Date of Award


Document Type



College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Robin Narruhn


Brianna Woodruff


Background: Large-bodied people make up the majority of the American population, but healthcare providers are rarely taught specific techniques and strategies for management of their care and medical spaces are designed with furniture and equipment that does not accommodate large bodies. This alienation has resulted in a measurable detriment to the population’s mortality and morbidity, such increased mortality of 60% from experiencing weight stigma and over 50% high combined cancer death rates as compared to the rates of those with normal BMIs (Sutinet al., 2015; Calle et al., 2003).

Objective: This project will examine the evidence about weight stigma, efficacy of weight loss methods, investigate the large-bodied community’s experience of healthcare, and create an anti-weight stigma educational simulation for nurse practitioner students.

Methods: Data was gathered using an online survey of self-identified fat/overweight/obese/large-bodied individuals experience with healthcare, in addition to published literature on the large-bodied patient experience, to create a high-fidelity educational simulation in accordance with the International Association for Clinical Simulation and Learning (INACSL) guidelines and with expertise of the Seattle University Clinical Practice Lab.

Results: Based on the survey results a simulation of a routine wellness exam for a large-bodied mid-thirties assigned female at birth individual was developed with potentially stigma affirming care pieces of weighing the patient, armed patient chair in the exam room, a “normal’ sized blood pressure cuff, a usual sized patient gown, patient exam table, physically examining the patient, and provider communicating the exam with the patient.

Implications: The simulation created is one tool to help address weight bias and stigma. Due to the non-evidence supported nature of weight loss recommendations there is much more extensive anti-weight stigma and bias work needed for medical education and provision of care to be equitable.

Included in

Nursing Commons