Disabled Who Are Obese Face Rising Healthcare Costs

The writer, who has cerebral palsy, discusses the difficulties faced by disabled people who require specialized medical equipment and the difficulties they face from insurance companies

October 30, 2012 -- Since 1994, the obesity rates among children with cerebral palsy (CP) have doubled. This is because such children, who received inadequate nourishment in utero, or were seriously ill when very young, continue to eat nutrient-dense foods after they are out of medical crisis.

I have CP, and typify the former norm, being of low weight for a woman of my height. I am beginning to present something of a challenge to the medical profession, who are accustomed to treating bariatric patients, including those with other disabilities. Often their equipment, such as patient lifts and commode chairs, is designed for individuals much larger than I.

I became particularly aware of this after a physical therapy session during which the therapist, unable to locate the sling ordinarily used to transfer me, substituted one with a weight capacity of 800 pounds. Many times smaller than that, I lay, rather than sat, in this sling, and nearly fell through the bottom.

Of course, those with CP are not the only people with disabilities to face obesity. The disabled, among them those who become significantly impaired later in life, through accident or injury, are 58 percent more likely to become obese. This is true for those with cognitive, as well as physical disabilities, because of the difficulty in mobility that accompanies many cognitive impediments. Collectively 36 percent of the disabled population in America is obese, as opposed to 21 percent of the population without disabilities. Obese people individually incur a cost of $1,429 each year, and, as a group, generate $147 billion annually in healthcare costs. The disabled who are obese account for $44 billion of this.

Standard wheelchairs—those made for people who weigh 300 pounds or less — cost between $5,000 and $7,000, depending on individual manufacturer-suggested retail price, and other adaptive features. Bariatric wheelchairs—those designed for people whose weight exceeds 300 pounds, and may reach 600—may cost more than $14,000. This doubling in price exists for medical equipment of all types, including:

  • Bariatric canes: $70

  • Bariatric walkers: $300

  • Bariatric shower and commode chairs: $1,000+

  • Bariatric patient lifts: $2,000-$6,000

  • Bariatric beds: $1,000-$4,000+

These vast expenses likely arise from the need to build sturdier medical equipment designed to support more weight. It stands to reason, then, that the cost of maintaining or repairing such equipment would rise correspondingly. Many people with disabilities, whether or not they experience obesity, encounter resistance from their health insurance companies which are often unwilling to pay for the repairs, changes or replacements. As the cost increases, the insurers even hesitate more, and the larger and sturdier a piece of equipment, the more expensive it will be.

Meanwhile, an obese person who loses weight and can then use standard equipment will see a marked decrease in their medical equipment expenses.

But how does a morbidly obese person with an unrelated disability lose weight, if the conventional methods of exercise and a healthful diet are ineffective? The National Institute of Health recommends bariatric surgery only as a last weight-loss resort for those without disabilities. But for those with other conditions that limit their mobility, or affect their nutritional intake, and thus preclude traditional exercise or restrict their diet, bariatric surgery may be the only resort.

Dr. Emma Patterson of Oregon Weight Loss Surgery has performed bariatric surgery on disabled patients, and her clinic offers patient lifts and personal care equipment to assist those with mobility challenges. For the convenience of deaf patients, she contracts with sign language interpreters.

Bariatric patients face greater odds of developing health problems related to their weight, including, cognitive challenges, resulting from constriction of blood vessels in the brain, Patterson said.

FOR MORE INFORMATION

Bariatric Medical Equipment. (n.d.). QuickMedical®: Medical Equipment and Supplies. Retrieved October 1, 2012.

Disability and Obesity. (n.d.). Centers for Disease Control and Prevention. Retrieved October 1, 2012.

Hutcher, Neil. Cost of Weight-Loss (Bariatric) Surgery. (n.d.). Retrieved October 1, 2012.

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