Obesity Stigma in Anatomy and Osteopathic Manipulative Medicine
Authors: Hall Shelby , Reynolds Amberly 
Published: May 2022

Weight stigmas are discriminatory ideologies targeted towards individuals because of size. Medical students are not immune to bias and prejudiced treatment of patients by physicians is often a result of stigmas.1 Medical students must confront bias so as not to compromise appropriate medical care. Given the holistic approach of osteopathic medicine, osteopathic medical students should be trained on biases and how to best mitigate them. Several studies have focused on overcoming weight stigmas but with marginal success2,3. Weight stigmas arise in several medical school courses including anatomy and osteopathic manipulative medicine (OMM). Data show medical students perceive cadavers with excessive weight as “difficult”, “unhealthy”, and “evoking disgust”.4 Although these studies do provide information regarding weight stigmas in medical schools, the limited focus on osteopathic schools is what garners interest. The purpose of this study is to assess how obesity stigma arises in OMM, a course reliant on surface anatomy.

An extensive literature review was conducted for body and weight stigma in OMM, producing no results. Further investigation into body and weight stigmas in OMM will occur through a survey of first and second year osteopathic medical students. A sample of the survey questions:

‐Do you feel BMI is a valid measure for overall health?

‐Do you feel the Osteopathic Manipulative Treatment you perform on an athletic individual would be the same quality and as treatment performed on an overweight individual?

‐Do you have concerns about treating overweight patients with OMM?

Analysis of survey results will be available by presentation time.

Current results include qualitative observation, and following are some of our resultant data:

‐Faculty members commenting on a student used for an OMM demo as being “fit and athletic”

‐Students expressing concern about difficulty finding anatomical landmarks on an overweight student

‐Observations that the largest student in the class was not chosen quickly as a practice partner

Future directions of this study following survey results could lead to curricular changes that address weight stigmas or prevent them to uphold the tenets of osteopathic medicine and its commitment to holistic care and inclusivity. Based on data from the CDC, the average male’s BMI is 26.6 and the average female’s BMI is 26.5; therefore, the average patient physicians treat is overweight. When medical students begin practicing with obesity stigmas, the effective and empathic care of patients is compromised. Something must be done to reverse the stigma and even prevent the stronghold it could occupy in future physicians. Action can be taken in the both the anatomy and OMM labs.

Phelan, S. M., Burgess, D. J., Yeazel, M. W., Hellerstedt, W. L., Griffin, J. M., & van Ryn, M. (2015). Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. obesity reviews, 16(4), 319‐326.

Wiese, H. J., et al. (1992). Obesity stigma reduction in medical students. International journal of obesity and related metabolic disorders: journal of the International Association for the Study of Obesity, 16.

Alberga, A. S., et al. (2016). Weight bias reduction in health professionals: A systematic review. Clinical Obesity, 6.

Goss, A. L., et al. (2020). The “difficult” cadaver: weight bias in the gross anatomy lab. Medical education online, 25(1), 1742966.