Living large may be the easy life for some, but for the growing number of morbidly obese Americans life is anything but.

For years furniture and fixtures designed to help the extremely obese get around and get comfortable were scarce. And what was available often was prohibitively priced and marketed mostly to health care facilities.

But recently more medical equipment companies have brought so-called bariatric equipment closer to the mainstream. That’s because the morbidly obese population is growing faster than any other segment of the obese population, estimated at about one-third of American adults.

Nearly 5 percent of American adults were morbidly obese in 2002, up from less than 3 percent in 1991, according to the Centers for Disease Control and Prevention.

Morbid obesity is defined as having a body-mass index (BMI) greater than 40. A normal adult’s BMI is less than 25.

Though companies have expanded or reinforced car seats, bathroom scales, beds and even toilets to match the average American’s growing girth, such modifications generally aren’t sufficient for the extremely obese.

Bariatric equipment includes toilets rated to 1,500 pounds, beds built to hold 1,100 pounds, even something called a “trapeze” that helps people who weigh 1,000 pounds turn over in bed.

“People aren’t buying these products as luxuries. They’re necessities,” said Jerry Hutchens, owner of MedicalProductsDirect.com. “Nobody wants my products. They have to have them.”

For Linda Purdy, a cane made the difference between being housebound and having a life. Though she’s now lost 200 pounds, two years ago she weighed nearly 430 pounds and even getting up for a glass of water was difficult.

“It made me feel like I had a bit more stability,” the 40-year-old Manchester, N.H., resident said. “The knees were a bit weak. I probably should have had a walker, but at 37 years old I just couldn’t do it.”

Though medical facilities are buying more bariatric equipment, it is the home market that has the industry scrambling.

Gary Epstein, a marketing analyst who has studied the obesity industry, says that change likely is due to a growing recognition by the obese and by manufacturers that extreme weight is a lifestyle, not just a medical condition.

As equipment becomes more affordable and more stylish, people increasingly buy it for themselves – from $18 nail clippers with long handles to oversized beds and chairs that cost thousands of dollars.

Retailers report that sales for institutional and home use are about even. And though bariatric equipment represents a tiny fraction of items sold, it frequently accounts for a disproportionate percentage of sales.

For many customers it’s a matter of buying a bit of dignity.

“It’s the simple things that we take for granted, such as being able to bend over and cut your toenails,” said Kevin Robison, a specialist in bariatric equipment sales at Knueppel HealthCare Services in Milwaukee, Wis.

“You can imagine what it’s like to be 35 years old and having to call someone to clip your toenails.”

As items are redesigned to be more attractive and better suited for the home, the stigma of buying heavy duty items is reduced, said Shawn Garber, a bariatric surgeon and spokesman for the Association for Morbid Obesity Support.

The Internet also has reduced the stigma. Specialty retailers, such as Amplestuff.com, which sells small car steering wheels to give large drivers more room, make purchasing more private.

And the growing capacity of the equipment has opened the market to more people, industry officials say.

“At one time it was kind of a one size fits all,” said Steven Cotter, president of Gendron, an Archbold, Ohio-based manufacturer of bariatric equipment. “It was kind of like a 500-pound weight capacity in this width will have to do.”

That left out anyone who exceeded the limit.

Helping those purchases along is a drop in prices (some beds now cost thousands of dollars less than just a few years ago), and a growing willingness by insurance companies to pay for bariatric furniture in the home.

But for some, especially the poor and uninsured, the changes aren’t enough.

Bariatric furniture remains expensive. Beds still can run more than $11,000, scooters $3,500 and recliners $2,500. Even canes and step stools can cost hundreds of dollars.

Linda Purdy’s brother, Richard, is a 558-pound computer consultant from Keene, N.H. He complains that while special chairs and beds (he breaks a regular bed at least every three years) would make life easier, he simply can’t afford them.

At his last job, the company bought him a $1,400 bariatric office chair. But now he’s self employed and money is tight. The only seat he could afford that would hold him isn’t really even a chair – it’s an oversized plastic cooler.

“It’d be great if I ever went to the beach. I’d bring my office chair with me,” he said. “The least expensive office chair I think was $795 for one that was rated to 550 pounds. (Thin people) can go in Staples and get one for $99.”

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On the Net:

Association for Morbid Obesity Support: http://www.obesityhelp.com/

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EDITORS: J.M. Hirsch covers food and diet for The Associated Press.

AP-ES-09-04-04 0946EDT