Weight & Balance: overweight/obesity in Pilots
- Dr. Rob Massera | DAME
- Feb 26
- 6 min read
Q: What is overweight & obesity?
Simply put, overweight and obesity mean carrying excess body fat (fuel), usually around the abdomen in men and the thighs or buttocks in women. While many see it as a cosmetic issue, the reality is that excess weight is an unhealthy physiological state that increases the risk of serious health problems. From heart disease and high blood pressure to sleep apnoea and fatigue, it can directly impact both your health and fitness-to-fly. Staying within a healthy weight range isn’t just about looking good - it’s about keeping fit and medically certified over your career.
Did you know? In Australia, 66% of adults and 25% of children are overweight or obese & obesity is now the second most common cause of preventable death after smoking!
The good news for pilots? Weight gain is preventable with the right “maintenance cycle”, and even modest weight loss of 5–10% can make a big difference - improving health, quality of life, and reducing the risk of weight-related medical issues.
Q: Why is overweight & obesity relevant to pilots & aviation safety?
As pilots, we know the importance of staying within weight and balance limits for safe flight. Similarly, when it comes to our own health, being outside our ideal “weight & balance” envelope is an Undesired Aviator State - one that puts both our performance and medical certification at risk.
Excess weight isn’t just a number on the scale; it’s a direct contributor to high cholesterol, diabetes, high blood pressure, and cardiovascular disease - raising the risk of incapacitating angina or heart attack. It’s also strongly linked to obstructive sleep apnoea (OSA) and hypoventilation syndrome, which can cause chronic low oxygen levels, leading to fatigue, daytime sleepiness, and hypoxia at altitude.
Further, an aviation career involving: long hours sitting, shift work, and poor food options at airports - makes weight management even tougher. These same factors also contribute to chronic lower back pain, which can be distracting in-flight or even lead to temporary grounding. Finally, significant excess weight can limit movement in confined cockpits, impact flight control operation, and hinder emergency evacuation - critical factors for aviation safety.
Maintaining a healthy weight isn’t just about passing a medical—it’s about staying fit, capable, and in control every time we step into the cockpit.
Here's a question: during pre-flight planning we calculate & confirm the aircraft’s weight & balance - If it’s outside limits, would you: (a) ignore it & take-off anyway? or (b) take corrective action - remove fuel or baggage - to avoid an in-flight safety risk? The same logic applies to your own weight & balance - staying within limits isn’t just ideal, it’s essential to your long-term health & performance.
Q: What causes overweight & obesity?
For pilots weight gain isn’t sudden - it creeps up over time due to: limited healthy food options at airports, lack of regular exercise, a sedentary job, shift-work, sleep disruption & stress. At its core, it is caused by an imbalance - taking in more fuel (calories) than we burn over a long period of time. Fortunately, our “biological machines” are actually very good at regulating our weight - but even small excesses add-up over time.
Think about it: an average Aussie consumes 100 kg of dairy each year (10 kg yoghurt + 90 kgs of milk) - yet gains just half a kilo annually - even so, over 10 to 20 years that adds up to 10 kg to 20 kg of excess fat - & greatly increased risk of weight-related diseases.
Aviation Tip: If there is just one causal factor to avoid, it is a diet high in HIDDEN SUGARS & simple carbohydrates - Think: soft-drink, fruit juice, beer/wine, white-bread & sugary buns”
Q: What are the symptoms & how is it diagnosed?
While excess body fat around the waist, thighs, or buttocks is the most visible sign, the symptoms of overweight and obesity often go unnoticed - such as:
Craving sugary foods or feeling hungry soon after eating
Emotional eating - using food to cope with stress, anxiety or low mood
Increasing clothing or belt size over time
Fatigue, daytime sleepiness, or snoring (possible signs of sleep apnoea)
Increased sweating, breathlessness and reduced exercise tolerance
lower confidence or mood
Diagnosis: Overweight and obesity are diagnosed by your GP or DAME using measurements of height, weight, and waist circumference to calculate:
Body Mass Index (BMI)
Waist-to-Height Ratio (WHtR or WCHR
These assessments help determine if your weight is within a healthy envelope for optimal health, performance and fitness to fly.
Q: Can I fly with overweight and obesity?
The short answer is 'yes'…but not without risk. Unlike an aircraft exceeding its weight and balance limits, pilots can carry excess weight for years before serious issues arise. However, overweight and obesity are an "Undesired Aviator State" - a condition that threatens long-term fitness to fly. The key is to recognise it and take corrective action before it impacts your health, performance, or medical certification.
Q: How does overweight & obesity affect my medical certificate?
Excess weight isn’t just a health risk - it’s a potential threat to your medical certification. This is because, overweight and obesity increase the likelihood of numerous conditions that can ground pilots - like: high blood pressure, type 2 diabetes, heart disease, stroke, sleep apnoea, joint problems, reflux, mental health issues and even certain cancers. The more excess weight, the greater the risk.
Because of these risks, CASA requires additional medical tests for pilots with obesity:
BMI > 30 (40 years & over) or BMI > 35: Fasting blood glucose, + oral glucose tolerance test + sleep study.
BMI > 40: Cardiological assessment + comprehensive tests + a sleep study + an operational check with a CASA testing officer.
Overweight and obesity are Undesired Aviator States - ignoring it is a pilot error that can eventually lead to grounding. The best approach? Stay ahead of the risks - take action before your medical (and career) is on the line.
Warning: Overweight/obesity also increases the risk of sexual (erectile) dysfunction which - won’t impact your fitness-to-fly but - will certainly impair your performance!
Q: How is overweight & obesity treated?
Ideally, overweight in pilots is proactively managed with regular “preventative maintenance”, such as: good nutrition, regular exercise, sleep-optimisation & GP-support. However, definitive treatment of obesity may requires medication (such as Ozempic or Saxenda) or weight-loss surgery. The medical or surgical treatment of obesity in pilots requires consultation with a DAME as some weight-loss medications and the post-operative period are incompatible with flying.
Q: What countermeasures & corrective actions can pilots take?
Just like handling an inflight issue, early recognition and corrective action is key when it comes to weight management. The good news? Small, consistent changes can keep you within your personal “weight & balance” envelope and protect your medical certification.
1️) Pre-Flight Planning: Nutrition
Prioritise high-protein, low-GI meals to maintain energy and avoid blood sugar crashes.
Pack healthy snacks to avoid relying on poor airport food options.
Stay hydrated - dehydration can mimic hunger and increase fatigue.
2️) Maintain Operational Fitness: Exercise
Move daily - even short walks or bodyweight exercises can counteract long hours of sitting.
Exercise habit - Incorporate resistance training to maintain muscle mass and metabolism.
Use airport layovers for quick workouts or stretching sessions.
3️) Fatigue Management: Sleep & Recovery
Prioritise consistent sleep to regulate metabolism and reduce cravings.
4️) Performance Monitoring: Regular Health Checks
Track weight trends like you do aircraft performance
Schedule an annual medical check-up - early detection prevents weight-related issues
Consider professional guidance (GP’s, nutritionists, trainers) to stay on trac
The Bottom Line: Weight gain is preventable, and weight loss is achievable. Taking action now keeps you fit, certified, and in control - so you can keep flying for years to come.
Q: Got more questions?
Contact us: info@aerokare.com.au
References & links to more information:
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