don's report archive

by Donald B. Ardell, Ph. D.

Wellness in the Headlines
(Don's Report to the World)

True of false – the following statement is an urban legend: Hospitals are struggling to accommodate all the obese patients who can’t fit into imaging machines whose excess girth renders ultrasound nearly useless.

Before I give you the answer, here is another statement. True or false? Some hospitals in several American cities must transport elephantine human beings to zoos in order to obtain needed X-rays.

The latter is an urban myth; the former is true. However, since 30 percent of all Americans are obese, even the second statement sounds plausible. That is why it is a popular rumor still widely circulated. The Harvard doctor who researched both rumors said that while “gargantuan veterinary scanners at zoos have not been used to date, they may be needed if Americans get much bigger. (See “Caught by Surprise: Size Matters,” David Ollier Weber, H&HN News.) 

Increases in obesity levels among the American population have had a big impact on the medical system, especially hospitals. Diagnostic imaging, for example, is not practical for the 15 million Americans with body mass indexes of 40 or more, or who have BMI’s around 30. These are “obesity thresholds” for such testing. Consider: CT and MRI scanners have a diameter of only about two feet. Even if the images were not distorted by layers of adipose tissue, as they are, how could technicians insert 300 to 400 pound patients into these constricted, donut-hole devices? The image quality of ultrasound scans degrades dramatically when used on obese patients, rendering diagnoses of abdominal pain, gallstones, kidney stones and other GI issues much more difficult.

Here is a partial summary of added costs directly attributed to the expansion of overweight hospital patients since 1980, when only half of all adult Americans were overweight and only one in five was obese. 

• Larger and sturdier surgical tables must be purchased for operating rooms. 
  
  
• Routine procedures no longer are routine; on the contrary, they are more complicated and perilous  (for example, larger incisions, operations require more time, etc.).
  
  
• Beds and mattresses must be purchased to support up to 1,000 pounds.
   
• Overhead lifts are required.
  
  
• Special toilets, sinks and shower seats must be purchased that can support at least 600 pounds without buckling.

Obese people are less healthy. Half of all patients have three or more chronic conditions. According to the H&HN story cited above, “for every 20 pounds they are over ideal weight, health care costs rise by $400.”

What else could be done, other than to spend more money on the higher incidence and costs of obesity? Can a way be found to halt the rise in obesity levels? Regrettably, the answer to these questions seems to be nothing and no, respectively.

In a nutshell or a few words, the answer seems to be “not much.” For a complex of reasons, primarily involving cruel genetic fates combined with a high fat, sedentary culture that does not place much stock in disciplined lifestyles, the chances most have of choosing and sustaining behaviors consistent with staying trim and well seem somewhere between slim to none. Ok, maybe that’s too harsh. How about slight to non-existent?

In the next essay on this theme, I’ll explain why “I can’t do it” seems to be the fate of most obese Americans.

(Note: This essay will be filed in the archives in the PHYSICAL DOMAIN under the skill area of exercise and fitness. Additional articles related to this theme may be found there.)

(Ed. Note: Views expressed in this and other columns are those of the author and not necessarily those of the SeekWellness Editorial Board.)

 Send e-mail to Don Ardell