It’s a rare day when Richard Drake turns down a dead body, but last week, he had no choice.
At 6-foot-1 and 350 pounds, the deceased in question was simply too big for the Cleveland Clinic Body Donation Program, which provides specimens for anatomy classes at the Lerner College of Medicine and elsewhere.
“Someone that’s shorter and carrying a lot of weight, that is a problem,” said Drake, director of anatomy and a professor of surgery. “The storage is one issue, but when you are obese, there’s a lot of tissue everywhere. The students don’t get as good a learning opportunity.”
Reluctantly, Drake informed the dead man’s family he’d have to turn down the donation request because their loved one exceeded the size limits for medical research.
“They understood that, because, actually, they had tried a few other places,” Drake said. “They were sort of checking around.”
In a country where more than a third of adults are obese, the impact of extra weight extends, it seems, even beyond death.
Officials at some whole body donation programs in the United States tell msnbc.com they’ve turned away corpses that are too fat for scientific study. Others say the bigger issue is that potential donors simply don’t sign up once they learn of weight limits that can be as low as 170 pounds, but generally top out at 300 pounds.
“Family members, or the person themselves, sometimes they’re a little taken aback,” said Stephen D. Anderson, coordinator of the Willed Body Program at the University of Louisville School of Medicine in Kentucky. “They didn’t assume there were any restrictions.”
That surprise could be a problem, considering that a 2004 Johns Hopkins School of Medicine study found that about half of adults surveyed would consider donating their bodies to science.
But officials at the university-affiliated programs that supply perhaps 10,000 to 15,000 dead bodies each year to the nation’s nearly 140 medical schools say that weight and height limits are an unavoidable part of the process.
“The embalming process adds considerable weight. Generally, a 250-pound person might weigh 350 to 400 pounds when embalmed,” said Richard Dey, professor and chairman of the Department of Neurobiology and Anatomy at West Virginia University in Morgantown. His program receives about 275 bodies a year and turns away at least a few.
To be frank, bodies taller than about 6-foot-4 or heavier than about 300 pounds simply don’t fit on the trays that are sometimes stacked six high in the coolers where the deceased are kept, experts say.
It can be difficult for technicians to handle huge corpses, which have to be lifted and transferred frequently, often by slim technicians or students, said John Lee Powers, curator of anatomical materials at the Brody School of Medicine at East Carolina University in Greenville, N.C. That program limits donors to between 170 pounds and 180 pounds, though an exceptionally tall donor might be allowed at 190.
“It’s the maximum our equipment will handle,” Powers said.
There’s also the educational aspect to consider. Donated bodies are used primarily for first-year anatomy students, who need to learn how the human body is supposedto look, said Ronn Wade, director of the Anatomical Services Division of the University of Maryland Medical School in Baltimore.
“In a perfect world, they’d like to have a perfect body with perfect anatomy — or near perfect,” said Wade, whose program is among the largest in the nation, with a peak donation of some 1,800 bodies a year.
Studying obesity and other pathologies can come later, once students are familiar with the basics, he added.
Obese bodies are more difficult, time-consuming and unpleasant to study, said Wade, who also heads his state’s anatomy board.
“Basically it’s having to get at the structures you want to see,” he said. “Between the skin and the rest, there’s layers and layers of fat cells.”
Only about a quarter of the bodies Wade receives meet the ideal criteria, he said. Perhaps 5 percent of them are morbidly obese.
Wade generally doesn’t reject them outright. But they won’t be used by medical students in first-year classes. They might wind up as clinical specimens used for practice by paramedics or other medical professionals. Some obese bodies can’t be used at all, so they’re simply cremated and the remains are returned to the families — without ever serving any research purpose.
So far, medical schools are still able to get enough lean bodies for students to use, experts said. Some programs use corpses from for-profit tissue brokers, which are loosely regulated and supply an unknown number of bodies each year.
Still, considering America’s growing girth, some experts are worried about the future.
Anderson, the director of the University of Louisville program, says he can’t use about 10 percent of the 175 to 200 bodies donated each year because of size problems.
He said he’s thought about upping the program’s weight limit from 200 pounds to 250 pounds to ensure a steady supply.
“If we keep it at 200, we may see that we’re turning down potential donors because of that,” he said.
Having to turn down any willing donor is a shame, said Drake, the Cleveland Clinic expert who is also an officer with the American Association of Anatomists. He doubted the family of the 6-foot-1, 350-pound man would find a program to accept his remains. Instead, they likely had to make other arrangements for the man’s disposition.
“It is an emotional thing,” he said. “People really do want to do this.”
That was the case for the mother of Tara Parker-Pope, a New York Times health reporter who recently wrote about the struggle to lose weight and keep it off, both in her own family and in the population at large.
“My mother died of esophageal cancer six years ago,” Parker-Pope wrote. “It was her great regret that in the days before she died, the closest medical school turned down her offer to donate her body because she was obese.”
Those who leave their remains to science tend to be sensitive folks interested in enhancing the public good, said Wade, the Maryland expert who has promoted whole body donation for more than 35 years.
At the end of a life perhaps spent struggling with weight, learning they’re too heavy to fulfill those altruistic wishes can be devastating.
“It’s kind of another stigma,” said Wade. “They kind of feel victimized.”
