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.

The FAA does not have a specific "cutoff" BMI that automatically disqualifies a pilot, but a BMI of 40 or higher triggers a mandatory medical review. According to the 2026 FAA Guide for Aviation Medical Examiners (AME), any pilot with a BMI of 40+ must undergo a clinical evaluation for Obstructive Sleep Apnea (OSA). This is because severe obesity is a high-risk indicator for sleep-related fatigue, which is a major safety concern in the cockpit. If the AME suspects OSA, the pilot may be required to undergo a sleep study and, if diagnosed, must prove they are successfully using a CPAP machine or other treatment to maintain their medical certificate. While a high BMI is not an "automatic fail," it adds significant administrative hurdles and testing requirements to the medical certification process.