The fatter Americans get, the more businesses stretch to accommodate them; even funeral homes, and casket and mortuary lift retailers.
"This is, unfortunately, a sign of the times, both experienced in life and after death," said Leslie Bonci, director of sports nutrition at the University of Pittsburgh Medical Center. "We're seeing the widening of seats, the widening of cup holders and, now, the widening of caskets."
About one-third of U.S. adults are obese, according to the Centers for Disease Control and Prevention in Atlanta. About 17 percent of children and teens are obese, triple the rate from a generation ago.
As one generation grows older, another one begins to die off. And with that death comes casket and funeral needs.
Keith Davis, owner of Goliath Caskets, a Lynn, Ind.-based company that "serves the oversize casket needs of bigger people," said his business has grown considerable in the past two decades.
"We're, unfortunately, a necessary frustration," Davis said. "A lot of times, a person's obese loved one has passed away, and they're not sure where to turn for help."
Goliath Caskets creates and sells caskets starting at 29 inches wide; they can run up to 52 inches wide and 8 feet long.
Even the standard casket size has grown from 24 inches to about 27 inches. Davis said the typical size changed about 15 years ago as people became increasingly overweight and obese.
"When we first started in 1990, 36 inches was the widest casket out there," Davis said. "Now we're up to 52 inches wide, which can hold someone who weighs 800 to 1,000 pounds."
Davis said he hadn't expected to sell more than one 52-inch casket when he made it in the mid-1990s.
"We sold 11 that first year, and we fluctuate from six to 12 of the biggest ones each year," he continued.
Davis sells about three to four various oversized caskets per week.
But it's not just a few specific companies that cater to obese customers. Almost every casket manufacturer has some kind of large option for people who cannot fit into a standard sized casket.
Tim Calderon, owner of Casket Connection in San Antonio, Texas, sells a wide variety of caskets to people across the country. When Calderon first joined the funeral industry about 10 years ago, it was pretty rare to have an oversized casket order.
"Now, I'd say probably every 10th call is someone who needs an oversize casket," he said. "And even some of our oversize caskets aren't big enough to accommodate the person."
Calderon said Casket Connection now stocks the larger caskets to accommodate the growing demand.
"A lot of companies are moving in that direction," Calderon said. "We have to or we'd be losing about 10 percent of our income."
Most oversized caskets do not cost much more than the standard size, he said. But it is additional expenses that make funerals costly.
Stones, grave openings and closing, vaults, flowers, transportation and the service itself can substantially increase the total price.
"And all those things can become an issue because a person is larger," Davis of Goliath Caskets said.
After selecting the casket, funeral directors measure the cadaver's body width from elbow to elbow. But in obesity cases, they measure elbows, the waist and thickness of body, Davis said.
"The measuring [for obese customers] really doesn't follow any formula, but the last thing we need is a lid that will not close when the time comes," Davis said.
Even then, oversized caskets cannot always fit into a standard hearse. In that case, Davis said, families sometimes have to get creative with their transportation options.
"They may need an alternative method of transport, like a nice van," he said. "We've also had people use open-box trucks, fire trucks and horse-pulled wagons to carry the casket."
Also, grave plots are usually about 38 inches wide, so if the coffin is wider than the plot, a family must buy two plots, which adds a significant additional expense.
But before grave plots and transportation options, a funeral director must prepare the body.
Realizing the need for assistance to lift overweight bodies during preparation, Katie Hill started marketing the Mortuary Lift, a piece of equipment that lifts and elevates a cadaver with the push of a button. It can also raise certain sections of the remains, which helps when dressing and positioning much heavier bodies, Hill said.
The device can lift up to 1,000 pounds.
"The No. 1 injury in this industry is a back injury," Katie Hill of Cedar Rapids, Iowa, said. "There's no good way to lift deceased remains, and the Mortuary Lift reduces time, eliminates injury and allows women and men to perform at an equal level because there is no difference in strength."
Without such assistance, Hill said, funeral directors sometimes have to ask for help from neighbors, friends and fire and police departments in lifting heavy cadavers.
She has seen her sales grow by more than 20 percent in the past several years.
Lift or no lift, it seems that oversized caskets have likely earned their place in the funeral industry.
"Obesity is a gigantic public health problem, and I think it's going to get worse in adults because there are so many obese children," said Dr. Carla Wolper, a dietitian at the Obesity Research Center at St. Luke's-Roosevelt Hospital in New York. "I don't see the problem getting better for a while."
The result, many funeral directors and casket retailers believe, is that the oversized casket is here to stay.
Davis said it's important to be realistic and work out the details so that, if an alternative method for part of the funeral is needed, everyone will be prepared.
"If funeral directors can figure out [logistics] beforehand," he said, "the person's life can be celebrated with dignity instead of being made fun of or scoffed at."