Obesity and Architecture

March 2018

If you've been to your doctor's office, hospital, or medical clinic lately, you may have noticed a few new things in the waiting room; namely, large, oversized chairs that look like they might be love seats. These are bariatric chairs designed to support more than 300 pounds of evenly distributed weight. Good healthcare and skilled nursing design includes making sure that obese patients will maintain a sense of dignity during their visit. This means not having to struggle to get in and out of chairs and that bariatric seating blends in with the other furnishings in the room. This ensures bariatric individuals will feel comfortable physically and emotionally.

Skyrocketing Rates

Our nation's obesity epidemic is at an all-time high. The Centers for Disease Control and Prevention states that almost 40 percent of American adults and nearly 20 percent of adolescents are obese. This is the highest obesity rate ever recorded for the United States.

What is Obesity

The most commonly accepted method of identifying bariatric patients is the body mass index (BMI), a formula currently accepted by the U.S. Department of Health and Human Services (DHHS). According to the BMI, being overweight is defined as having a BMI of 25.0 to 29.9. Obesity is defined as having a BMI of 30 or higher. Morbid obesity is typically defined as being 100 pounds or more over the ideal body weight or having a BMI of 40 or higher. The BMI is a simple calculation of the height of an individual divided by his or her weight.

You may be wondering what this has to do with architecture. Here's the answer:

With the increased rate of obesity, architects must incorporate design solutions that not only accommodate obese individuals, but also minimize the risk of workplace injury to those caring for these patients. These accommodations include such things as wider doorways, additional space for larger, heavy-duty beds (the maximum weight a standard hospital bed can handle is 350 pounds), heavy-duty toilets, bariatric chairs, and the addition of lifts, which may be freestanding or mounted on the ceiling. Many obese patients have limited mobility, and may be unable to leave their bed without the help of a mechanical device. In new construction, architects must design the structural support with this lift equipment in mind.

Shortage of care available

Hospitals routinely discharge patients to skilled nursing centers for the final stages of their healing. For obese patients, finding a facility that will take them is extremely difficult. Many times, they are left stranded at the hospital.

We recently visited a senior living center that was built in the late 1960s. The administrator said that she gets at least 2 or 3 calls a day asking if they admit obese patients. She said she has to turn them away because they are unable to accommodate them. Many obese seniors find themselves turned away from nearby senior living facilities simply because that facility does not have the necessary equipment and staff to care for them.

Most skilled nursing and rehab centers are simply unprepared to care for the increasing number of morbidly heavy patients. They are lacking in adequate staff, equipment, and knowledge. They also lack the funds to provide care as accommodations for obesity are very costly. Many care facilities cannot afford to care for them as a mechanical lift (those with lift tracks on the ceiling) can cost up to $10,000 and extra-wide beds $5,000. Architects must design specially outfitted wings for these patients/residents.

Even though obesity rates in the United States are at an all-time high, there is good news. Based on an article by Scott Kahan, MD, MPH:

• We now have a national dialogue on obesity. With this open dialogue come new treatments and how to mount an effective approach.
• We recognize obesity as a serious health problem rather than a cosmetic issue.
• There is easy access to more information about obesity and resources than ever before.
• More primary care doctors are helping their patients implement strategies for weight loss.
• The public and private sectors are on board. Governments, communities, schools, organizations, and even the food industry are working to address the policies, settings, contexts, and environments that set the stage for weight gain and obesity.
• Significant research, advocacy, and policy discussions about weight bias are now occurring daily.

Read the entire article by Scott Kahan: http://scottkahan.com/is-obesity-a-public-health-achievement/