A qualitative evidence synthesis: Perspectives and experiences of medical fatphobia

The fat liberation movement has advanced alongside research that highlights fat people’s experiences in medical settings and exposes how weight-based discrimination is embedded in healthcare. A growing body of research shows that fat people assigned female at birth (AFAB) not only deviate from outdated health metrics like BMI, but also fall outside societal beauty standards that equate slimness with health. As a result, fat people AFAB are medically perceived as “failures” and incapable of making their own health decisions. Moreover, studies suggest that weight-focused medicine is not only ineffective at leading to weight loss, but can lead to worse health outcomes such as cycles of weight loss/gain, distraction from other health concerns, and weight stigmatization leading to chronic social stress. Scholars also argue that weight-based discrimination reinforces other types of oppression, such as racism, classism, heteronormativity, and transphobia. Despite the documented failure of current medical approaches to weight, few studies have aggregated qualitative research on fat people AFAB’s realities and perceptions in healthcare settings. By deconstructing patients’ lived experiences, this qualitative synthesis lays the groundwork for improved medical and public health efforts designed to meet fat patients AFAB’s needs. Four overarching analytical themes emerged while conducting this qualitative synthesis: 1) the experience of hyper(in)visibility among patients; 2) neoliberal values shaping weight-focused care; 3) the labeling of patients as a “burden”; 4) patients coping with and combating discrimination. This paper suggests concrete ways to address stigma and better incorporate perspectives from fat people AFAB into future research and interventions.