BMI and scuba diving

[Duke Dive Medicine]

So I want to learn to dive recreationally and because I have a chronic medical condition, I had to get a doctor to sign me off. I checked the relevant boxes on the form and went for my medical a few days ago. The doctor was fine with my health condition and the medication I take (common mental health condition with no major meds, very stable, and a stable autoimmune condition). He asked me if I was active and I said that I was relatively active, I walk alot and I also swim. I wild swim in the sea and lakes, and also pool swim and while I don't have a specific distance in mind, I can do laps for an hour so I'm confident I could meet the swim requirement without difficulty. Checked my BP - normal. No diabetes, heart or lung problems at all. I'm age 30. He then did my height and weight. Because my BMI came out at >40, he then failed me.
Now I understand that my excess weight is a problem, I know it is. I want to lose weight and I am trying to, but I'm frustrated that I spent the money for a private medical only to be told that I can't dive because of something that wasn't on the form in the first place. If the front of the PADI form said to tick a box if your BMI was above a certain limit, and that was a fail, I would have been fine with that, worked on losing some weight and not wasted my money.

However if I didn't have the mental health issue I would never have needed the medical. I therefore can't see that I would have been stopped from diving unless my physical fitness was insufficient (and I assume at the dive centre they check fitness - of course if I didn't meet that then I can't dive and that's fine). If there's an absolute set in stone BMI cutoff then surely this should be on the front of the PADI form? It was only checked because my local dive shop (correctly of course) said I needed medical approval because of my medications for my autoimmune condition.


Perhaps I'm being unreasonable, I'm just very disappointed and I'm frustrated that I wasted my money and got so excited about something that I now can't take part in. I'll try and lose some weight and come back to it, but this was the perfect time in my life to do it because of the way my work is currently. I think this absolute BMI cutoff needs to be made more clear to stop other people from wasting their money on medicals like I did.

Is there anything I can do? Any recommendations for someone online who would consider my actual level of physical fitness rather than a number on a scale?

As others have mentioned, BMI is something of a blunt instrument when assessing fitness to dive. That said, the UKDMC guidelines linked by @-JD- above provide something of a rationale in that very high BMIs are strongly associated with morbid obesity and are frequently linked to other underlying health issues. The strains that are placed on the heart when diving are different than those on the surface, so a body system that's in something of an equilibrium on land may not be the same when diving. I would encourage you to continue your journey toward a healthier lifestyle.

Best regards,
DDM

 

[PirateFoxy]

If the primary concern is cardiovascular issues, wouldn’t waist-hip ratio be just as easy to measure in a doctor’s office setting but provide a more accurate picture? I’m sure I’ve read several studies that found that waist-to-hip ratio maps better to cardiovascular issues than does BMI, as BMI doesn’t care where your weight is, and the type of fat it is (and thus where it is on your body) is extremely relevant. Waist-to-hip would also catch people who are not ”overweight” or “obese” BMI but still at higher risk of cardiovascular problems.

 

[DrG123]

Thanks for all the input guys! Unfortunately my GP said she couldn't sign the form as she wasn't a dive medic, and everyone else I've asked has had 40 is the cutoff and that's that. I am working on losing weight and I know that I need to, but it's disappointing all the same as if I wasn't on medications which have nothing to do with my weight I wouldn't have had the medical in the first place. More to the point, I wish I'd known that the UK had a set cutoff, then I wouldn't have wasted £85!
I'm going snorkelling instead on my upcoming Malta holiday, so I've got that to enjoy with my friends while I continue my weight loss journey. Hopefully by next year I'll be in much better shape, and I can plan to learn then!

 

[Boarderguy]

Thanks for all the input guys! Unfortunately my GP said she couldn't sign the form as she wasn't a dive medic, and everyone else I've asked has had 40 is the cutoff and that's that. I am working on losing weight and I know that I need to, but it's disappointing all the same as if I wasn't on medications which have nothing to do with my weight I wouldn't have had the medical in the first place. More to the point, I wish I'd known that the UK had a set cutoff, then I wouldn't have wasted £85!
I'm going snorkelling instead on my upcoming Malta holiday, so I've got that to enjoy with my friends while I continue my weight loss journey. Hopefully by next year I'll be in much better shape, and I can plan to learn then!

If you're going to Malta then it may be worth contacting a dive shop there to get certified. PADI does all online coursework now so you'd only need to do the pool and 4 dives while there. What better way to spend a vacation on the med than under the surface.

 

[DrG123]

If you're going to Malta then it may be worth contacting a dive shop there to get certified. PADI does all online coursework now so you'd only need to do the pool and 4 dives while there. What better way to spend a vacation on the med than under the surface.

I have definitely thought about it, but I'd still need a medical so I feel like they're quite likely to say no again (some stuff I read suggested that they use the same standard as British dive medicals so no difference there unfortunately!)
I've resigned myself to it not happening and planned some nice things with my friends instead, so while I'm disappointed I've accepted it.

 

[Boarderguy]

I have definitely thought about it, but I'd still need a medical so I feel like they're quite likely to say no again (some stuff I read suggested that they use the same standard as British dive medicals so no difference there unfortunately!)
I've resigned myself to it not happening and planned some nice things with my friends instead, so while I'm disappointed I've accepted it.

I'm glad you're seeing a positive side in all this. Might not be a terrible idea to speak with your mental health specialist to see if the current medicating can be reasonably altered to benefit your physical health. Maybe less or something different? Just an idea. Otherwise, hope have fun in Malta with your friends.

 

[drrich2]

I have definitely thought about it, but I'd still need a medical so I feel like they're quite likely to say no again (some stuff I read suggested that they use the same standard as British dive medicals so no difference there unfortunately!)

Keep in mind here are other places that probably don't use that standard. I'm not opining whether you should dive or not. I'm just saying that if you wish to make that decision yourself, rather than let others make it for you, and your decision is to pursue and get certified to dive, you can likely make that happen. Perhaps not in the U.K. or Malta, but there are other places. Whatever you decide, best wishes.

 

[BoltSnap]

So the only objection is the BMI? No other contraindications to diving such as specific illness or medical condition?

 

[FishWatcher747]

In my own personal opinion I think BMI is nonsense. I just did a PFO test where one part of the test was stress testing. I am 185cm tall and weigh 130kg. I'm a large person of soon to be 62 years of age. Yet I take daily walks up and down steep mountain trails. My knees suffer and I may need to rest at times from the pain. My back isn't the best either. Yet I took a medical for my upcoming TDI ANDP course I will do this year. My instructor has known me for over 8 years and we have done a lot of diving together so my size is not new to him. I am medically cleared for my next diving course.

I have no issues with my health and my heart is fine. My resting heart beat is from 55 - 58 per minute and my blood pressure last tested at resting was 118/60. No diabetes, heart or lung problems, no coronary artery disease. I'm fine for taking my diving course. I do take meds for high blood pressure. My BMI was not tested.

Your BMI was calculated. 38.

What Is My BMI?

Use this simple tool to calculate an adult’s body mass index (BMI).

www.cdc.gov

 

[GDHLEWIS]

I hope it all works out for you in the end