Bariatrics momentum is slowing down

For several years now, bariatrics has been a robust growth market for home medical equipment, following the rise in obesity across the U.S. As Americans' waistlines have bulged, HME manufacturers have responded by producing heavier duty versions of standard products across various categories.

Sales have been historically strong for mobility, support surface, bath safety and aids to daily living equipment, prompting a focus on continued development of new bariatric products. Yet there are signs that the assembly line may be slowing down, yielding to an attitude of quality over quantity, notes Jay Doherty, director of clinical education for Exeter, Pa.-based Quantum Rehab.

“Bariatric seating and wheeled mobility remains a niche market that has seen advances in our understanding of the needs of this client population,” he said. “However, the number of products available to meet the bariatric client's identified needs has not grown nearly as quickly. I wouldn't say momentum is stagnant, but I don't see the manufacturing community putting significant resources into the design and development of products for the bariatric client as for other populations.”

There are several factors working against bariatric product innovation, but the driving force is a lack of funding, Doherty said. The bariatric clientele is challenging due to the various body types and the distribution of soft tissue, he said, and that variance makes it difficult for manufacturers to accommodate.

“With comparatively low utilization and a high cost of materials needed to support the weight and unique shapes of bariatric consumers, manufacturers are not able to leverage economies of scale,” Doherty said. “Hence, bariatric products are significantly more expensive for providers to purchase and it takes more time for the evaluation, recommendation, fitting and delivery process. Yet reimbursement does not take this into account.”

Jim Ernst, product manager for Kansas City, Kan.-based Burke/Leisure-Lift, says more HME providers are selling bariatric products than ever before, but warns they should deeply scrutinize the selection and quality of available items.

“Many are just standard duty products reinforced to try and hold extra weight, but don't necessarily serve the needs of the patient,” Ernst said. “Most products have had bariatric versions for quite some time, but many were in name only. Reinforcing a previous product designed for lower weights is not the same as creating a truly bariatric product. Providers need to look at a manufacturer's history and their ability to meet specific patient's needs.”

Market arrow up

Bariatric product development may have slowed, but research data shows that demand will continue to climb, said Joe Oberle, product manager for beds and patient room at Port Washington, N.Y.-based Drive DeVilbiss.

San Francisco-based Grand View Research reports that the growing trend in sedentary lifestyles, physical inactivity and unhealthy food habits are the contributing factors responsible for the high incidence of obesity and resulting growing demand for bariatric products. Moreover, the Institute of Health Metrics and Evaluation reports about 30% of the global population is either obese or overweight.

“Based on industry analysis, we anticipate the momentum to continue for at least the next several years,” Oberle said.

For Drive, overall bariatric bed business has increased 40% just since 2015 and ancillary bariatric patient room product sales have increased as well, Oberle said. Within the bed category, he said demand for beds with weight capacities between 750 and 1,000 pounds has risen by more than 30%.

Additionally, Drive has experienced double-digit year-over-year growth in the commode, walker, canes/crutches and rollator categories and “we believe that will continue,” said Chad Mathon, director of product management for mobility.

Patient assessment

Real progress has been made in understanding the specific needs of bariatric patients, Doherty said, which has advanced the critical process of home and accessibility assessments.

“A person in this group may be able to ambulate through a doorway and in some cases may have to shift redundant tissue to make it through the door,” he said. “However, that same individual seated in a wheelchair correctly configured for their width may not have the same capability with the wheelchair. HME providers that have a home access division within their business can be more successful in meeting the comprehensive needs of this bariatric population.”

In mobility, seating and support is crucial and “every effort must be made to support and protect the entire body properly,” Ernst said. Careful measurements and planning for future needs are also critical, he said, because the average lifespan of the product is five years and potential problems must be considered.

“It is not just 'bigger' all around, but rather custom modifications that truly fit the patient to the product,” he said. “Just because someone fits in a seat does not ensure comfort or proper support. Extensive measurements and modifications are required for all but the most basic bariatric need.”

Oberle advises providers to “look at bariatric patients holistically by providing products and services that will maximize their abilities to live independently and help them overcome the limitations of their size and weight. A single bariatric product may only address a single need and providers must conduct an overall assessment to determine the products that are needed to help their patients live better and more functionally independent lives.”