PDA

View Full Version : the yanks are really peeved at the BMI issue

dubbleyew eight
28th Jan 2014, 15:31
the FAA medico has bought in a ruling that anyone with a BMI (body mass index) over 40 and a neck measurement over (forget the number) has to be assessed for obstructive sleep apnoea problems.
are the americans ever getting pissed off at this!!

some sanity here.
body mass index is a rule of thumb calculation of how fat you are.
the calculation is simple.
take your weight in kilograms and divide that number by the square of your height in metres.
If you are an american there is a graph in imperial units that is actually the metric calculation converted to imperial units.

a sample calc.
take a two metre high person (roughly 6ft) who is 100kg. pretty typical big guy in australia.
100 divided by (2 x 2) = 25

to have a BMI of 40 the 2 metre person has to weigh 160kg, that is 353pounds. that is over 25 stone. bloody hell.

a druine D3 turbulent was designed for a 65kg pilot.
the usual design weight of a person is 77kg.

if the americans are railing against a BMI of 40 either they dont understand the concept or they've started using C130 hercules aircraft as trainers and the weight no longer matters.

at 5ft 10" and 85kg I have a bmi of 26.9 :E:E:E

the poor yanks. I wouldnt want to be sat on by one!

Shaggy Sheep Driver
28th Jan 2014, 15:37
Surely the point is... Is there a problem with aeroplanes falling out of the sky because of pilots with high BMI?

Though not.

So why are the medicos meddling?

More 'yellow jacketism'? Jobsworths looking to justify their existence?

28th Jan 2014, 15:49
Thought you were talking about the airline for a sec.

Lon More
28th Jan 2014, 15:51
More 'yellow jacketism'? Jobsworths looking to justify their existence?

Hardly, I couldn't care less abouy yhe BMI as long as the plane remains within weight and balance limits but the possibility of the pilot taking a nap halfway down an approach to minimums would cure anybody's constipation

500N
28th Jan 2014, 15:52
Not going to comment on the 40 figure and how it relates to flying
but no doubt 40 is big.

However, BMI doesn't take into account whether it is fat or muscle.

My last Army medical, the Capt said I was "bordering on Obese" :rolleyes:
My expletive nearly got me charged with insubordination !

5ft 11" and about 90 - 95kg so a BMI close to 30 which according to the chart
was right on the border of overweight / obese.

But most of it was Muscle and I had just completed all physical tests well within the time required to a higher standard than the standard military one's.

And I knew of at least 2 or 3 that would have a score close to 40 that wouldn't be classed as unfit although I told one to lose some bulk as he suffered from
chaffing because of big muscles.

Not a fan of BMI.

dubbleyew eight
28th Jan 2014, 15:54
but a bmi of over 40 that isnt muscle....

how on earth does a 300lb guy even fit in a light aeroplane?

rgbrock1
28th Jan 2014, 15:56
As 500N insinuated, BMI measurements are full of shit because they don't take into account body weight as related to muscle mass. A friend of mine, who is built like a brick shit house, is well over a BMI of 40. Yet, has not an ounce of fat on him.

Shaggy Sheep Driver
28th Jan 2014, 16:04
but the possibility of the pilot taking a nap halfway down an approach to minimums

Maybe you didn't read my earlier post. So I say again...

Is there a problem of aeroplanes falling out of the sky because the pilot has a high BMI?

Prazum
28th Jan 2014, 16:32
I think this post isn't referring to bmi, but rather the sleep apnoea potential in people with a high bmi.

Solid Rust Twotter
28th Jan 2014, 17:43
Yup, met a few 'roid monkeys among US mil types who would be right up there as far as BMI goes, but who could hardly be called fat. Never really got the point of that as it looked a bit high maintenance. Going hard routine for a few weeks would have been an effort for them, whereas the skinny bone and sinew types would skate through it.

awblain
28th Jan 2014, 18:06
At bmi 40 isn't it an economic issue?
Rows 1-5 would need to be empty for weight and balance.

Plus, your cardiac event rate has to be up a bit.

Lon More
28th Jan 2014, 18:37
In the Six Nations I'd bet that almost all the forwards have BMIs over 40

Shaggy Sheep Driver, read the first sentence of the original post

anyone with a BMI (body mass index) over 40 .... .... has to be assessed for obstructive sleep apnoea problems.

No mention of aircraft falling out the sky; that will come later when the Daily Fail gets hold of the story.

Checkboard
28th Jan 2014, 18:52
It's a "thin edge of the wedge" problem:

Airman applicants with a BMI of 40 or more will have to be evaluated by a physician who is a board certified sleep specialist, and anyone who is diagnosed with OSA will have to be treated before they can be medically certificated. 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. Note: We plan to implement the same assessment and treatment protocol for ATCSs, but we have to finalize some logistical details before we can proceed.

... but it appears to have been given a stay of execution for now:

FAA puts sleep apnea policy on hold - AOPA (http://www.aopa.org/News-and-Video/All-News/2013/December/20/FAA-puts-sleep-apnea-policy-on-hold.aspx)

Shaggy Sheep Driver
28th Jan 2014, 19:00
Lon - you miss my point. No aeroplanes falling out of the sky = no problem.

So why are the medics wanting to meddle?

Lon More
28th Jan 2014, 19:24
Actually the BMI is only a possible link to apnea. I suffered from it, my BMI was about 35. It can occur in anybody, even children, and you feel completely knackered all the time. I actually fell asleep behind the radar before deciding to call it a day. A couple of weeeks after being medically retired the problem disappeared so stress is presumeably also an important factor.

500N
28th Jan 2014, 20:00
Following on from Lon More's post, I found this interesting.
(I am yet to search for the true medical report)

I know this is from the Daily Mail but I read it because I am trying to lose
some weight and wanted to see what the two Doctors found.

One gave up sugar. one gave up fat.

The bit about one being slow and tired and one being significantly
faster in brain function was interesting.

One twin gave up sugar, the other gave up fat. Their experiment could change YOUR life | Mail Online (http://www.dailymail.co.uk/health/article-2546975/One-twin-gave-sugar-gave-fat-Their-experiment-change-YOUR-life.html)

Keef
28th Jan 2014, 20:13
I was told at my last Class 2 that the CAA is on the BMI trail too - apparently, a CFI has to certify that you can do "full back stick" without the tum fouling the stick. BMI limit for that is, he said, 35. Whew!

PTT
28th Jan 2014, 21:23
One gave up sugar. one gave up fat.A sample size of two with no control group? Sounds like an excellently designed experiment and one we should all take seriously...

BenThere
28th Jan 2014, 21:30
I have to get an FAA physical every six months and to date, my last physical was last November, the subject of BMI has never been brought up. I'm fairly trim, though, so maybe it's only an issue if one is on the edge.

500N
28th Jan 2014, 21:31
PTT
A sample size of two who were IDENTICAL TWINS, which means they have identical DNA which means the changes relate to diet, exercise etc being equal.

That is why identical twins, triplets etc are so important in medical and psychological testing.

From the article
"Identical twins like us are extremely useful in experiments because we have exactly the same genes. This means any changes we observed would be due to the diets and not genetics."

As with any medical or psychological tests, it has to be replicated
and peer group tested but you have to start somewhere.

galaxy flyer
28th Jan 2014, 21:43
Slight bit of insight here. The NTSB has identified sleep disorders being causal in several transportation accidents--rail, bus and trucking. The rail industry here has a terrible fatigue problem and apnea does not help. Apnea is somewhat related to overweight, not to say BMI. The CAMI is attempting, wrongly in my estimate, to get ahead of the problem, perhaps without real evidence of apnea and fatigue-related aviation accidents.

The uproar is about the cost--full medical review is around 5000 USD and takes several days at one of the rare-ish sleep labs. The plan begins at BMIs of 40, but will eventually include all certificate holders. Overkill, but fatigue is the Number One killer in ground transportation, so maybe inevitable.

GF

PTT
28th Jan 2014, 21:55
PTT
A sample size of two who were IDENTICAL TWINSYeah, thanks, I've read "I was Doctor Mengele's Assistant" and I do understand the way twins can be used to factor out the genetic issues. What it doesn't factor out is all the other environmental issues the twins have each been subject to, each of which has been different for the past 35 years of their lives. That's why it's a crap experimental design and one created for media consumption rather than anything serious. The moment you start taking experimental design tips from the Daily Mail is the moment to give up on science ;)

500N
28th Jan 2014, 22:06
Agree.

Which is why I said i hadn't had time to look at the report itself.

I'd like to look into it further and cross reference it with other studies
that have been done.

Interesting how one of them who went to the US ballooned out from
12 St to nearly 18 St.

awblain
28th Jan 2014, 22:21
Checkboard,

If that's the thin end, I'd hate to see the thick end.

And yes, while you can potentially be healthy with a BMI of 40, I suspect few of those being investigated for sleep apnea are fully-drug-tested powerlifters.
A BMI 40 is fully 60% heavier than the normal range at the same height. That's not easy to achieve while maintaining healthy internal organs.

Oktas8
29th Jan 2014, 03:45
Nice article 500N. I was dubious to say the least about the DM headline, but it was good reading.

I second the remarks about BMI. Rugby forwards are all "obese" apparently!

Apparently waist-to-height ratio (http://www.medicalnewstoday.com/articles/245328.php) is a more effective general predictor of health.

29th Jan 2014, 04:17
The problem wasn't really that it was set at 40. There is certainly a correlation between obesity and sleep apnea - this has been proven. But the FAA said they wanted to bring it down in time to 30 BMI. Now, this wouldn't even then be a big problem, except that doing full sleep apnea evaluation is a very expensive thing and very time consuming. You basically have to be monitored at a hospital for a full few nights at a coast starting at \$2000, roughly. Imagine having to do this every 6 months to renew your class 1? It would literally stop anyone from being a pilot over the age of 35. It was just a not very well thought out idea and thankfully AOPA made that one die for now.

Cut to CAA implementing it fully, because they've yet to come across a daft idea invented under the guise of safety they haven't implemented...:ouch::}:ok:

500N
29th Jan 2014, 04:30
"A BMI 40 is fully 60% heavier than the normal range at the same height. That's not easy to achieve while maintaining healthy internal organs."

I just checked and my BMI is 36.
It says my "Normal" weight should be 77kgs.
I haven't been 77kg since Age 16/17. I think I left school at about 78kg
and Army meds I was around 82 - 88 kg so "overweight" to start with.

Re "maintaining healthy internal organs", I would have thought so to
but at the behest of my GF, I went for a full med / tests and came through
with no issues at all - much to my surprise as I have far to much sugar
and tobacco.

Anyway, am working on getting the weight off and getting my BMI down to 32 (or below) :rolleyes:

westhawk
29th Jan 2014, 05:01
Galaxy nailed it in my estimation. Fatigue related incidents and accidents have indeed become a focal point in NTSB reports over the last several years with respect to both air and ground transport modes. Being a pilot, and therefore the natural enemy of medicos with the power to decide one's professional fate, the meddling jobsworth theory is appealing to me as well! :cool:

Using BMI as a screening tool for sleep apnea is like using a chainsaw to slice bread! Too many false positives will result. While many obstructive sleep apnea sufferers may have a high BMI, the reverse isn't necessarily true.The military use BMI to uphold appearance standards and physical fitness tests to evaluate fitness. One can have a high BMI and pass PT tests with flying colors. There is no agreement in the medical profession that BMI is an effective indicator of sleep apnea. Quite to the contrary it appears.

I've heard from more than one pilot that sleep apnea has also been used as a weapon in certain disputes between airlines and their pilots regarding the issue of fatigue policy. That's second hand info but I find it credible. Call fatigued once too often and get referred for a sleep study. In fact the FAA has referred pilots who fell asleep while flying for sleep studies. After all, the airline will take the position that they follow the regs so it couldn't have had anything to do with work schedule. Since the airlines DO follow the the FAA regs, it's easy to see how the FAA might react. It just might be the fault of the fat pilot that they weren't rested and fit for duty.

I think they need to go back to the drawing board on finding an effective and accurate screening tool to identify those individuals requiring examination for sleep apnea. It's not the only reason pilots turn up for work tired or unable to maintain adequate cognitive function for the duration of their duty period.

And just for clarity, my own BMI is in the low 30s. They won't get me with a standard of 40! In a future with a more discriminating standard I may need to get it lower though. In the meanwhile, a more objective solution should be sought by the medicos. This one ain't gonna fly.

westhawk

con-pilot
29th Jan 2014, 15:54
My BMI is 25.5, but what would bother me if I still had to get a FAA flight physical, is that there is also a neck size of a max of 16 inches.

My neck size is 17, has been for ages.

Perhaps more research should be done.

Oh wait, I'm talking about the FAA.

Never mind.

rgbrock1
29th Jan 2014, 16:09
Well con, with a neck size of 17 you really never have to worry about the Taliban, or Al Qaeda, catching up with you and chopping your head off as it would take them a month of Sundays to remove your head! :}