Co-morbid conditions in overweight and obese airmen: Trends and aeromedical implications

Introduction: Excess bodyweight is known to be associated with many medical disorders which can be disqualifying for aviators. The actual prevalence of these conditions and associations with BMI in U.S. airmen has not been previously defined. This project explores overweight and obesity in valid holders of U.S. aeromedical certificates as of November 2003. Methods: A de-identified database of all holders of valid FAA medical certificates was queried for pilot's BMI and a variety of co-morbid conditions that have been associated with obesity and overweight. There were a total of 630,670 airmen. Conditions included: hypertension, diabetes, myocardial infarction, sleep apnea, kidney stones, gall bladder disease, arthritis, and hypothyroidism, among others. Results: The total prevalence of overweight and obese airmen is as follows: 47.15% are overweight and 21.11% obese. In regards to class of airmen, 48.48% of 1st class pilots are overweight and 15.35% obese, 2nd class are 47.58% overweight and 22.44% obese, and for 3rd class, 46.18% are overweight and 23.78% obese. Female pilots have a much lower prevalence of overweight and obesity. Most associations between BMI and health conditions were expected. A unique finding was that overweight and obese pilots are more likely to require a special issuance certificate than normal weight pilots. Conclusion: This data for all U.S. certificate holders suggests that conditions associated with excessive bodyweight will account for disqualification of a significant number of aviators.