Bariatric Rehabilitation Challenges

• Both men and women in the U.S. are approximately one inch taller and 25 pounds heavier than they were in 1960.
  
• Bariatric Physical Therapy allows patients of size to receive high-quality rehabilitation treatments.
• Bariatric rehabilitation comes with various challenges that include physical and medical complications, as well as psychological and behavioral difficulties.
• Occupational and physical therapists often face challenges treating bariatric patients due to a lack of specialized equipment and inadequate staff training. 
• Bariatric-specific equipment improves safety, dignity, and rehab outcomes. 

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Bariatric rehab is a consistently growing industry due to the fact that more than 40 percent of U.S. adults have obesity (with over 70 percent considered overweight or obese). This creates a rising demand for bariatric rehabilitation.

Long-term care facilities, or LTCs, and rehab hospitals continue to receive more bariatric patients. It should not come as a surprise that many of these adults who are overweight are more susceptible to being injured and requiring rehab treatment.

What is Bariatric Rehabilitation?

Bariatric physical therapy is specifically designed to help patients of size recover from a surgery, a medical incident, or to improve their quality of life while contending with a chronic medical condition. It involves creating personalized exercise plans to improve cardiovascular fitness, increase strength and endurance, and regain mobility.

Bariatric rehab combines tailored exercises, nutritional counseling, behavioral therapy, and medical support, all intended to improve physical, mental, and functional well-being while also promoting long-term sustainable weight loss.

Integral components of bariatric rehabilitation include postoperative rehabilitation to address mobility, weakness, and long-term lifestyle changes. 

Primary Challenges of Bariatric Rehabilitation 

Bariatric rehabilitation comes with significant challenges due to the complex medical, physical, and psychological needs of patients of size. Multiple factors account for the difficulties in rehabilitating bariatric patients. Larger patients tend to develop more frequent and severe medical complications.

Key difficulties include ensuring safety with specialized equipment, addressing nutritional deficiencies, and overcoming high rates of psychological distress and weight regain.

Barriers to successful bariatric rehabilitation include limited space, high financial costs, and the need for personalized, multidisciplinary support.

Here are some of the main challenges that come with bariatric rehab for occupational and physical therapists by category. 

Physical and Mental Complications

Slow Recovery and Complications 

Patients who are overweight typically experience a longer recovery time. They are also at higher risk for complications such as internal hernias, anastomotic leaks, sepsis, and peritonitis.

Physical Limitations

Pre-existing joint discomfort, muscle weakness, and low physical fitness make early mobilization quite challenging.

Respiratory and Circulatory Issues

These include, for bariatric patients, a high propensity for obstructive sleep apnea, obesity hypoventilation syndrome, venous thrombosis, and pulmonary embolism.

Skin and Wound Care

Patients carrying extra weight are susceptible to skin infections in deep tissue folds, excessive sweating, and wound infections, which are common in the early postoperative period (often within the first 10 days).

Infrastructure and Care Resources

Specialized Equipment Needs

Rehabilitation requires bariatric-specific equipment, such as bariatric assistive devices, as well as reinforced walkers, larger beds, and specialized lifting devices. These types of equipment can be hard to find and access for many LTCs and hospitals.

Staffing Challenges

There is no getting around the fact that increased staff is necessary when treating a bariatric patient in rehab. An LTC facility must bolster its staff in order to provide safe, daily care of patients of size, especially during patient transfers. Without doing so, you place your employees at risk for musculoskeletal injuries.

Psychological and Behavioral Obstacles

Mental Health Struggles 

Among bariatric patients, there tends to be a high prevalence of depression, anxiety, body image distortion, and, in some exceptional cases, an increased suicide risk.

Unrealistic Expectations

There can be dissatisfaction expressed if the weight loss does not match expectations, or if excessive skin creates discomfort and limits physical activity.

Weight Regain

More than half of bariatric patients may experience weight regain within two years, brought about by returning to old, unhealthy habits that include overeating and lack of exercise.

In essence, key difficulties in treating bariatric patients during a rehab regimen include managing severe co-morbidities, ensuring safety with specialized equipment, addressing nutritional deficiencies, and overcoming high rates of psychological distress and weight regain. 

Potential Solutions to Bariatric Rehab Challenges 

Proper Equipment 

Having available equipment at your rehab hospital or LTC facility bariatric assistive devices or any type of reinforced, high-capacity equipment will help to ensure that your patients of size are receiving the best quality rehab services. Examples of this type of equipment include the following:

Safe Patient Handling Devices, such as ceiling-mounted lifts and wider slings that allow for safe transfers and reduce the injury risk for both patients and clinicians.

Motorized, multi-functional platforms which combine several rehab tools into one, such as the Barihab™ S2S Standing Frame with its sit-to-stand technology, integrated weight-bearing scales, and digital feedback for more efficient therapy.

The Barihab™Series of Treatment and Assessment Platforms Cater to the Needs of Bariatric Patients

Barihab™’s range of products offers patients with limited weight-bearing tolerance the right physical therapy equipment to facilitate a swift and comfortable rehabilitation from their surgeries and chronic medical conditions. The Barihab™ Treatment and Assessment Platform combines several rehab tools into one versatile, all-in-one solution. Its hand-controlled sit-to-stand technology, integrated partial weight-bearing scale, adjustable components, and real-time digital feedback ensure patients experience comfort, elevated confidence, and faster progress.