Tuesday, July 25, 2006

Chubby Americans have one more thing to worry about: The obese are getting short shrift at checkup time. Extra pounds are compromising proper medical diagnosis.

Flab is interfering with X-rays, ultrasound imaging and other high-tech diagnostic tools, according to a study released yesterday by researchers at Massachusetts General Hospital (MGH), Harvard Medical School and Emory University in Atlanta. It found that the number of inconclusive test results because of “patient size” has doubled in the past 15 years.

“Americans need to know that obesity can hinder their medical care when they enter a hospital,” said Dr. Raul N. Uppot, lead author and a radiologist at MGH.

The study analyzed the number of incomplete X-rays, magnetic resonance imaging (MRI) and other diagnostic reports at MGH with the telltale label “limited by body habitus.” Indelicately translated, the phrase means the patient was simply too fat to fit in — or on — the machine.

In 1989, 10 percent of images were inconclusive because of patient obesity, Dr. Uppot said. By 2003, despite improvements in technology and imaging techniques, the number was 20 percent.

An estimated 66 percent of adults in the U.S. are overweight, obese or morbidly obese, according to the Department of Health and Human Services, causing hospitals to “feel the strain,” the study noted. Wheelchairs, beds, operating tables and imaging equipment can no longer accommodate hefty patients.

The researchers found that abdominal ultrasounds posed the greatest challenge for doctors with bulky patients, followed by chest X-rays , abdominal computerized tomography (CT), abdominal X-rays, chest CT and general MRIs. In some cases, faulty images required repeat testing, more power output or a stronger dose of radiation for success.

“In the short term, the medical community must accommodate these patients by investing in technology to help them,” Dr. Uppot said. “In the long term, this country must make cultural shifts that promote more exercise and a healthier diet.”

The study will be published in the August issue of Radiology.

Meanwhile, the World Bank has estimated that 12 percent of our national health care budget goes to treat obesity-related illness.

Another hospital study released last November found that standard needles were no longer long enough to inject the buttocks of 92 percent of women and 44 percent of men — because of extra fat. And emergency medical crews across the country must spend extra money on reinforced gurneys and retooled ambulances — some costing up to $250,000 each — for the hefty.

The challenge doesn’t end there. Auto, casket, office furniture, bed and even toilet manufacturers are increasing size and strength of their products to accommodate what the industry terms “big users” or “ample people.” Many airlines are rethinking both cabin dimensions and fuel budgets after a study released earlier this year by the American Journal of Preventive Medicine revealed that airlines spend an extra $275 million annually to get overweight passengers airborne.

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