A study reveals that an increasingly large number of Americans are too fat to fit in MRIs and have X-rays that lack resolution:
More and more obese people are unable to get full medical care because they are either too big to fit into scanners, or their fat is too dense for X-rays or sound waves to penetrate, radiologists reported Tuesday.
With 64 percent of the U.S. population either overweight or obese, the problem is worsening, but it represents a business opportunity for equipment makers and hospitals, said Dr. Raul Uppot, a radiologist at Massachusetts General Hospital.
"We noticed over the past couple of years that obesity was playing a role in our ability to see these images clearly," Uppot said in a telephone interview.
Radiologists have their own term for it when writing up reports: "These images are limited due to body habitus."
...
"Overall, 7,778 or 0.15 percent of 5,253,014 reports were habitus limited," they wrote in the August issue of the journal Radiology.
"It essentially doubled over the last 15 years," Uppot said.
The researchers looked more closely at the records of 200 of the patients, who weighed, on average, 239 pounds.
"It is a major issue because ... the patient may still have a tumor, the patient may have appendicitis, the patient may have other inflammatory processes," Uppot said.
"This is affecting radiologists all over the country."
Ultrasounds are most affected, Uppot said.
...
An MRI can get a good picture if the patient can fit into the tube or get onto the table, Uppot said. Some manufacturers have started to make MRI machines with larger-bore holes, but with the cost in the millions of dollars per machine, only large groups or institutions can afford them.
That is just sad. I mean it is still a very, very small number of people, but I think not being able to fit inside the MRI should make one an immediate candidate for bariatric surgery.
On a side note, we sometimes use high Tesla magnets to do Diffusion Tensor Imaging (DTI...an imaging way to look at myelin). The magnet is a small bore, so you just put someones head in. Someone in my lab told me the other day that they couldn't use a subject because their neck was too short to put in the hole. They kept getting only the top of her head.
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Add to that the number of nurses who injured their backs while trying to turn those patients...
[disclosure: I have a perseveration with body sizing having grown up morbidly obese. I just recently blogged how I lost those 150 lbs, 25 years ago and kept it off]
I blog about the apparel industry. Without fail, when it comes to the discussion of sizing for the obese, the prevailing attitude (from the public) seems to be that manufacturers OWE fat consumers whatever product it is that suits their needs or a manufacturer is guilty of deliberately insulting or ignoring the heavy consumer. The attitude seems to be that we should be COMPELLED to meet that demand, simply because it exists. I've discussed the associated costs of having to make well designed apparel to fit them but they become incensed at having to pay the higher costs. What it seems to boil down to is that they expect all of us (other normal wgt consumers, manufacturer etc) to subsidize the costs of their obesity. In clothes, they want great clothes but they expect to pay the usual prices thinking the difference only amounts to a little extra fabric (ha!). And I see this in everything (airplane tickets etc, they only buy one ticket but end up taking up half your seat). And if you suggest they pay their fair share, it's construed as discrimination or fat bashing.
I resent subsidizing these costs (75% of health care dollars goes to treating obesity related diseases; smoking costs are only 10%). I think the only solution is to do what has worked with smoking, making obesity socially unacceptable. Obesity imposes costs on everyone else. If it became socially unacceptable to smoke due to imposing costs and health problems on innocent bystanders, the same should hold for obesity. Fat bashing and discrimination has nothing to do with it. No excuses cut it...and I get real tired of people who say they're fat because of genetics because everybody in my family is obese but that didn't mean I had to be as well. It boils down to assuming personal responsibility, period.
Oh boy...here's a serious, but maybe morbid idea:
If companies or the government could subsidize massive liposuction services for obese and overweight American, then we might could solve our dependence on foreign fossil fuels. Bio-Blubber. The fat from lipoed matter can be extracted and converted into Bio diesel. If Australian cattle companies are using the fat waste from cow butchering to fuel their transportation fleet, why can't we trim our American blimpo bodies and save the planet at the save time;)
sad i agree. some patients were being taken to the CT scanner at the city zoo (intended for animals). i don't know if this is urban legend or not, but i'm afraid it's true.
I was under the impression this was scienceblogs.com, not valuejudgements.com.
Blogging about very fat people like they're freak show exhibits, with a snide snigger ("Weird News"?) and faux pity - it's pretty appalling. Even if you believe that it's most fat people's own fault that they're big, would you make a post about how "sad" it is that business owners are forced to install ramps and disabled toilets? Because a hell of a lot of disabled people got that way by their own hand, such as drink driving, diving into shallow water without looking, not wearing a helmet or seat belt, and many other risky activities. Everyone deserves medical care with respect and dignity.
As for the formerly-fat commenter who resents subsidising the extra resources used to make clothing for larger people (and the like): Do people who are fat because of medical conditions or medication side effects have to pay extra for their clothes even though it's not the fault of poor lifestyle? Does a, say, 6'8" slim, fit basketballer who has the same surface area as a 5'2" fat person also have to pay extra?
How about we just have everyone get a special medical certificate signed by two doctors stating the reason for their size, and a measurement of their height, weight, and surface area, and then the sales assistant at the clothing store can charge for the clothing on a pro rata scale. It's the only way to be truly fair.
Ah, there's nothing like the self-righteousness of the ex-smoker, the ex-fattie, the ex-drinker, the ex-whatever's-the-vice-du-jour.
You probably won't believe this but I'm not even fat - no blaming this on some fat person trying to "defend" their size. I'm just sick of the hysteria and moral outrage and bad science everywhere about OH NOS TEH FAT PEOPLE WILL EAT US ALL. I went and did research for myself and discovered, to my surprise, that obesity is nowhere near as unhealthy or widespread as the media would have you believe. The constant focus on people's size as a measure of health is plain old bad science. So there's a study that says "fat people are X% more likely to get disease Y". Now, ask the big science question: WHY? Did the study measure only weight, or did it take into account smoking, drinking, eating habits, exercise habits, environment, stress, mental health, etc? Is it excess adipose tissue in and of itself that causes poor health or is it something else? You'll find that most fat people who have a poor lifestyle, when they start eating better and exercising, will, in the long term, only lose 2 - 10% of their original body weight but will be vastly healthier even if they remain large.
I suggest reading the references listed at http://www.bigfatfacts.com/ for a start on non-hysterical-outraged-mocking research on fat and weight. Try some actual scientific method, not conclusions based on aesthetics and moral indignation.
Let me get this straight: you thought that someone whose width measurements didn't fit the MRI should immediately be a candidate for surgery to mutilate their stomach, but you weren't suggesting any surgery for someone whose neck measurement didn't fit the DTI? Why the inconsistency?
thanks ...
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