How to Choose a Plus-Size Bariatric Diaper: Extra Large Adult Diapers Guide

Posted by Nathan Sheffer on Jun 29, 2023

How to Choose a Plus-Size Bariatric Diaper: Extra Large Adult Diapers Guide

Table of Contents

Currently, over 44 million Americans have some level of incontinence or loss of bladder control. For adults who are heavier, the risk of incontinence is higher. Recent data shows that there are approximately 18.6 million adults who are both obese and incontinent. While being categorized as obese and experiencing incontinence does not mean that plus-sized or bariatric adult diapers are needed, many individuals who are over 250 lbs benefit from bariatric products.

Bariatric adult diapers

What Are Bariatric Diapers?

Bariatric diapers, also known as bariatric briefs, are adult diapers with tabs that are specifically designed for individuals who are heavyset. These products typically fit waist/hip sizes of 64” - 108” and a general weight measure of over 250 lbs. Bariatric diapers are usually described by sizes of 2XL-5XL. Many bariatric briefs feature a superabsorbent core, stretchy side panels and other features that make them ideal for heavier individuals.

History of Bariatric Diapers

In 2002, Principle Business Enterprises (PBE), the manufacturer of Tranquility Products and a proud partner of Comfort Plus, introduced the first bariatric diaper to address the need for larger-sized absorbent products. In fact, Comfort Plus founder and long-time owner, Martha O’Neill, was introduced to the need for larger disposable products from customers she served in the Southwest U.S. Martha shared this feedback with PBE, and a new Tranquility product was created. Initially, Tranquility incontinence briefs were widened by hand-gluing additional side panels onto each product. Over time, PBE purchased the first bariatric manufacturing equipment that began producing briefs with multiple panels on each side to stretch around the body. In 2019, Tranquility furthered its efforts on serving this market by launching the largest incontinence product on the market, sized at 4-5XL and fitting wearers with a 70" - 108" waist.

Why are Bariatric Diapers Needed?

Bariatric-sized adult diapers are needed for several reasons. First, to properly manage incontinence with an absorbent product, sizing and fit are critical. Without a properly sized and fitting product, accidents and leakage become a regular occurrence. Additionally, a product that is too small or too tight is uncomfortable to wearers and can lead to skin damage.

For years before the development of Bariatric Diapers, plus-sized children and adults with loss of bladder control often managed incontinence using a catheter or “open-air” management along with an absorbent underpad. In “open-air” incontinence management, the person experiencing incontinence does not wear a disposable brief or underwear, rather, they sit or lay on top of an underpad and allow the underpad to absorb any urine or stool. This practice is both a concern for the wearer’s dignity and quality of life, and could lead to potential skin health and infection issues.

Another reason for bariatric disposable products is the demand for larger products and the increased likelihood of incontinence for heavier individuals. While not all who classify as “obese” wear bariatric-sized incontinence products, 27% of people who are “obese” experience incontinence. This is partially due to the fact that the risk of incontinence increases by 20% for each 5-unit increase in Body Mass Index (BMI). In America, about 42% of the population is categorized as obese, meaning a BMI over 30 ( learn more about BMI and obesity here). With over 18 million adults with obesity and incontinence, the need for bariatric products is evident.

Additionally, there are situations in which bladder or bowel control challenges cannot be treated surgically due to the patient’s weight. Therefore, absorbent products are used for incontinence management while the patient works to lose weight in order to be eligible for various surgeries that may resolve the incontinence or the condition that is causing incontinence.

What to Look for in Bariatric Diapers

When looking to try or buy a bariatric diaper, there are many product attributes and features to consider. With the growing demand for bariatric products, there are also many brands of products to consider.


The most important aspect of any bariatric brief, or most absorbent products in general, is finding the proper size. Without wearing the correct size, leaks and accidents are almost inevitable. A secure and proper-fitting product will allow better absorbency, improved comfort and minimized leaks. Bariatric diapers are usually described by sizes of 2XL-5XL. Most 2XL products, the smallest of bariatric products, start with a waist measurement of 60”. If you or the person you care for has a waist measurement of less than 60”, it’s likely you should look into XL-sized products, as bariatric sizes are not always needed for plus-size individuals. On the other end, 5XL is the largest size disposable brief on the market, fitting up to a 108” waist.

How do you know your waist measurement?

How to Measure adult diapers

Use a tape measure to measure in inches the widest part of your body between waist and hip. This number is used to determine the product size.

You can use this sizing guide to help understand waist/hip measurement to identify absorbent product sizing.

Adult Diaper Size Guide for largest size

Sizing is not always perfect; the sizes shown are recommendations, not a guarantee.


Larger-sized disposable products are currently only available in tab-style briefs. Most pull-on style underwear only go up to size 2XL. For children and adults with waist sizes over 80”, tab-style briefs are the product style available. For more details on style, read How To Choose Incontinence Products: Adult Diapers & Underwear from our partners at Tranquility.


Another important aspect to consider when purchasing a bariatric disposable product is the level of absorbency it offers. For those who wear disposable products or care for someone who does, the type of incontinence experienced and the amount of urine or stool typically lost in an episode will help dictate the amount of absorbency needed in an incontinence product.

For some, bladder loss is very light. A few drips and dribbles when laughing or exercising. For others, there may be no bladder control and full urinary episodes occur. This is often referred to as heavy incontinence. With heavy incontinence, it is critical to identify and purchase bariatric diapers that are highly absorbent. This may require sampling a few products to understand how absorbent they are and test them for your needs. Some product manufacturers clearly state the absorbent capacity of their products while others do not. This often causes confusion and challenges for wearers and caregivers in identifying which products are the most absorbent.

Additional Product Features

After considering the size, style and absorbency of bariatric products, there are a number of product features you may want to consider.

Middle-aged Couple


Breathability is one product feature to consider. Many disposable products have breathable side panels, whereas fewer products are 100% breathable. The importance of breathability is that it allows moisture vapor to escape the product while keeping fluid trapped. This air circulation allows for better skin health and is often more comfortable for wearers. In instances where an individual may be immobile or have limited mobility, breathability helps keep the skin healthy and reduce the risk of irritation.

Refastable Adult Diaper Tabs

Refastenable Tabs

Tab-style disposable diapers tend to have two types of tape-tabs. One is single-stick tabs, meaning they secure just one time when placing. Alternatively, refastenable tabs can be removed and refastened for a more secure fit. Wearers and caregivers prefer refastenable tabs as they are more flexible and often more secure, to allow for a degree of error when placing – since they can be replaced if not perfect the first time.


Leg Cuffs

Legs cuffs, also referred to as leg gathers or leg guards, are small “walls” just outside the absorbent core of disposable products. These cuffs keep urine or liquid stool from escaping the absorbent core and channel fluid back into the product. Legs cuffs are designed to minimize leaks at the leg openings for fewer accidents and better product performance.

Higher Rise

High-Rise Fit

Some bariatric diapers feature high-rise waistbands, meaning they provide fuller and higher coverage in the front and back to assure a better fit and improved comfort. Certain wearers prefer this high-rise fit, while others don’t find it necessary. This product feature is primarily a personal preference.

Adult Diaper Wetness Indicator

Wetness Indicator

Wetness indicators are printed lines that go around the disposable product and change color when wetness is present. The purpose of wetness indicators is to help wearers and caregivers know when the product needs to be changed. Wetness indicators not only signal when it’s time for a product change, they can also help to reduce waste by ensuring caretakers only change the product when it is necessary. Read more about wetness indicators, their importance of them and how they work.


The most popular brands of bariatric diapers are Tranquility, Tena, Prevail and Unique Wellness.

Based on information from our customers, below are the three most preferred bariatric diapers.

Air Plus Bariatric Adult Diapers

#1: Tranquility® AIR-Plus Bariatric Brief

Since being improved and re-introduced in 2019, the Tranquility AIR-Plus Bariatric Brief has quickly become the most popular bariatric brief because it is the largest disposable product on the market. Sized at 4-5XL, this product fits wearers who are over 250 lbs with waist measurements from 70” - 108”. It is also popular because it is 100% breathable, has a generous 34 oz of absorbency and features refastenable tabs. With a wetness indicator and Kufguards ® (leg cuffs), wearers and caregivers love all the product features and associated benefits.



Hi-Rise Bariatric Adult Diaper

#2: Tranquility® HI-Rise Bariatric Brief

Another very popular product is the Tranquility HI-Rise Bariatric Brief. The primary difference with this product compared to the AIR-Plus Bariatric Brief is that it is slightly smaller, fitting waist/hip sizes 64” - 96” and only the side panels are breathable. It also has 34 oz of absorbency, refastenable tabs, wetness indicator and Kufguards® (leg cuffs).



Tranquility Bariatric Brief

#3: Tranquility® Bariatric Disposable Brief

Another popular bariatric diaper is the original Tranquility Bariatric Disposable Brief. It is an identical product to the HI-Rise brief but without the high-rise front and back. Depending on the preference of wearers and caregivers, this bariatric brief offers the right coverage and comfort. Between these three bariatric briefs from Tranquility, our plus-size customers find great comfort, protection and absorbency so wearers and caregivers can properly manage bladder or bowel loss.


Check out the video below to learn more about these popular Tranquility Bariatric Briefs.

Bariatric Adult Diapers Video


Nathan Sheffer

Nathan Sheffer

Nathan is a Gerontologist who currently works as a Content Marketing Specialist for a leading continence care product manufacturer. He has worked in the healthcare industry for nearly 10 years, including the last four years focusing on incontinence-related educational content.

For more information or questions about this article, please call Comfort Plus at 1-888-656-8055 or email

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