Show of Strength at the Sickbed -- MEDICA - World Forum for Medicine

Show of Strength at the Sickbed

Photo: Hospital staff

Obese people present hospitals
with a challenge; © PHIL

Lever down, car moves up – using a hydraulic ramp is a natural thing for car mechanics. This could also happen to physicians and nursing staff in German hospitals when heaving obese people into bed becomes a standard procedure. This could be the case in future according to Doctor Jürgen Ordemann, assistant medical director at the obesity centre of the Charité Berlin. “Obesity is a global problem and will take on epidemical size during the next years.” This means for hospitals that they have to react. But the oversize equipment and the special treatments for patients with more than a potbelly are expensive.

Staff at the university hospital of Munich is aware of the citizens’ weight development. And that a normal operating table carries about 150 kilos which means that a more stable table is needed when the patient weighs more. The same is true for beds. “A normal sickbed cannot be used electronically when the patient weighs more than 180 kilos”, explains Birgit Müller. In addition, obese patients need special sanitary equipment. “If a patient with 200 kilos sits down on a toilet seat fixed on the wall, it will break”, says the subsidiary nursing director.

Currently the university hospital of Munich has some beds which can carry a weight of 320 kilos. In the next years the plan is to purchase more. Furthermore, widespread plans exist for the hospital to deal with an increased turnover of obese patients. Details, especially to the financing, are not official yet. At the Charité the situation is similar. To act is important, says assistant medical director Ordemann. But he also does not wish to comment the financing.

The fact that hospitals have to prepare for more and more obese people is proven by many studies. For example, the International Association for the Study of Obesity (IASO) has shown that three quarters of men and more than half of the women in Germany are overweight, a part of it is obese. This means that German people are the fattest in Europe. And in the offspring generation the tendency is similar. According to reports of the Robert-Koch-Institute (KIGGS) about 15 percent of children and teenagers between three and 17 years are overweight, about six percent of them are obese. This is twice as much children and teens as in the eighties or nineties.

But despite this development many hospitals do not realise the demand to act. At the university hospital of Halle no plans for a conversion of buildings exist. "The equipment is only a few years old and complies with modern standard", says the press office. The university hospital of Heidelberg has a similar opinion: "Currently the treatment of people with “normal” overweight is not a problem. Some beds can carry a weight up to 250 kilos. In extreme cases there is the possibility to rent special beds." At the University of Dresden obese patients are seen as an exception – also for the future. There would be no need for action to expensive rebuilding measures of the hospital in the next years, so the press spokesman.

However, Dr Jens Aberle from the obesity centre of the university hospital Hamburg Eppendorf (UKE) thinks that no hospital can avoid treatment of obese patients in the future. “Preventive measures do not achieve everyone in the population. After the horse has left the barn it's too late to close the door. Than hospitals have to act compulsorily.” It would make sense to built own wards for obese people. This would be profitable in multiple regards: “Obese patients are among themselves and feel less stigmatised than in a normal ward”. Furthermore expensive conversion of the house can be used by many patients. Another advantage: Special educated physicians of interdisciplinary fields could work there. The reason: obese people often have concomitant diseases like high blood pressure or diabetes.

The UKE will change in a new building at the end of the year and prepares to the future: 16 operating tables than will carry about 250 kilos, even one up to 500 kilos. “Sooner or later not only hospitals have to react, but also physicians in general”, says Aberle.

Simone Heimann