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

Posted by Nathan Sheffer on Mar 08, 2024

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 the right bariatric diaper 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 measurements/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 who require a product fitting a larger waist size.

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 made plus sized diaper, and fitting product to fit a wider range of waist sizes, 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 bariatric adult diapers, there are many product attributes and features to consider. With the growing demand for bariatric products, there are also many popular 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.

Tranquility now offers a 3XL pull-on style underwear to help with bariatric incontinence, made for those who prefer the feeling of underwear vs. tape-tab briefs. Whether an individual prefers a pull-on underwear style or a brief is a matter of personal preference.

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, specifically 4XL-5XL. Most pull-on style underwear only go up to size 2XL.

However, Tranquility is proud to offer pull-on style underwear that is made in 3XL. 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.

Tranquility briefs and underwear help contain bowel incontinence and urinary incontinence. Our bariatric briefs can hold up to 34 fl. oz. of liquid, helping to keep bariatric patients comfortable and dry all day and all night.

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 when shopping for a bariatric diaper or bariatric brief.

Middle-aged Couple


Breathability is one product feature to consider in a bariatric brief. Many disposable products have breathable side panels, whereas fewer products are 100% breathable.

The importance of breathability is that it allows excess 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. It can be helpful for those with bowel incontinence and/or urinary incontinence as it provides additional coverage and make wearers feel more secure. Certain wearers prefer this high-rise fit in their bariatric briefs, 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.

Wondering what are the best bariatric diapers? We hear that a lot! That's why we created the top-rated bariatric diapers preferred by customers – a helpful list of the most loved bariatric diapers currently available in the market. Explore our selections for the most favored adult diapers here:

See Now


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

Related Articles