In the past year, some hospitals spent as much as $5 million to update and enlarge their facilities to accommodate obese patients, according to a recently released report by Novation LLC, an Irving, Texas, health-care supply chain company that produces annual commentary on the cost of bariatric care.
Larger patients need supersized beds, chairs and wheelchairs, open MRI machines and toilets bolted to the floor instead of the wall, the report noted. But with more than 200,000 weight-loss surgeries performed each year at a cost of up to $26,000 per surgery, many hospitals consider the extra cost a wise investment.
Hospitals are just one example of the way the world is adapting to accommodate expanding waistlines. Here are six more areas that have been recently plumped up in response to the more than 68 percent of Americans who are now considered either overweight or obese, according to the Centers for Disease Control and Prevention.
Studies estimate the total cost of obesity to U.S. employers at $73 billion a year. That number doesn't factor in the everyday ways businesses are changing the physical workspace for a plus-size work force.
Take the office chair. Chair seller ErgoHuman in Austin, Texas, said the average office chair is for a 250-300 pound person, tops. Clearly, that's not strong enough for many American workers.
Seeing a need, Ergogenesis was one of many manufacturers that introduced chairs for the extra large in the past few years. Its Bodybilt chairs were designed with an extra wide "bariatric" seat pan that can support someone who weighs up to 600 pounds. The chair has a hefty price tag too -- $1,300 – but the company reports it's selling briskly. One government agency bought 645 of them in 2012.
If it seems as if it's harder to get a seat on the bus in recent years, that would be right. In 2011, the Federal Transit Authority proposed raising the assumed average weight per bus passenger from 150 pounds to 175 pounds, which could mean that across the country, fewer people will be allowed on city transit buses.
The transit authority also proposed adding an additional few inches of floor space per passenger. The changes are being sought "to acknowledge the expanding girth of the average passenger," the agency said in a statement.
A woman's size 14 at the Gap in 2008 fit someone with a 37-inch bust, 29-inch waist and 39-inch hips. Today that size has crept up to fit someone who's 37.5-29.5-40.
Many clothing manufacturers now engage in this "vanity sizing" because they know the psychological boost someone might get from wearing a garment two sizes smaller, even when they've undergone some obvious expansion. Today's size 4 was a size 8 two decades ago.
Even department store mannequins are sporting curvier figures. A photo of a plus-size department store dummy kicked up controversy last November when a reddit user posted a picture of it and asked the question, "Anyone else horrified that they make obese mannequins too now?" Ed Gribbin, president of mannequin manufacturing company Alvanon, estimated the mannequin would wear a plus size 24-26.
"Finding a scale that went higher than 300 pounds was nearly impossible a few years ago," said Gary Shane, the sales manager for the Precision Weighing Co., a website that sells scales. "Now they routinely go up to 400 or 500 pounds."
Shane's company does a brisk business selling models such as the Siltec Model WS1000, which measure up to 1,000 pounds of body weight. Some are sold to TV production companies whose programs focus on people needing to lose big.
It isn't just a matter of registering larger numbers; a well-designed obesity or "bariatric" scale has a significantly roomier platform to accommodate larger feet plus support bars or arm rests. Shane noted that the new specialty scales are an improvement over those of a decade ago, when hospitals weighed in heftier patients on basement laundry scales.
Extreme obesity complicates the simplest things, even something as basic as going to the bathroom. Enter Big John, makers of oversize toilet seats. They cater to the more than 72 million overweight Americans by offering generously padded seats that are 19 inches wide and 2 inches taller than the standard seat, which measures 14 inches wide. They have a weight capacity of 1,200 pounds.
Big John also sells supports that can be placed under the bowl to bolster the typical wall hung toilet, which has been known to crack or collapse under heavy loads. Since the company started making the seats in 2004, revenue has skyrocketed, increasing 50 percent every year, according to the company.
Pair that with an Ideaworks Long Reach Comfort Wipe, a 16-inch extender wand that holds toilet paper for those who can't quite make the reach around. It sells for $7.99-$12.99 on Amazon, and reviewers give it four out of five stars, noting that it's a terrific product once you get over the learning curve and are OK with having to replace it every few months.
Even in death, some people require extra leg room. Laurens Fish, director of the Weed-Corley Fish Funeral Home near Austin, Texas, said he'd begun selling caskets up to 54 inches wide, more than double the size of the standard 24-inch width. When Goliath Casket began producing triple-wide caskets, which hold up to 700 pounds comfortably, in the late 1980s, it sold an average of one per year. Now it ships half a dozen models a month.
As in life, having some extra girth makes death more expensive too. Super-size caskets carry a price tag of up to $3,000 more than the average-priced casket. If a larger plot and concrete vault are required, that can add $1,000 to burial costs. "When a casket is really large," Fish said, "you may be required to buy two plots."