EVERETT, Wash. -- Funeral homes and the Snohomish County medical examiner's office are having to find larger equipment like cots and power hoists to accommodate a growing number of deceased obese people. The trend has led to the use of bigger cots, larger cremation and embalming facilities, and more staff and power hoists to properly care for overweight people who die.

"It's very important that you treat the deceased with dignity and respect," medical examiner spokeswoman Carolyn Sanden said.

About 22 percent of adults in Washington are obese and another 36 percent are overweight, according to the Centers for Disease Control and Prevention. Nationwide, an estimated 33 percent of adults between 20 and 74 years old are obese.

"It's not unusual to encounter 300-pound people now, which used to be the exception rather than the rule," said Jim Noel, who has worked 47 years in the funeral home profession and is executive director of the Washington State Funeral Directors Association.

In Snohomish County cases investigated last year, the medical examiner provided the weight of 326 people, with 84 adults considered obese based on their body mass index, which takes into account height and weight. Fifteen weighed more than 300 pounds, and a 6-foot-tall, middle-aged man weighed 499.

Injuries to workers removing and transporting heavier bodies have cost an average $16,000 a year since 2003, according to staff reports to the county council.

This year the medical examiner's office has requested spending $75,000 for an on-call body transport service. That will allow the county's seven medical investigators to focus on investigations, case work and going to new calls.

The county also has spent $18,000 in recent years on larger tables and electric hoists because the older, smaller tables couldn't accommodate rolling a body over for examination.

"To accommodate the larger body, we needed the larger table," county Medical Examiner Dr. Norman Thiersch said.

Electric winches are used to pull heavy bodies from stretchers into investigation trucks. Nylon straps and hoists help transfer bodies within the medical examiner offices.

Devices also protect the bodies from unintended damage, which can offend families or obscure evidence of crimes or disease.

Special equipment is needed at funeral homes, too, said Noel, noting that roughly two-thirds of people in Washington state are cremated after they die.

Funeral homes sometimes must contract for larger cremations, said Mark Hunstman, managing director at Solie Funeral Home and Crematory in Everett.

First Call Plus of Washington is often called when bodies reach about 300 pounds.

"We have the equipment to handle these morbidly obese folks, the decedent remains and the expertise in cremating them," said Jerry Webster, who owns the Kent-based body removal, cremation and embalming company.

He has cots -- worth about $4,000 -- that can carry a 1,000-pound body, as well as tables sturdy enough to hold larger bodies.

Webster has seen where families have bought custom-sized caskets, and the family of one 784-pound woman had to buy three cemetery plots.

"Our hope and goal through everything is that a large person is handled in a dignified and respectful manner regardless of their size," Webster said.

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