Anti-Fat Attitudes in Healthcare

Background: Anti-fat attitudes and weight-based discrimination are well documented as pervasive in western society. The dominant medical narrative of weight serves to maintain the assumption that weight is wholly within an individual’s control. As such, fat people are discriminated against and blamed for their ill-health. The nation’s weight has gained further attention as a result of COVID-19 placing significant strain on our healthcare system. The current pandemic serves as another example of how fat people are discriminated against and seen as lower priority for care in comparison to others.
Aims: To consider the public’s awareness and views about these issues, and whether there would be public support for future policies seeking to mitigate weight discrimination in healthcare.
Method: Employing a critical realist approach, this study used qualitative methods of engaging twelve participants in semi-structured interviews. Interviews were analysed using Thematic Analysis.
Results: Two main themes were identified. ‘Social Representations of Weight’ which considered the way that fat people are spoken about and the dominant narratives in our society that shape public views. The second theme, ‘Intersections with Services and Systems’ captured the moral and conceptual dilemmas involved in the prioritisation of healthcare and discrimination that fat people face.
Conclusions: Findings highlighted the complex, yet flexible views that people hold in relation to fat people accessing healthcare. There was an awareness of
the negative effects of discrimination on access to healthcare, and the inequity of this. Participants held contradictory views simultaneously; oscillating between
the consideration that an element of discrimination is unavoidable, and possibly acceptable in some instance, whilst stating that discrimination is unethical, and
that healthcare is a human right. The findings offer the hope that perhaps antifat attitudes are not as fixed as previous research indicates. Additionally, that there may be public support for policy change and the possibility of weight becoming a protected characteristic.