By Chris Adams

Dr. Robert Cima sees the impact of America’s obesity crisis in the operating rooms of Mayo Clinic, where changes range from the super-sized instruments doctors use to the XXL-size of patient beds.

It is an often-unexplored consequence of America’s obesity crisis – one that will only get worse in coming decades.

“It has changed and is changing the entire infrastructure of health care,” Cima told journalists at a National Press Foundation obesity training session.

By infrastructure, he means the actual buildings, which will need to be substantially strengthened as more and more patients tip the scales as obese or morbidly obese. While that retrofitting of America’s hospitals is happening in some places, most hospitals have yet to spend the money necessary to prepare for the bigger patients they are going to encounter.

Cima, who is the chair of surgical quality at Mayo, also explained obesity’s impact on his surgical instruments, which must be longer in order to work through the extra inches of visceral fat that heavier patients carry.

Outside the operating room, changes are apparent as well. Wheelchairs are wider to hold patients up to 450 pounds; doorways are wider, in order to get bigger beds through; specialized toilets are bolted into beams, to prevent accidents when patients are in the bathroom.

Hospital staff has to be organized differently as well. At some hospitals “lift teams” are employed to ease the burden on nurses who struggle to help larger patients.