Feature | December 17, 2007 | Sheila Ewing

Bariatrics: Product Lines Have Expanded Nearly as Much as Waistlines

The incidence of obesity and its related co-morbidities are increasingly becoming more visible. Primary pathologies, such as high blood pressure, elevated blood sugar, abnormal cholesterol levels, and secondary conditions such as sores, ulcers, arthritis, chronic pain, sleep disorders and depression all can be traced to rising incidences of obesity.
The climbing prevalence of these conditions is placing a significant strain on the healthcare system. Recent estimates show the cost of obesity-linked illnesses to the Medicare and Medicaid programs in the U.S. is over $40 billion.
Who Are the Obese?
People are classified as obese or morbidly obese based on their Body Mass Index (BMI). Those with a BMI of 30 are considered obese and those with BMI over 40 or above are described as morbidly obese. The number of people with a BMI of 40 or greater has quadrupled between 1986 and 2000, shifting from approximately 1 in 200 adults to 1 in 50.
Not only is the number of morbidly obese people rising, those that are defined as clinically obese are also rising, their numbers having doubled from 1 in 10 to 1 in 5. Significantly, the largest growth was in people with a BMI of 50 or more, from 1 in 2000 adults in 1986 to 1 in 400 in 2000. Today, over 65 percent of adult Americans are overweight and 31 percent are obese, while 14 percent of American teens and children are obese.
This epidemic is not confined to adults. A child is obese if their weight is more than 20 percent higher than the ideal weight for a boy or girl of their age and height. Since 1980, the number of obese teens and children has more than doubled in the last two decades. Over 15 percent of U.S. children are obese. Being obese as a child increases their risk for serious medical conditions. Overweight children are at a greater risk of being obese as an adult. What once was a problem in adults, obesity is now increasingly prevalent in teens and children.
Bariatric Market Expands
While the homecare setting is also witnessing an increase in bariatric equipment as patients move from nursing homes, the highest demand remains in acute care. As the bariatric population grows, healthcare facilities are realizing that their bariatric equipment may be inadequate, unreliable or outdated. The lack of bariatric equipment in the acute care setting often causes overweight and obese patients to be turned away from treatment. The rapidly rising number of obese patients coupled with an increasing awareness of patients’ right to be treated, is compelling acute care centers to provide appropriate facilities and in some cases even separate facilities specialized for this population.
To meet the demands of this expanding population, the medical industry is developing bariatric equipment that is specifically designed to assist the obese population. Manufacturers have lagged in bariatric product development as a result of higher production costs and lack of reimbursement codes by Medicare. Providers have been slow in accepting bariatric products due to their focus on other, more profitable segments such as oxygen concentrators. Providers were reluctant to embrace bariatric equipment due to the high servicing costs associated with the products’ larger size and increased weight.
High Equipment Costs
A major challenge for the bariatric equipment market is the high price. For example, a bariatric power chair can cost up to 200 percent more than the average chair. Medicare recently revised the definition of bariatric-grade products allowing higher fees for heavier-duty equipment. As a result of heightened demand and increasing reimbursement rates, market participants are broadening their portfolio of bariatric equipment and complimentary product lines.
What once was a niche area where manufacturers and providers supplemented their product lines, bariatric equipment is now one of the fastest growing segments in the durable equipment market.
Growing Number of Bariatric Products
This market is finally receiving the attention it deserves with manufacturers directing more of their resources to product development. A growing number of companies have launched new lines of bariatric products. Over the past three years, this market has expanded almost as quickly as waistlines, from specialty beds to compression hosiery. The latest additions to bariatric equipment include items such as walkers, patient lifts, bath benches, canes and crutches.
Two years ago, Medline Industries had approximately a dozen bariatric products. Now, the company offers over 100 products, including beds, wheelchairs, walkers, bath safety products, stretchers and scales with a capacity as high as 1,000 pounds. Product lines are expected to continue increasing as manufacturers realize the importance of comprehensive bariatric product lines.
Many manufacturers entered the bariatric market by increasing their standard weight capacity of equipment to 350 pounds, but now that is not nearly enough. The capacity of bariatric equipment is rising to 700 pounds and even 1,000 pounds. Bariatric equipment should not only be wider and deeper to accommodate the patient’s size, but it is imperative that the equipment be designed to hold their weight. For example, metal frames for wheelchairs, shower chairs and walkers must be strengthened by reinforcing the tubing and joints, using a stronger metal such as steel rather than aluminum and utilizing tubing with a thicker diameter. Bariatric equipment can also be customized to fit the person's size and weight. Powered conversion kits may be added to a manual wheelchair to give the patient additional power for maneuvering ramps, hills and other terrain Advancements in bariatric equipment such as these are increasing market penetration and growth in this segment.
The obesity epidemic has prompted growth in sales of bariatric products of over 10 percent annually. The U.S. bariatric specialty bed and support surface market is experiencing tremendous expansion in bariatric specialty beds, mattress replacements and overlays. In 2006, market revenues were almost $200 million and are anticipated to reach close to $500 million in 2012. Bariatric manual wheelchairs have now become the largest segment of the wheelchair market, yielding revenues of over $40 million in 2006. Power bariatric wheelchairs are also gaining significant market share. By 2010, the U.S. bariatric market could reach upwards of $1 billion in revenues. There are more than a dozen participants in each of these segments with more manufacturers rapidly entering this profitable market.
Although healthcare watch-groups continue to raise awareness of the risks associated with obesity, these measures are likely to have little affect on the short-term demand for bariatric equipment.
As the bariatric equipment market advances, manufacturers and providers should reevaluate their products to ensure they adequately address this growing population. Market participants must develop an appropriate strategy for their bariatric products, not just an expansion of their current line of equipment.
The increase of imports will become a key issue for bariatric manufacturers due to more intense competition and product innovation spurred by increasing demand. Foreign competition continues to present challenges for domestic manufacturers, but many import bariatric products lack additional features and reinforced structure similar to that available in U.S. products.
Bariatric equipment manufacturers that spend time understanding the specific needs and challenges posed by obesity will be able to tailor their product lines to effectively and efficiently capture market share.

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