Who Should Pay for Obese Health Care?

Treating Obese Patients in Obstetrics and More

The hospital is adding to the number of bariatric wheelchairs, blood pressure cuffs and gowns it already had.

"None of these costs have been passed on to the patients," Fullenlove said.

Alongside the movement to revamp equipment is a move into specialized treatment for bariatric patients in other specialties. Both the University of Michigan Hospital and St. Louis University Hospital developed special units for obstetric care for obese mothers.

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"We want to monitor these patients very closely," said Dr. Raul Artal, a professor and chairman of the department of obstetrics, gynecology and women's health at St. Louis University Hospital in Missouri. "We see them more frequently. We have a dietician who works full time and [will] dedicate more time to these patients."

Artal explained that women who are obese, especially if they have a Body Mass Index of 40 or higher, are more likely to have miscarriages, babies with birth defects and "a multitude of problems."

"For some of these patients, they are so obese for the last weeks of their pregnancy [that] they cannot walk, so they are confined to a wheelchair," he said.

But the clinic has good news, too. Artal said about 40 percent to 50 percent of his patients are able to fully comply with nutrition, diet and exercise programs during their pregnancy and, overall, 70 percent to 80 percent of patients make some progress.

"We see patients who have had hypertension when they enter the program, and when they exit the program their blood pressure is normal," he said. "We have success stories, but we would like to extend this clinic."

Artal said the patients at his clinic pay no more for their extra care than any other woman with a high-risk pregnancy.

Activists have felt that while additional charges might be considered discriminatory, specialized bariatric care, in general, might be supportive.

"Women who are at a BMI of 40 -- they may have special care available because they are at a greater health risk," said Thompson. "It strikes me as good medicine, and I applaud them for not charging a higher rate."