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DOT Physicals: Can You Pass with a High BMI or While Overweight?
Foley
11 mins read

The DOT (Department of Transportation) physical is something every commercial driver operating vehicles over 10,000 pounds (CMV) must pass at least once every 2 years. This physical isn’t something you need to worry about, but changes to regulations around drivers’ BMI (body mass index) score in recent years has caused some confusion.  

Whether you’re preparing for your first DOT physical or are worried about what to expect when you go for your next exam, our guide below will explain what to expect from your physical regarding your weight and BMI. If you are preparing for your first DOT medical exam and aren’t sure what to expect, make sure you click here to read our overview first to familiarize yourself with the process.  

Can You Fail the DOT Physical for Being Overweight?

You cannot fail the physical exclusively for being overweight, however, the exam does check for signs and symptoms of health complications that are caused or exacerbated by being overweight. The DOT physical is all geared toward checking that you are healthy enough to operate such a large vehicle and not potentially have a medical complication that would put yourself and others at risk.  

The DOT physical tests you in a range of different ways, but one of the markers is BMI.  

What is BMI?

BMI stands for body mass index, and it’s a value calculated by the weight and height of a person to indicate whether their weight is in a healthy range or not. It was invented in 1830s by a Belgian mathematician 

BMI is a somewhat controversial and outdated way of measuring body composition because it really doesn’t take into account actual body composition – two people who are 6’ tall can be the same weight but one can have a lot of muscle and low body fat, while the other can be the opposite.  

This is one of the reasons why drivers have considered measuring BMI for the DOT physical to be an unreliable measure of their health. It’s important to note, however, that there is no BMI that will exclude you from being able to pass your physical after additional testing. BMI is still used today because it can be calculated based on very little information about someone and gives a general overview of their health.  

What is the Maximum BMI for a DOT Physical?

There is no BMI value alone that will cause you to fail the physical exam. However, there are certain BMIs that will flag you as being high risk for certain conditions, which may cause your medical examiner to do further tests into things like blood sugar.  

Your medical examiner is required to recommend you for a sleep study to detect sleep apnea if you have a BMI over 40, or over 33 and meet certain conditions, which we’ll outline in the section below.  

What are the New BMI Requirements for the DOT Physical?

The requirements around BMI have been confusing since at least 2016, when the FMCSA first started suggesting the DOT physical use BMI as an indicator for obesity and necessitate a sleep study to detect sleep apnea.  

However, the new DOT physical requirements for BMI have now been defined, though it’s worth noting that it is still a debated topic and so may change again in the future.  

Your medical examiner is now advised to only recommend you for a sleep study if you have a BMI of 40 or over, whether or not you have any other medical conditions, or a BMI of 33 or more and at least 3 or 4 of the following conditions:  

  • Are a male or post-menopausal female  
  • Are aged 42 or over  
  • Hypertension (whether treated or not)  
  • Type 2 diabetes (whether treated or not)  
  • Personal history of stroke, coronary artery disease, or heart arrhythmias  
  • Micrognathia or retrognathia  
  • Loud snoring  
  • Witnessed sleep apnea episodes  
  • Small airway (reduced space at the back of the throat)  
  • Neck size over 17 inches for males, or 15.5 inches for females  
  • Hyperthyroidism  

What Happens if I am Recommended for a Sleep Study?

If you meet the criteria that means your medical examiner must recommend you submit to a sleep study, the FMCSA recommends that your medical examiner give you a 90-day certification to give you time to complete your sleep study and pass the physical, or receive treatment. Treatment for sleep apnea is to carry a CPAP machine with you when working.  

The CPAP can seem scary or unnecessary, but it’s designed to help you sleep better at night so you wake up well-rested and alert while driving on the road. Many drivers who have a CPAP machine report that it drastically improves their quality of sleep and thus their quality of life, so it’s definitely not something you need to worry about!  

Will my Insurance Pay for the Sleep Study?

Some do, some don’t. Talk to your medical examiner if they ask you to do a sleep study and ask them what options you have, the costs involved, whether your insurance is likely to cover you, and whether you have the option of losing weight before your 90-day certification is up. Anecdotally, most people have found that their insurance will cover the sleep study.  

What Can I do to Pass the DOT Physical if I’m Overweight?

If you are overweight and have a BMI over 33, it’s worth calculating how much weight you’d need to lose (using the chart below) to bring your BMI down to 30 or below, and consider if you can lose it in that time. The good news is that being larger means that you can often lose a lot of weight quickly with just a few tweaks to your diet and lifestyle.  

If you have time, cut sugar and processed foods from your diet as much as possible, as they raise your blood sugar and will keep your cells in a state in which they convert that excess energy to fat. Cutting this sugar and other fast foods will kickstart your weight loss. Try to cut down on your sodium intake, as not only can this raise your blood pressure, but it will cause your body to hold onto excess water which can raise your weight, even though it’s not fat, muscle, or tissue.  

Combine these better habits with some aerobic exercise – whatever is preferable to you. Aerobic means cardio, so consider walking, hiking, swimming, and the elliptical. Something as simple as parking at the far end of the parking lot and walking across to the store can help you increase your steps and burn calories, especially if you walk briskly. Weight training is great for your health, but if you’re trying to lose weight by a deadline, stick to aerobic exercise for now. This is because muscle weighs more than fat, and so you may find your weight stays the same, even though you’re doing everything right. When you’ve passed your exam, then start weight training.  

When you go for your DOT physical, make sure you tell your medical examiner about your good new habits.  

The DOT Physical BMI Chart

BMI-chart

 BMI Chart created by Vertex42.com. Used with permission.

 It’s important to remember that your medical examiner isn’t looking for ways to fail you, and the FMSCA and DOT are simply interested in ensuring that your health doesn’t put you and members of the public at risk while you’re behind the wheel of a CMV. If you are found to have a BMI over 33 or 40, don’t panic – work with your medical examiner and doctor to take the necessary steps to ensure you can continue your career and experience good health for many years to come.   

Links to Related Articles in This Series:

The DOT Physical: Everything You Need to Know 

DOT Physicals: Can Chiropractors and Other Doctors do DOT Physicals?

DOT Physicals: Vision Requirements for the Eye Exam      

DOT Physicals: Can I Get a DOT Physical in Any State? 

DOT Physicals: Can You Pass with a Hernia? 

DOT Physicals: Will I Pass with Diabetes? 

DOT Physical Blood Pressure: Requirements & Tips for Passing 

DOT Physicals: What if I have a Medical Condition? 

DOT Physicals: Do They Include a Drug Test? 

How to Prepare for Your DOT Physical? 

DOT Physicals: What Happens When You Fail? 

Fail a DOT Physical? You Have a Right to a Second Opinion 

DOT Physicals: Understanding Medical Variances 

 
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