There's no question about it. America has a weight problem, and there are no signs that the population will change its ways and trim down anytime in the near future.

Over the past two decades, this country has seen a doubling of obesity in adults, a tripling of obesity in adolescents and a quadrupling of morbid obesity, says Dr. Kevin Huffman, a bariatric physician with more than 20 years of clinical experience in obesity management and bariatric advisor for Gendron.

“It's growing exponentially, and the most rapid growth is in the segment of the morbidly obese (those who are more than 100 pounds over their body weight),” he notes.

According to Joe Chesna, national sales director of standard power for Pride Mobility Products, 32 percent of men and 28 percent of women age 60 or older are obese. “Manufacturers are continuing to look at this as a growing market segment and incorporating more bariatric models into their core products,” Chesna says.

“Unfortunately, the statistics show that our population is getting larger in size, and that makes this a growth market opportunity,” adds Sue Jotblad, marketing manager for Sunrise Medical. “A plus for providers is that there are a number of manufacturers providing products in this category now, which has made product pricing very competitive.”

Further, bariatric patients typically require more products at higher price points than the average patient, she explains. A single patient may require several pieces of equipment, such as a bariatric bed, wheelchair, shower chair or toilet and respiratory equipment.

“You've got good funding on these product lines,” says DuWayne Kramer, president of Leisure-Lift. “Even with competitive bidding, bariatrics is going to be a profitable line.”

Understand Special Needs

Providers that wish to be successful in this sector need to do more than just randomly sell a few bariatric items, however. They must understand the market and have a game plan, advises Jotblad.

“Serving the bariatric market is a niche business,” she says. “To be a leader in this market, it must be a conscious business decision.”

One place to start is understanding what bariatric patients need. According to Huffman, some of the special needs for this population that HME providers should be aware of include:

• Equipment that will help them ambulate

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  As patients become heavier, it is more difficult for them to support their own weight. Wheelchairs, walkers, rollators and canes that are rated for heavy weight and have stronger frames and motors will keep the patient moving safely. “First comes safety, then comes comfort. We have to deliver that in a dignified way,” Huffman says.

• A safe bathroom environment

  Many bariatric patients have poor balance, so they are more likely to slip and fall, Huffman says. Also, many patients don't bathe as frequently as they should and, as a result, their skin breaks down, he says. Grab bars, shower chairs and other bathroom aids can make it easier to bathe and help to prevent accidents.

• Reach aids

  Larger patients often have difficulty reaching certain areas of their body, making it difficult to maintain proper hygiene. In these cases, a reach aid may be helpful, Huffman says.

• A safe place to sleep

  It is important that bariatric patients have a bed that can maintain their weight and not collapse and cause injury, Huffman notes.

  Many bariatric beds can be lowered close to the floor to make transferring easier, and, in some cases, eliminate the need for safety rails, says Len Feldman, owner of Big Boyz Industries. Since many bariatric patients are bedridden, the heads of some beds can be raised to allow patients to sit up and eat, and the foot sections can be lifted to help reduce edema.

• A proper support surface to sleep on

  For bariatric patients who are confined to their beds, many have open wounds in their skin from abrasion, Huffman says. For these immobile patients, proper support surfaces, such as low air-loss mattresses, are important to prevent pressure wounds. “I tell my physicians to treat these [super-obese] patients as if they're quadriplegic — they're just not moving,” he says.

• Lifts and transfer equipment

  Some patients may weigh 500 pounds but are being cared for at home by a 100-pound spouse, Huffman notes. “If they go down with back injury, you have two people that are incapacitated.”

• Sleep equipment, such as CPAPs

  Sleep apnea is extremely prevalent in the U.S., especially among bariatric patients, Huffman says, adding that some bariatric centers say 90 percent of their patients have sleep apnea. Because sleep apnea remains underdiagnosed, he says, more education needs to be done to inform physicians and increase sleep testing.

• Diabetic supplies

  As a patient's weight goes up, so does insulin resistance, Huffman notes, and patients must control their blood sugar to prevent further complications. “Almost all of our [bariatric] patients are diabetic,” he says. “That's where we have real concerns, because diabetics are at risk for amputations, blindness and kidney failure.”

But not all bariatric patients are built the same. This is why it is vital for providers to be able to evaluate each patient individually for each product, particularly in the case of wheelchairs, says Kramer.

Display for Multiple Sales

“There are lots of seat depths and widths and custom backs,” he says. “Pear shapes and apple shapes have different seating requirements.” For example, if a patient protrudes out backward, they may need an extra-high gap between the seat and bottom of the back, Kramer notes. Otherwise, their tissue may push them so far forward in the seat that they can't touch the backrest and be comfortable in the chair.

Just as each individual needs to be evaluated, each individual's home also must be evaluated to make sure it can accommodate bariatric products, says David Jacobs, president for durable medical equipment, Medline Industries.

“While there's adequate profitability for these products, it requires a lot more work to make sure that the home is ready for these products,” he says.