Nowhere is this trend more apparent than in the bariatric seating marketplace. As a rule, bariatric furnishings should be built to a much higher standard due to the enormous workload that they must endure every day. Not only are they sat upon, climbed upon, rocked side to side and picked at from every angle (as all healthcare furnishings are), they are also inundated by the very patients that they are designed to serve; excessively obese individuals. Often this is the worst mistreatment that they will face and, frankly, many models that are offered today cannot stand up to the abuse, despite claims to the contrary by manufacturers.

Consider the following: On average, a person exerts one and a half times their body weight in force as they sit down into a chair: this is known as "shock load". Though some are rated much higher, the typical bariatric chair is rated to support 500 lbs. If a person who weighs 400 lbs. happens to sit down in an average bariatric chair the force that they are exerting (600 lbs.) is much greater than what the chair is designed to support. The initial danger of failure here is obvious, and with each use this risk is increased due to repetitious abuse. Unfortunately, many purchasers are only interested in the weight rating of a chair, erroneously believing that if the chair states that it will hold 500 lbs., then it will hold a person that weighs 500 lbs., which it clearly will not…at least not safely.

This dilemma stems from a lack of knowledge on the purchasers behalf. Frequently, it is a surgeon, or even a nurse (these positions typically have the most patient interaction and, therefore, a better understanding of equipment needs) that will shop for the chairs and make the call to purchase them. Unfortunately, many of these people do not have the time to invest in proper product research and, to date, the bariatric seating industry is sorely lacking a standardized product testing methodology, as well as an easily accessible means of posting test results for buyers to reference. Without a trustworthy standard, medical professionals (who are perpetually short on time) are often forced to purchase products based solely upon the manufacturers’ claims of capability.

Due to the growing inadequacies in bariatric furniture and the lack of proper testing, I have two pieces of advice for potential bariatric seating customers: First, know what constitutes a quality product before you begin shopping and, second, ask as many questions as possible during the sales process. This will help keep your sales person focused on your project and will work to discourage him or her from making claims that their product cannot live up to.

To differentiate between a superior product and one that is a sham you must have an understanding of some major elements in a sound piece of bariatric furniture. First consider the frame. It is advisable to steer clear of wood furnishings as they are typically not as sturdy as steel framed chairs due to their joints; typically simple mortice and tenon joints supplemented by glue. However, even if a steel framed chair is chosen, be sure that the steel is of an adequate gage (generally 16 gage or lower), as well as of a sufficient diameter (typically 1 ¼" or more; though some are less due to heavier gage steel and/or other chair reinforcements). Also be sure to ask your sales rep about the welds on the chair. As a rule, box welds feature better holding power than spot welds and should be used. Second, consider the chair cushions and their foundations. Great fun could be had elaborating on foam but, to keep things simple, ensure that your chairs have extra thick, high density, 100% urethane foam. This will ensure that the full weight of the occupant is not rested upon the cushion foundation, which should also be of greater thickness than an average chair. Most chairs will feature engineered wood seat cushion foundations and should be at least ¾" or more in thickness. Finally note the hardware used in the construction of the chair. All screws, nuts, bolts, etc. must be of sufficient grade to withstand the heavy abuse that they are likely to endure during their use in the chair. All of this information can be acquired from your sales rep, so be suspicious of anyone unable or unwilling to answer your questions promptly and thoroughly.

Next, delve into the testing process that is used by the manufacturer to determine whether or not it is sufficient for your application. I would advise asking the following questions:

1. What methods and/or devices were used to test this piece of furniture?

2. What was the maximum static load that the chair withstood during testing?

3. Were any of the tests cyclic and, if so, what was the load on the chair during these tests?

4. How were the chairs tested for side load capabilities? Be certain to also ask how much weight was applied in both the cyclic and static side load tests.

5. Can official documentation of this testing be provided?

By asking these questions you are gaining crucial insight into the true durability of the chair. As mentioned earlier, there is no standard methodology concerning the testing of bariatric chairs so you will have to determine, by asking these questions of each of the manufacturers whom you are considering, who is testing their products the most rigorously so that you may have confidence in your purchase.

You may find that some manufacturers test their furniture to what seems like unreasonable extremes. Keep in mind that the chairs will be subjected to very high static weight loads as well as proportionately higher shock loads for their entire lifetime. Therefore, they should be considered equipment, rather than furniture, so the testing should seem excessive. Also, during your comparison shopping, you may encounter BIFMA (The Business and Institutional Furniture Manufacturer’s Association) which is, according to www.bifma.org, "a not for profit trade association of furniture manufacturers and suppliers that have associated to address issues that are of common concern". Of these concerns, proper testing of products is of high importance, hence the BIFMA Standards that so many furniture manufacturers wear on their sleeves. The testing that furniture must endure is adequate for furniture that will experience typical use from average sized individuals, however it is not rigorous enough for furniture that is intended for use by obese patients. Unfortunately some bariatric furniture providers advertise the fact that their products pass these tests, leading consumers to presume that they have been sufficiently tested and are safe for use with obese patients. This is a very dangerous presumption. Ineffectually tested bariatric furniture runs a higher chance of failing when it matters most; when a patient attempts to use the piece.