Hosts: Mignon Fogarty and Adam Lowe
Transcript: This episode originally aired December 27, 2005
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Mignon: One thing that has really come out in the last few weeks is that not only is obesity a problem for long term health, but it's also becoming a problem just for doctors trying to deliver medical treatment to patients. There are now so many overweight people that doctors are starting to have problems delivering just regular medical care.
For example, there was a story that was pretty widely circulated, where (a small study , only 50 people), found that only 25% of patients in the study who got an injection into their buttocks actually receive an intramuscular does of the drug they administered.
In this case it was only a placebo, but a lot of important drugs are delivered by this route.
And perhaps even more alarming, the needle didn't reach the muscle in any of the women in the study. Not one. Not one woman got a dose of the drug, presumably because women, you know, we have a little more padding down there.
Adam: And for people to understand, the reason why they do those intramuscular injections is that muscles have a really incredible blood supply. So it's a very good way to get drugs into the blood supply very quickly. Fat tissue doesn't have a very good blood supply, so it really goes against what you are trying to do with an intramuscular injection if it goes into the fat tissue. Instead it doesn't get where it needs to go.
Mignon: And it can even cause an infection in some cases if it gets into the fat tissue because it lingers there.
Adam: It's pretty amazing to think that so many people aren't getting injections into their muscles. And it probably wasn't that long ago that physicians began doing intramuscular injections, and I think it is an indication of how much obesity has grown in the population in not that long a period of time.
Mignon: One thing I heard as a recommendation in the stories was that doctors might consider using longer needles, or perhaps giving injections somewhere other than the buttocks where it is easier to reach the muscle.
Adam: What happens if you are a skinny person and you get one of those long needles.
Mignon: Ow!! It's goes all the way to your bone?! Doctors are going to have to be more careful about individualizing treatment, not in terms of personalized medicine, but just in terms of what size needle they choose.
NEXT: Obesity is a problem for radiologists too.
Mignon: Then I did some investigation and I found that injections aren't the only problem. In fact, radiologist have been struggling with how to deliver good care to obese patients for quite a while. It's been a hot topic at the annual meeting of radiologists for at least the last couple of years.
There was a doctor this year, Dr. Raul Uppot, who is an assistant radiologist at Massachusetts General Hospital and a radiology instructor at Harvard University Medical School, and for the last couple of years at this annual meeting he's been talking about how the scanners, so MRI machines and CT scanners and some kind of ultrasound machines aren't big enough for obese people who are coming in for medical care. And he says he''s talked to technologists who do the scans, and that they run up against this problem every single day. And it's frustrating for patients too because they can't fit into the machines, they can't get the scans they need.
And he's talked to venture capitalists who see that the market of obese people is undeserved and therefore a market opportunity.
Adam: And probably also because these are obese people they probably have more health problems.
Mignon: That's right they may need these scans more than most people.
Adam: It's really frightening that again the percentage of people who are obese is growing and just the extent of obesity within those individuals seems to be going up and up.
Mignon: Right. In fact, obesity surgery is the fastest growing area of elective surgery in the abdomen.
Adam: And it is pretty incredible because I think there are quite a number of risks associated with surgery that people go to such extent to try to deal with their obesity problem.
Mignon: There are. Dr. Uppot also pointed out that not only is it these scanning devices, but hospitals are also having to purchase larger wheelchairs and bigger beds. It's effecting a lot of different areas of health care. For example, he said that a typical CT table can't hold someone who weights more than 425 pounds and a typical MR unit can't hold someone who weights more than 325 pounds. You know, these people who are quite obese I think are still a minority of the obese population, but that is a growing population.
Adam: In more ways than one.
Mignon: Yeah, in more ways than one.
NEXT: A BETTER WAY TO MEASURE OBESITY
