The U. S. Centers for Disease Control and Prevention report that 30% of Americans are obese and another 34% are overweight, making almost two-thirds of the population obese or overweight. These numbers have doubled since 1980. Just as alarming is the fact that 3% of the population is now morbidly obese (more than 100 lb. overweight), a number that has quadrupled since 1980.
"The obese now represent the most populous group of people in the U.S.," points out Bruno Kordic, marketing and sales director for the Great John Toilet Co., which is based in Monterrey, Mexico. "If they ever organized, they could elect their own president every time."
Institutional issues
A survey by Novation found that over the last three years 80% of hospitals are treating more obese patients (called bariatric patients in medical terminology) than ever; 40% have altered their procedures to accommodate the needs of obese patients, and 17% have remodeled their facilities to accommodate obese patients. Novation is a supply management company that serves the needs of a number of community-based hospitals, working with suppliers to secure purchasing agreements, which the member hospitals then utilize.
"Hospitals are telling us that some of their obese patients weigh as much as 600 lb.," reports Sandy Wise, senior director/medical services.
One frequent remodeling feature relates to commodes. More hospitals are switching to floor-mounted commodes, which can accommodate heavier individuals.
"Wall-mounted commodes can accommodate patients and visitors up to about 250 lb.," Wise explains. "If someone who is heavier than that uses these commodes, they may come off the wall."
Shifting from wall-mounted to floormounted is not the only issue, though.
"I am also getting a lot of requests for floor-mounted toilets that are wider, longer and deeper, and I am trying to locate some of these," she adds. "In fact, we are having a meeting with our suppliers to emphasize to them that there is a growing need for larger and stronger toilets."
One hospital that has remodeled is Froedtert Memorial Lutheran Hospital in Milwaukee.
"When we remodeled and built new rooms for bariatric patients, part of the remodeling involved replacing wallmounted toilet fixtures with floormounted fixtures," says Lynne Mueller, R.N., clinical materials resource manager.
All the toilets are a little farther away from the wall than the wall-mounted toilets for additional comfort. The primary reason for shifting to floormounted was not comfort, though.
"The main reason was that some of the wall-mounted toilets were coming off the wall due to frequent use by heavier people, including patients, family members and staff," Mueller notes. "The remodeling has also been of benefit to our nurses and other staff, allowing them to take care of these patients more easily."
The hospital is also planning to install a floor-mounted toilet in at least one stall in each staff and visitor bathroom, which will usually be the stall that complies with the Americans with Disabilities Act.
The nation's obesity epidemic spawns new products for the plumbing market.
For facilities that don't want to shift from wall-to floor-mounted toilets to accommodate obese people, there is another option. Bar Industries manufactures a metal toilet support that fits under wall-mounted toilets, providing support to the floor for up to 1,000 lb. Glenn Wright, the owner, says he came up with the idea in his position as chief engineer at a hospital in Atlanta.
"It's not a universal mount," he explains. "We have a different design for each of the major manufacturer's models."
'There is a growing need for larger and stronger toilets.'
Wright, who has been in business for a year, reports that sales have been increasing every month. The company sells direct through its Website, www. bar-industries. com, as well as through distributors.
Residential concerns
Miles Allen, owner of Ray Allen Plumbing in Tyler, Texas, reports that he has a number of obese customers who, when they sit on the toilet, end up falling the last 6 in. or so.
"With that type of mass and acceleration, they're hitting that toilet with more than just their body weight — for some people, maybe up to 1,000 lb. of pressure," he points out.
As a result, Allen has had to replace several toilets because of impact fractures. He is considering the idea of replacing some of these toilets with stainless steel prison-model toilets.
That's just one problem Allen faces. He has a 500-lb. customer whose midsection is very large. When he is sitting on the commode, he can't get his hand within 12 in. of his groin area, which ends up hanging over the front of the toilet by 6 to 7 in., Allen says. As a result, his urine usually ends up on the floor. Allen is trying to find a toilet large enough to accommodate this man's need, one that is about a foot longer in the front and can handle all that weight.
"Someone needs to talk to the toilet manufacturers and tell them to start manufacturing these larger toilets, because this problem isn't going to go away," he says. "In fact, it's only going to get worse."
Some companies are already listening. Aitan Levy, the inventor and designer of the Big John toilet seat, manufactured and sold by Big John Toilet Seat Co., has worked in the plumbing industry since his youth.
His father was a plumber, and Levy worked in plumbing showrooms for years, he says. Customers would occasionally ask him for larger toilet seats, not only obese people, but very large or just tall people, such as athletes.
"One basketball player sat down on a toilet in the showroom and showed me how his knees ended up higher than his head," Levy recalls.
He tried to talk some manufacturers into designing a larger seat, but none of them were interested, so he designed his own. The result is a seat with a larger inside diameter as well as a larger sitting surface, and it is 2 in. to 3 in. higher than traditional toilet seats, complete with durable steel hinges.
"We also have 10-in.-long rubber bumpers that go around the whole seat to completely grip the porcelain and prevent the seat from slipping," he adds.
The product is available for order by calling 866/366-0669 or via the Internet at www.bigjohntoiletseat.com.
The Great John Toilet Co. has gone even further, manufacturing a complete toilet for large people. The company's management comes from a family that has manufactured toilets for 75 years. The length and width of the toilet are larger than standard (26 in. wide and 38 in. from wall to front, including an extra 6 in. length at the front), providing 150% more sitting area than a standard toilet.
"However, it can still be used safely and comfortably by a child," Bruno Kordic notes.
It is also higher, so when obese people fall onto the seat, they don't end up falling as far or as hard.
"While standard height is around 14 to 16 in., ours, when the seat is taken into account, is almost 19 in. high," Kordic says.
It is also built stronger, he adds, to reduce the potential for breakage, using a reinforced structure (ceramic tested to 2,000 lb.). The toilet features additional anchorage points and reinforced steel hinges.
"Despite all of these features, it still meets existing standards for performance and can be installed exactly where a current toilet is," Kordic says. "There are no additional plumbing requirements."
The Great John Toilet was recently awarded a "Best New Bath Product" award at the Kitchen/Bath Industry Show in Chicago. The company offers a residential model and a commercial model, and they are available through almost a dozen distributors throughout the United States.
For additional information, go to www. greatjohn. com, or call 877/268-2396.