Weight Loss Medications: It's More than Weight and Balance Limits

Obesity is a tremendous public health problem. It occurs when you take in more calories than you burn through typical daily activities and exercise. Your body stores these excess calories as fat. Studies have shown that most folks’ diets are too high in calories. This is especially true if you eat a lot of fast food and high-calorie beverages. People with obesity might eat more calories before feeling full, feel hungry sooner, or eat more due to stress or anxiety, like learning how to fly!

Significant obesity can predispose to a number of nasty health problems. Heart disease and stroke, adult onset diabetes, certain cancers, heartburn, gallbladder and liver disease, arthritis of the lower joints and sleep apnea are all strongly associated with significant exogenous obesity. Indeed, if a pilot comes in for a flight physical and his Basal Metabolic Index (BMI) is above 35, alarm bells go off and he is screened for possible obstructive sleep apnea. Don’t want ya falling asleep on Final!

Over the past few years a group of drugs initially developed for diabetes treatment have proven very effective in promoting weight loss.

So how do you know if you are obese? Having to trade in your belts may be one indication. A more exact one is the Basal Metabolic Index (BMI) which is a ratio of your weight to your height. You can Google it and get any one of a number of on-line sites that will compute it for you. According to the National Institutes of Health you are OK if your BMI is below 25. 25 to 29 is overweight. 30 to 39 is obese. Above that you are morbidly obese and at extreme risk for a lot of the problems we mentioned.

Treatment, for starters, include diet and exercise. Unfortunately, that simple program doesn’t work for a lot of people. Even if a hard push results in a lot of pounds being shed, over the next year or so they have a very strong tendency to pile back on. Over the past few years a group of drugs initially developed for diabetes treatment have proven very effective in promoting weight loss. The FDA has approved this use and docs are now prescribing them to curb obesity. Also, the FAA has developed protocols for your Aviation Medical Examiner to follow. First of all you can’t be using these medications for treatment of diabetes. That is a separate certification issue. To support this, your Hemoglobin A1c has to be less than 6.5. This is a blood test that measures the average blood sugar levels over the past few weeks. If it is below 6.5 you are unlikely to have diabetes. Also you can be using only one of four approved medicines for weight loss: metformin, liraglutide ( Victoza and Saxenda ), semiglutide( Wegovy ) or tirzepatide (Zepbound ). Further you cannot have had any episodes of hypoglycemia (low bold sugar) over the past 12 months. If you are any of the last three mentioned drugs, you should not have had any history of problems with substance abuse, psychosis, suicidal ideation at any time. Those are potential side effects! You will need a note from your doc attesting to all of

that before you come in for a flight physical. Alternately, She/he should fill out a “Weight Loss Management…Status Report” to bring to your AME (https://www.faa.gov/ame_guide/media/Weight_loss_prediabetes_status_report.pdf).

Bring in all of that for your flight physical and you should be good to go and to slim down. It makes calculating weigh and balance a lot easier!

Fly wisely. See you next month!

As always, comments, questions and suggestions are welcome: jdlakinmd@gmail.com

Also, we’ve moved our office to Airlake Airport’s FBO (KLVN). Call 952-469-4414 or email info@aloft-aviation.com for a flight physical appointment.