Bariatric market expands with America's waistline

Tuesday, January 31, 2006

YARMOUTH, Maine - Spend a few minutes with Dr. Kevin Huffman, a board certified bariatric physician, and you'll soon realize--if you haven't already--that America's obesity epidemic holds tremendous business opportunity for HME providers. Unfortunately, it comes with an equally tremendous cost to the healthcare system. Obesity produces a host of co-morbidities: diabetes, hypertension, joint disease, sleep apnea and heart disease, to name a few. A good chance exists, researchers project, that by 2020 every other person in the United States will be obese--30 pounds or more above their ideal body weight. Today, 10 million Americans belong to that club; an additional 129 million Americans qualify as overweight--10 to 30 pounds above their ideal weight. Huffman, who has consulted with Invacare's bariatric division for about two years, talked to HME News recently about the obesity epidemic. Here's what he had to say.
HME News: When it comes to obesity, is the root cause, as we hear so much, that people are eating too much and not exercising enough?Huffman: In most cases, you need to have some genetic propensity, and in addition to that you need the excessive calorie intake that the typical American has and the sedentary lifestyle. That is what has gotten us in trouble in America. The genetic pool hasn't changed over the last 100 years. What has happened in our society is that we've become more sedentary and our calorie intake has gone up.
HME: Do people have misconceptions about obesity.
Huffman: Yes. The general public and even primary care doctors will see someone who is overweight and say stop eating and exercise, and that is the extent of the advice. Well, if that worked we wouldn't have 129 million Americans overweight. It is more complicated, and you have to treat it more extensively than just saying: Quit eating and exercise.
HME: Are some people more at risk of becoming obesethan others?
Huffman: The stereotype is someone who has a poor education or is lazy, but that is not the case. There is no higher prevalence in the uneducated then there is in the educated. If you look at the socio-economic distribution, it is the low socio-economic and the very high socio-economic that are more likely to be obese. With the high end, it is the availability of resources to live that sedentary lifestyle and have access to any food they want. In lower socio-economic, it appears that having limited resources, they tend to gravitate to fast food. Some of them live in environments where they can't go out and exercise. There are propensities, as well, in certain ethnic groups. African American females have a high rate. Latinos have a higher rate of obesity than Caucasians.
HME: What are the special needs of these patients when it comes to home medical equipment?
Huffman: I used to go out and see my patients at their homes, and they couldn't get into a bed because the bed wouldn't hold them so they stayed on the couch. There are patients who are 800 to 900 pounds who need help with mobility. Almost 90% of the patients going in for (bariatric) surgery have sleep apnea.
HME: Do you see a role for the HME provider in the treating and servicing of the bariatric population?
Huffman: Yes, I do. A lot of these people do not go to physicians because they are either too large to get out of their house or are uncomfortable going into a physician's office. Most of these patients avoid the physician's office until a crisis. But the home healthcare people have access to them and see them and know what is going on. They are already in their homes delivering products and services. These folks have a real good opportunity to help these patients with their other needs. They may say there are walkers for them or (other) equipment that can help them get off the couch or diabetic testing supplies. I think home health care will have the greatest impact on the obesity epidemic.
HME: Do you see the rate of obesity slowing down eventually?
Huffman: We think so. Look at what is happening with lung cancer: We expect that next year for the first time since the 1960s, when we began the education process, to see a dip in smoking deaths. But we started campaigning 40 or 50 years ago against smoking. We just began campaigning for obesity and healthy eating awareness in the last 10 years. It is going to take time to get the vending machines out of the schools and physical education back in so that in 20 to 30 years we'll begin to seeit taper.