and costly tests. If you change your weight by even one pound it can change your grouping. I hope no one will try to get a medical right after the big holiday period, particularly if you like to indulge at that time because your weight could be out of normal. And people have weight fluctuations all the time, and a somewhat arbitrary scale is not the best way to judge you….your history, I.e.

  12. Linda Berl says

    This makes me angry on so many levels I don’t even know where to begin. It is insulting, mean, and is not designed to help pilots in any way. Their goal is to make it as difficult, intimidating and as discouraging to pilots as possible…and is incredibly discriminating against people of weight.
    I sure don’t want to go through the torture that is that sleep testing for some treatment that would not improve my sleep (ever try sleeping with a huge plastic mask on your face?) or my flying. All this does is add more stress and fear to an already cumbersome medical certification process. How much more of this nonsense are we going to put up from the hateful FAA? Why do they continue to get away with this garbage?
    I am sick to death of their bullying tactics. It is time for us to get a spine and fight back. If we do not, the FAA will continue to find ever more creative ways to impede our path to flight certification, and eventually they will squeeze us all out of the sky! How many more silly hoops do you want to jump through during your next medical?
    Fight now or forever hold your peace. I choose blue skies and tailwinds forever!

    Delaware, USA

    • John Wesley says

      Actually the test is not bad, if you have it, the mask is a small price to pay for the gains in health. I felt the same,, but after getting used to the mask, I sleep better and feel better than I have in years, my blood pressure is now normal, my energy level is higher than ever. Too many people suffer and die early because they either do not or will not get tested for OSA.

      • Jim says

        You can drive a car or a van with several folks at 70 mph with a yellow line and a few feet between you and a bus coming in the other direction with a combined closing rate of well over a hundred. If you can hear and see okay and aren’t having attacks that leave you passed out, the state drivers agencies think your an acceptable risk.

        The medical requirements for the FAA are already way to strict and to add more with no evidence that overweight pilots are unsafe makes no sense. Fighting to keep your medical once a problem is found can be very costly. One airline captain I knew spent over a hundred grand to get his back. I’ve gone the LSA route but my flying is very limited because of a lack of LSA aircraft to rent. GA is in deep trouble with a shrinking pilot population, airports closing and the ever increasing cost of operating a plane. The FAA ought to back off on this one.

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