Big Demand, Big Market

America’s weight gain has meant bigger wheelchairs and bigger beds in the home care market, along with bigger profits for manufacturers and providers of bariatric products. Leaders in the market point out that it has been five years since the Centers for Disease Control and Prevention declared obesity an “epidemic” in the United States, but growth in bariatrics has yet to slow — and they predict little change in the near future.

“Demand is getting higher and higher,” says Jim Lein, president of Dalton Medical. “In the next few years, we’ll have at least another 5 to 10 percent growth on top of general market growth, so that’s 15 to 20 percent growth compared to growth in regular [durable medical equipment] of 8 to 10 percent.”

Despite the strong forecast, however, bariatric manufacturers talk about it with regret, and say they are not pleased by the number of Americans tipping the scales at upwards of 400 pounds. “I don’t see a slowdown in the bariatric market, and it’s unfortunate,” says Duwayne Kramer, president of Leisure-Lift. “When you [look at states where people] eat a lot of bratwurst and drink a lot of beer and watch a lot of football — it’s cultural.”

Explains Len Feldman, owner of Big Boyz, “Sadly enough, [the bariatric market] continues to grow. [It’s sad] for the patients. The population isn’t paying any attention to their weight or proper diet. They’re treating obesity as though it’s normal. No one is doing enough about it.”

Inattention to health and weight gain is especially prevalent for children 10 or 12 years old, notes Feldman, “and as they grow older, they become our patients.”

In a positive development, he continues, the medical community has begun to take a different view of obesity. Instead of being pegged as “fat” or “lazy,” obese people are being recognized as patients with serious problems that need proper treatment. “The medical community is taking a much bigger interest in bariatrics,” says Feldman. “They’re beginning to treat it as a disease and not as an addiction or as slovenly [behavior].”

Home Products Innovation

As obesity gains credibility among medical professionals and general understanding of the condition grows, demand is increasing for products tailored to the specific needs of bariatric patients — and their caretakers — in the home. Manufacturers are working to meet these new demands and promising technology that serves home-based obese patients’ requirements better.

“It seems a lot of people right now are getting into the obese situation, and some people — with diabetes, thyroid and other problems — have no control over it,” says Walt Yercheck, national sales manager for Evermed. “The market is growing at a very rapid pace.”

“There have always been these people, and they need special handling. People are beginning to deal with it more,” says Kramer. “There’s more aggressive care for these people.”

According to bariatric product-makers, the number of patients receiving bariatric treatment in their homes has increased, and innovation in the field today is geared toward equipment suited for the home environment. “Product development is more towards the home,” says Kramer.

Others agree that technology from institutional bariatric products has crossed over into products for the home setting, and this is especially true for bariatric beds. “We continue to design new bariatric beds with much better motors and battery back-up units — beds that are quieter, cleaner and easier to maintain,” says Feldman of Big Boyz. “We’ve switched to DC motors and very small but powerful battery back-ups in response to blackouts all over the country because of windstorms, rainstorms and snowstorms. So, if you have a power outage, you still have all the gadgets working,” he explains.

Though manufacturers have attended to the comfort, positioning and even the emergency needs of bariatric patients in the home, the industry has been slow to address mobility for these people outside of a nursing home or hospital setting, according to Kramer. He points out that bariatric products must not only be designed to meet patients’ needs but also those of their caregivers, who, in a home setting, are essentially on their own.

“These patients put a lot of strain on staff, whether it’s at home or in the hospital. This is a critical issue that home care people haven’t tuned into yet. It’s the same basic issue of trying to move a massive, delicate patient,” he says.

While a growing number of people classified as obese are being treated in the home, industry experts say bariatric patients pose extreme challenges regardless of where they’re cared for, simply because of their weight and the continuous stress they place on the products they use to help with their condition. “It’s a challenge to accommodate these patients in their environment,” Yercheck explains.

A Quality Challenge

Market leaders say another growing challenge comes from the rash of low-quality bariatric products on the market today, with too many inferior products labeled as “bariatric.”

“The challenge and the frustration is that a lot of [manufacturers] tried to jump on the bandwagon by beefing up what was a regular product and then selling it as a bariatric product. We get frustrated when someone tries to make a product bariatric rather than making a bariatric product,” says Leisure-Lift’s Jim Ernst. “There are a lot of products out there that say they will carry the weight but really can’t.”

While the market is becoming saturated with bariatric products, according to manufacturers, in some cases this can mean greater choice for end users in terms of selection and price. “More and more manufacturers are making these kinds of products for 400- to 800-pound patients,” says Lein of Dalton Medical, “and this is driving cost down because there’s more selection.”

However, experts point out, both DME dealers and bariatric customers need to take care in choosing among the flood of new products. “Innovation may not be quick,” says Lein, “but there’s more and more availability. [Patients] need to think about it, to make sure about products not just by price but by quality.”

Manufacturers say they are certain that as awareness increases, legitimate bariatric products will beat out the competition. Unlike their less expensive counterparts, they say, high quality bariatric products will last longer, address real bariatric needs and will be safer for the patient and caretaker. “Safety is the No. 1 issue,” Lein explains. “If our bed can handle 500 pounds, we say 400 [pounds].”

End users may have plenty of time to sort out the differences in bariatric products, since most feel that the market will continue to grow. While it’s true that more Americans and their medical advisers may be confronting obesity, bariatric experts predict the number of new patients entering this market will be considerable for the next three to five years at least.

Says Ernst, “This [situation] isn’t going to change overnight with the Atkins diet or whatever else. The market will continue to [grow].”

Experts interviewed: Jim Ernst, Leisure-Lift, Kansas City, Kan.; Len Feldman, owner, Big Boyz, Ivyland, Pa.; Duwayne Kramer, president, Leisure-Lift, Kansas City, Kan.; Pieter Leenhouts, vice president of marketing, Sunrise Medical, Longmont, Colo.; Jim Lein, president, Dalton Medical, Dallas, Texas.; Walt Yercheck, national sales manager, Evermed, Anaheim, Calif.

Making Bigger Sales

Once a patient reaches an obese weight, he or she may require a range of equipment simply to function. So, say manufacturers, the key to success for providers in the market is in bariatric product-group sales. By grouping various products for sale as a package to end users, patients’ needs will be better met, and dealers will increase their own profits.

“Home care dealers are going to have to work more closely with their referral sources to meet the needs of the patient by bariatric product-group selling,” says Walt Yercheck, national sales manager for Evermed, “by putting together a package [of bariatric products] that meets the patient’s needs, whether it’s in the home, a nursing home or a hospital.”

A product group might include a patient lift, cushions for wheelchairs and mattresses — “the whole product group in bariatrics,” he explains.

According to Len Feldman, owner of Big Boyz, when a dealer begins serving one need and the bariatric patient is happy, that same customer may request additional products and equipment such as wheelchairs, commodes, walkers, beds, respiratory care, diabetes or skin care products. Says Feldman, “One bariatric patient — from the standpoint of a dealer — will mean more equipment and more sales … than most other patients.”

Weighing In on Obesity

Recent research from the National Center for Chronic Disease Prevention and Health Promotion, a division of the CDC, indicates that obesity in the United States isn’t improving. On the contrary, it’s getting worse. Today, according to CDC reports, 20 states have obesity rates of 15 to 19 percent; 29 states have rates of 20 to 24 percent; one state (Mississippi) has a rate of more than 25 percent; and the numbers are increasing.

Obesity — defined as having a body mass index of 30 percent or more — has doubled in the last 30 years, according to the CDC. In 2000, its estimates gauged 30 percent of U.S. adults aged 20 years and older — nearly 59 million people — were obese. What’s more, among those same adults, 64 percent came close with a body mass index of 25 percent or more. The CDC also reports that 15 percent of children and adolescents are now overweight or obese, and these numbers, too, are on the rise.

According to a recent Wall Street Journal article, one of every 80 men and one of every 200 women are morbidly obese, weighing more than 300 pounds, and the cost of health care for these patients is extreme. In 2000, the cost of obesity in the United States was more than $117 billion, acording to the CDC.

For more information and additional statistics, www.cdc.gov/nccdphp/dnpa/obesity/index.htm.