“This doctor knows shit about you, but the first thing he says is, ‘you need to lose some weight’”: Anti-fat bias and the contradictory effects of fat medicalization in Czech healthcare

The anti-fat bias that is built on the premised principle antagonism between a fat and a healthy body remains entrenched in healthcare. Despite evidence that being fat is conditioned by many factors beyond a person’s control, fatness is often seen as a result of irresponsible behavior and moral failure and fat patients report being exposed to mistreatment, discrimination, and shaming in healthcare. Drawing on semi-structured interviews and written testimonies, we examine the experiences of people with fat embodiment in Czech healthcare contexts and explore how they approach their health, biomedicine, and weight management. Although obesity specialists are trying to address the weight stigma and create a respectful environment, an anti-fat bias dominates in the rest of the Czech healthcare system. Moreover, even if the medicalization of fatness contributes to reducing weight stigmatization in some contexts, it also reinforces the perception of fat as a medical pathology, which, in turn, creates an obligation for fat individuals to seek biomedical treatment. We identify three strategies that fat people employ to minimize their exposure to weight-based discrimination: avoiding all healthcare contexts seeking out younger physicians, whom they find to be generally more supportive and going to great effort to find a doctor with a nonjudgmental approach to obesity. In conclusion, we argue for a more well-being-oriented than weight-centered understanding of human health that will go beyond standardized indicators in favor of more personalized care.