Fly Well: 'Wall-E’ wisdom

Obesity can be assessed via body mass index (BMI) and although a good tool, it is not foolproof as very muscular people can have a high BMI. BMI is calculated by dividing weight in kilograms by height in meters squared, but to prevent mathematical migraine, you can use an online calculator. A result below 18.5 is underweight, 18.5 to 24.9 healthy, 25 to 29.9 overweight, 30 to 39.9 obese, and thereafter, one is deemed morbidly obese. Measurements of total body fat and even waist circumference (greater than 37 inches in men and 31.5 inches in women) are also good indicators of impending issues. The heavier one is, the higher the risk of health problems.

Heavy pilots can carry less useful load and burn more avgas, but obesity also increases risks of hypertension, heart disease, stroke, diabetes, various cancers, gastroesophageal reflux, gallstones, liver disease, impaired fertility, reduced sex drive, breathing issues, sleep apnea, sweating and skin problems, arthritis, depression, and social isolation. Obesity contributes to many deaths and a great deal of disability. And less time flying airplanes.

As the pilot population ages, obesity can wreak havoc on a pilot’s health and his or her aviation medical certificate.With an estimated 603 million adults and 107 million children deemed obese, and many more overweight, there is a global girth-growth phenomenon. The implications for national health care budgets are profoundly worrying.

Treating obesity is best done by avoiding it. If at a healthy weight when 18 years old, aim to acquire no more than 11 pounds into adulthood. Eat a balanced diet with controlled calorie intake, exercise regularly, and avoid behaviors that lead to overeating, such as watching television during mealtimes. Starting an exercise program if chronically sedentary or already overweight can be daunting. I like the nine-week plan available from England’s National Health Service, helping one get from couch potato to a 5-kilometer (3.1 miles) runner in nine weeks (www.nhs.uk, search “Couch to 5K”).

Medications to support weight loss are available but are not without side effects. For example, the drug Orlistat leads to modest weight loss in conjunction with a diet and exercise program but has fairly common, and rather obnoxious, side effects: abdominal discomfort, nausea, and the passage of oily stools and diarrhea. Enough to put one off ever eating fatty food again. This drug is allowed by the FAA after a week of symptom-free use, as flying with diarrhea is neither advisable nor acceptable to either pilots or passengers, I would venture. There are several other drugs that act differently, but they are contraindicated if one has heart disease and are not allowable by the FAA because of potentially serious side effects.

Surgical solutions are available to reduce the size of the stomach and include gastric band and sleeve gastrectomy operations. Additionally, one can bypass part of the small intestine with a “gastric pouch and Roux-en-Y” procedure. These are now often performed with minimally invasive techniques, sometimes with robotic assistance. Dramatic weight loss can follow, but there are, of course, risks, such as gallstones and the general dangers of any operation. Post-operatively one must still commit to changing one’s lifestyle and may have to take certain vitamins that are otherwise not absorbed by the adjusted anatomy. Folds of excess skin may cause emotional distress but can be removed later.

I recently read Sapiens by Yuval Noah Harari, a marvelous “brief history of humanity,” and I recommend it to you. He speaks of the growth—and errors—our species has made. Agriculture made us hungry, contradictions created culture, and science made us deadly. His next book I am waiting to consume is Homo Deus: A Brief History of Tomorrow. Let’s ensure it does not take us to the dystopian future imagined in Wall-E.

Email [email protected]