On one hand, we have to make the world safe for a fatter population, but the more we adjust our world to accept our weight, the harder it is to motivate us to do the healthier thing and lose the weight. If we tacitly readjust our world, in some sense we are responding to reality. At the same time, there is no doubt that making those adjustments makes it easier to live bigger.
—Arthur Caplan, chairman of the ethics department at the University of Pennsylvania School of Medicine ("Plus-Size People, Plus-Size Stuff," CBSNews.com, November 10, 2003)
Along with increased costs, many businesses have discovered that they must literally expand their products and services to meet the needs of overweight and obese consumers. An Associated Press article "Plus-Size People, Plus-Size Stuff" (CBSNews.com, November 10, 2003) described a wide array of products—from scales that weigh people as heavy as 1,000 pounds and steering wheels for drivers who do not fit behind standard wheels to seat-belt extenders and super-size towels—designed to meet the needs of obese Americans.
Service industries have also responded. In "That Tough First Step" (Los Angeles Times, January 26, 2004), Jeannine Stein reported that gyms are reaching out to attract and meet the special needs of people who are overweight and want to exercise. Some provide personal trainers who assist overweight clients to use equipment safely, design realistic exercise regimens, and maintain motivation. Other gyms affiliate with medical centers and health professionals to offer nutritional counseling, support groups, and exercises suitable for people who are overweight, including aquatic exercise programs in pools. Health clubs, gyms, and fitness programs not only understand the health benefits they can offer overweight clients but also the financial benefits they can realize by tapping into this market of people who have previously stayed away from gyms.
There are even new food emporiums that cater to the needs of people seeking to lose weight. Shops that offer a broader range of low-carbohydrate food products than generally available in local supermarkets are opening throughout the country. Jane Allen described the proliferation of stores that sell reformulated versions of "forbidden" high-carbohydrate foods in "Shops for the Low-Carb Set" (Los Angeles Times, January 12, 2004). The first low-carb retail outlet opened in 1997 in Boca Raton, Florida, and according to LowCarbiz, an online trade publication, a new store opened every other week in 2004. The shops stock low-carbohydrate bagels, muffins, pancakes, pasta, tortillas, cake mixes, and macaroni and cheese, as well as sugar-free sweets, puddings, and low-carb cheesecakes. Allen noted that many first-time shoppers are shocked by the high prices of these specialty foods—a bag of salty snacks can cost $5 and a cream-filled cake may cost as much as $9. High prices for low-carbohydrate food products and declining interest in low-carb diets during 2005 closed many low-carbohydrate food emporiums and prompted others to expand their inventories to include other diet foods, including those formulated for low-fat and low glycemic impact regimens.
According to the NPD Group, a market research firm, in 2000 women spent more than $17 billion on clothing sizes 16 and up, a 22% increase from the previous year. NPD data revealed that plus-size fashion grew 4% to 6% from 1997 through 2001 while growth in the balance of the apparel industry has hovered around 2% to 4%. Liz Claiborne was one of the first designers to lend her name to a full-figure line, Elisabeth, in the late 1980s. Other fashion houses, including Tommy Hilfiger, Ralph Lauren, Dana Buchman, Marissa Christina, and Jennifer Lopez followed. In 2004 plus-size clothing accounted for more than one-quarter of all retail clothing sales for women, and such major retailers as The Gap, Banana Republic, Old Navy, Macy's, J.C. Penney Co., Target, and Nordstrom compete with specialty stores that are exclusively devoted to large sizes such as Lane Bryant and Casual Male Big and Tall.
In 2001 Hot Topic, a California-based company that specializes in stylish clothing for teenagers and young women, launched a chain of six stores called Torrid, that offered fashion-forward plus-size clothing for young women. By 2005 seventy-six Torrid stores offered an array of shiny, sparkly, and frequently revealing clothing and lingerie for young women who wear larger sizes. According to the industry trade group Cotton, Inc., in 2004 about 30% of young women aged sixteen to twenty-four wore at least a size 12, and more than 60% lamented that they could not find fashionable clothing in larger sizes. The popularity of the Torrid chain is easily explained by the growing market it caters to—the NPD group reported that the plus-size market is the fastest growing segment in the apparel industry—up 49% from 2000 and projected to reach $47 billion in 2005.
In "The Widening of America, or How Size 4 Became a Size" (New York Times, January 20, 2004), health writer Jane Brody asserted that Americans' increasing girth has prompted size inflation throughout the fashion and apparel industry. Brody reported that the apparel industry has accommodated expanding Americans by increasing sizes such that women's size 4 in 2004 would previously have been a size 8, and a present day size 8 would formerly have been a size 12. Men's clothing also has expanded with pants that were formerly "regular" now designated as "slim cut" and easy fit, loose fit, and baggy styles to accommodate excess weight.
Demands for larger, sturdier hospital beds and stretchers to accommodate extremely heavy patients, special imaging equipment such as computed tomography scans and magnetic resonance imaging to accommodate obese patients, bigger blood pressure cuffs, recliners constructed to hold 350 pounds, automobiles that comfortably seat obese drivers and passengers, and devices that enable people who cannot bend over to put on their socks and shoes have prompted the design and manufacture of these and other specialty products. Even morticians have observed and responded to the obesity epidemic. In "On the Final Journey, One Size Doesn't Fit All These Days" (New York Times, October 5, 2003), Warren St. John reported that when the founders of Goliath Casket Company in Lynn, Indiana, opened their business in the late 1980s they sold just one triple-wide casket—the largest model they made—per year. During 2003 the company shipped about five of the over-sized coffins, which measure forty-four inches across compared to the twenty-four-inch standard model, per month. David Hazelett, president of Astral Industries, another coffin builder in Indiana, acknowledged the issue and added that the problem affects every aspect of the funeral industry. Hazelett explained that "The standard-size casket is meant to go in the standard-size vault, and the standard size vault is meant to go into the standard size cemetery plot." St. John discovered that hearse manufacturers have increased the width of their vehicles' rear doors, cemeteries have increased their standard burial plot size to accommodate wider vaults, and mausoleums have constructed larger crypts to accommodate oversize coffins.
In an article in the Birmingham (Alabama) Post-Herald (April 19, 2005), Mike Hauser, marketing director of the Ridout funeral homes and cemeteries explained that newer parts of the company's cemeteries now are laid out with wider spaces for graves to accommodate larger bodies. In the case of an extremely large casket and vault, families that purchased a family plot can allow the grave to take up two spaces rather than one. In 2004 the Batesville Casket Company in Indiana, one of the nation's largest casket makers, introduced thirteen new oversized models and now offers a total of fifty-three oversized models. The Goliath Casket Company also has continued to increase the size of its offerings. Sales at Goliath Casket doubled in 2004, and the company anticipated selling 800 "supersized" caskets in 2005. It recently introduced a fifty-two-inch casket—slightly wider than a standard pickup bed size—with extra supports intended for bodyweights between 650 and 1,200 pounds.
Naturally, these oversized accommodations carry additional costs, and as a result some families opt for cremation. For the most severely obese, cremation may not, however, be an option. The executive director of the Cremation Association of North America reported that most crematoria are not equipped to handle bodies weighing more than 500 pounds.
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