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  1. Gallagher, Susan M. RN, CWOCN, MA, MSN, PhD


In the early 1960s, only a quarter of Americans were overweight. Today almost two thirds of adults are overweight, as are 25% of children. Twenty-five percent of adults are considered obese; 10% to 15% are categorically classified as morbidly obese. Americans spend close to $33 billion annually in attempts to control or lose weight, while $100 billion are spent on obesity-related health problems. Despite efforts at weight loss, Americans continue to gain weight. Some argue that obesity is reaching epidemic proportions. These rising numbers affect health care delivery in a number of ways. Many hospitals report concerns because of inadequate equipment and personnel to accommodate the special needs of larger patients. In the critical care setting, the skin, which is the largest organ of the body, is especially at risk for injury. Demographics of obesity, the meaning of obesity, and factors that place the patient at risk are presented herein. Prevention of skin breakdown and early intervention are discussed.