Also known as anti-fat, is the implicit and explicit bias of overweight individuals that is rooted in a sense of blame and presumed moral failing. Being overweight and/or fat is highly stigmatized in Western Culture. Anti-fatness is intrinsically linked to anti-blackness, racism, classism, misogyny, and many other systems of oppression.

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Anti-fatness contributes to individuals not receiving adequate healthcare for a number of reasons, 1) the assumption is if someone is overweight they cannot be healthy, 2) clinical care teams typically lack experience in treating diverse body sizes, 3) weight related structural barriers, e.g., size of exam tables, gowns, blood pressure cuffs, and scale limits.

Fatphobia rears its ugly head


Dictated by celebrity influence and social media, body types have cycled through society just as fashion trends do. However, people have been slow to label this trend as what it really is — fatphobia. How is the new generation of young people supposed to grow up in an environment where standards of beauty seem to change daily? With body checks showing off one’s figure popping up on explore pages of TikTok, and fitness influencers constantly posting content telling people that they don’t look good enough, fatphobia has been on the rise. It has invaded so many of our society’s daily practices that it might seem normal for celebrities to take diabetes drugs as weight loss aids. This practice is far from normal, though, and it has started to cause widespread issues for people who actually need these drugs to survive.

Ozempic, or semaglutide, is used as a treatment for type 2 diabetes because it helps to regulate blood sugar, preventing it from skyrocketing to dangerously high levels. According to the Center for Disease Control, more than 30 million Americans have type 2 diabetes. Without insurance, Ozempic costs up to $200 a month, but as demand increases, and supply remains the same, the cost can increase significantly. Typically, this medicine is only available with a prescription, but as we know, celebrities and other wealthy people find loopholes in medicinal processes. When non-diabetic people are prescribed this medication to lose weight, it reduces available supply for type 2 diabetics who need it, forcing them to pay more for the drug out of pocket. While the use of Ozempic isn’t the huge issue that it’s made out to be — considering the medical and legal loopholes one has to jump through to obtain it — it is a sign of a larger problem.

Losing weight to a degree that fits society’s standards is often impossible and entirely unhealthy — the same is true with the use of Ozempic. According to a 2017 study done by researchers Maya Vadiveloo and Josiemer Mattei on perceived weight discrimination, it was found that discrimination can lead to physical health problems such as diabetes, as well as mental health issues such as anxiety and depression. The same research paper also mentions another study conducted with findings that reflected dissatisfaction with one’s body shape due to exposure to media and ads that promote being thin. In other words, fatphobia has become more of a reflection of one’s own insecurities than of judgements about others. Social media has forced us to constantly look at and compare ourselves to others, regardless of how little we know about their wellbeing, personality, feelings or background.

The most prevalent examples of celebrities encouraging this trend? The Kardashians. Kim Kardashian most recently wore a dress to the 2022 Met Gala that had been tucked away for more than 40 years. The dress was designed for Marilyn Monroe, a woman of a different time and stature. Kardashian was criticized for losing more than 20 pounds in just a few weeks to fit into the dress, and many called her out for promoting unhealthy, fast, weight-loss trends. She set a poor example for the millions of people that tuned in to the gala across a multitude of platforms. Yet again, social media reigned supreme in spreading news of an unhealthy habit and only added fuel to the fire of fatphobia. However, this issue became prevalent long before the rise of social media.

Many of us remember the tabloids of the early 2000s that contained pictures of celebrities at the beach not looking as “camera-ready” as they did on a movie set, or the “10 tips for weight loss” headline bolded across magazines in every grocery store check out aisle. What these tabloids labeled as catching celebrities “in the wild” really body shamed them and put unrealistic expectations on young, impressionable children just tall enough to read the headlines at eye-level. Now, these kids are in colleges across the country, and fatphobia has once again come to collect its penance.

“ As long as our society continues to be built around certain body types and other discriminatory practices, there will always be something that can be improved.”

In some ways, it seems that society itself is a reflection of a weight-stigmatized world. When we sit down and analyze everyday parts of life, like clothes or transportation, they appear to cater to people that fit a certain body type. Consider the times you have been out shopping at a mall or even online and have only seen sizes as large as a 12, or maybe a 14, despite the fact that per CNBC, approximately 70% of American women wear clothing in sizes 14 or larger. According to Refinery29, plus-size clothing consists of women’s items above a size 16 — which most typically corresponds with an extra-large — although this cutoff is contested by different sources. In a world that is clearly catered to thin people, it’s no wonder that numerous studies have shown internalized weight stigmatization. Platforms like TikTok and Instagram have begun to curate algorithms that highlight people — primarily women — that serve as an example of unattainable beauty standards. Mainstream media platforms know their audiences and how to market products; those products have simply turned into a lifestyle of being skinny. Influencers on these platforms that have millions of followers are projecting their own negative self images onto impressionable audiences.

However, influencers, other celebrities and large brands have started to push actual body positivity movements forward. Take the rise of plus-size models as an example, both in product modeling on websites and on the runway. Brands like American Eagle and Victoria’s Secret are including plus-size models on their main pages now, rather than delegating separate pages for them on their websites. It is high time for brands to market to the majority of consumers, rather than feeding into the destructive narrative of fatphobia. As long as our society continues to be built around certain body types and other discriminatory practices, there will always be something that can be improved.

TikToker Brittany Tilander Called Out The Bachelor’s Racism & Fatphobia. Your Move, Bachelor Franchise


Meanwhile, the virality is a double-edged sword; Brittany is encouraged by Fleiss’s reaction and the support across multiple social media platforms (even Reddit), but she also expresses frustration at the idea that viewers wanting fat contestants is novel. “It’s something that’s been talked about for a really long time,” she says. She is hopeful, however, that the humor in her delivery will be enough to spark the conversation anew. “I was lucky that it was funny enough to catch their attention, and maybe if I can, like hack into them with humor, then maybe something will change."

Another positive sign: one day after speaking with Brittany, a casting producer from The Bachelor, Chelsea Mièle, slid into her DMs to ask if she’d like to formally apply for the next season. It was all too fitting that she posted yet another successful TikTok video (using a sound clip from Euphoria) supposedly assessing why her boyfriend won’t support her going through with the casting process.

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Brittany admits that she had no real intention of trying to be cast on the show but was curious to learn more about the casting directors’ intentions. So much advice given to fat people and dating revolves around the idea that the magical key to ending fat marginalization is “confidence” and “self-love,” and Brittany notes that that perspective feels like they are “shirking the responsibility” of providing an environment that makes fat people comfortable to apply. She also compares the situation as a whole to how much public outcry and criticism it took for there to be a Black lead; meanwhile multiple white contestants who’ve taken pictures in Blackface have been cast.

While Brittany was “disqualified” from applying because she is in a relationship — though that didn’t stop two rose winners who were also in relationships, Jed Wyatt and Erich Schwer (whose relationship reportedly ended because his ex wasn’t willing to stay while he was on the show) — we’re all curious about what would’ve happened next. Would the candidate that Fleiss already “loved” have gone on to receive the “first impression” rose? What adjustments would have been made to accommodate a fat contestant? But more importantly, how long will we have to wait to find out?

“My hope is that everybody will look at themselves and look at their friends, their gorgeous, talented, smart, thoughtful, friends and if you would ever even consider being on, apply, a-f*cking-ply,” she says. Her video was more about putting the message out into the universe than it was about putting herself into the show. “It could be such a fun thing if we had some beautiful fat people on the show. I think it speaks for itself that so many people were echoing my sentiment. And mostly saying that they would come back and watch the show.”

Although the foundation of the franchise has been shaken by scandals, stagnancy, and the pressure to switch to streaming, the fairytale aspect of the show has arguably yet to be captured by any of its competitors and will possibly keep it going for the long haul. Though the casting criteria seems identical throughout this genre of unscripted TV, The Bachelor’s brand, complete with limousines, red carpets, and rose petals, has always been to create a modern semblance of a whirlwind romance. The only thing that could make it more magical would be if it reflected the reality that everyone deserves to love and to be loved in return.

Fatphobia in Health Care Is Way Too Common. Here’s How to Deal


Fat shaming, also called weight discrimination, happens at the doctor’s office when a patient is given inadequate care or blamed for their health because of their body size. It’s a persistent problem in medical settings that can cause patients distress or even cause them to avoid care all together.

In a reverse of what some providers may see as a tough-love way to motivate people to lose weight, bias against fat people induces harmful health effects. It encompasses everything from a provider being less likely to bond with their patient if they see them as overweight, to incorrect dosages of medications and more.

“No one should have to choose between whether they get preventative care, or a cancer screening or treatment for active symptoms because they’re afraid that not only will they get blatantly fat shamed, but that they will not get the care that they’re seeking,” says ani janzen (who styles their name with all lowercase letters), operations and projects leader at the Association for Size Diversity and Health, a nonprofit.

You might have already had an experience where you feel your health was ignored or mistreated in lieu of a hyperfocus on your size, especially if your body mass index is in the “overweight” range or higher on the BMI chart. What can you do about it?

First, it’s important to realize what you’re owed as a patient: quality care. If you don’t get it, that is not your fault as a person seeking health care services. Secondly, it’s important to realize that if a health care provider seems like they don’t know what they’re talking about in terms of advice for bigger bodies, it’s because they probably don’t.

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How doctors end up flying blind when caring for larger bodies

Dr. Fatima Stanford is an obesity medicine physician and scientist with Massachusetts General Hospital and Harvard Medical School. She says she learned more about nutrition and weight management leafing through wellness magazines than she did in medical school. (This was before her specialty training.)

“The answer to your question is we aren’t trained,” Stanford said, when asked about the training doctors receive to discuss weight with patients. “It’s not a nice thing to say, but it’s the reality.”

This lack of training in caring for larger bodies shows up in many ways, including offering nutrition advice (sometimes asked for, often not) that will only work for a small portion of patients, since diets alone usually aren’t effective long-term. It can also leave a patient feeling defeated when the reason they showed up to the doctor isn’t addressed, or generally disrespected as a societal bias against bigger bodies is equally as pervasive in the medical community.

How to get better care when you’re navigating fatphobia

Feeling comfortable with your doctor starts in the waiting room. If you’re looking to establish this office as your place of care, make sure there are seats that are accessible to you, and that you feel comfortable with staff at the front desk. Once inside the exam room, you can also make your decision on further details like whether the blood pressure cuff is accommodating and, most importantly, how well you feel you’re being understood by the provider themselves.

For some of the layout stuff, you can call ahead of your appointment or send a message, if possible. janzen also suggests presenting your goals for the appointment or concerns ahead of time, with a letter you give to the person at the front desk, who can then share it with your care team ahead of time.

“It’s not going to change anybody’s mind between the time you enter the waiting room and the time you go back to the clinic, but it gives providers a second to sit with what’s being asked of them,” they said.

Within the next few weeks, janzen says, ASDAH will finalize a list of providers who follow the organization’s Health at Every Size care framework, which may make it easier to find weight-neutral care near you. But finding a provider who subscribes to this specific label might not be the most important thing, janzen says. As providers, being able to “center” the patient and “meet the person in the room where they’re at today without judgment” is a basic standard of care that could improve the health care system overall.

All of that to say: don’t settle. If you don’t feel good about the care you’re receiving from your doctor, remember your rights as a patient and find a new provider.

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Reach out to community

Joining a local group of like-minded people, such as the Twin Cities Fat Community, is a good way to get recommendations for providers near you or even tips for personal care, janzen says. Another perk of reaching out online or finding a similar group is that you may also find a support person, or someone to come to a doctor’s appointment with you.

A friend or loved one who comes with you could also serve as a patient advocate – someone who will help coordinate your care, assist in coming up with questions for your doctor and more. Sometimes hospital systems or clinics have their own patient advocates.

You might also refine your search based on what kind of care you’re receiving. We found a fat-friendly Facebook group for people who are pregnant or trying to conceive, for example.

Redirect the conversation away from your weight

Having your weight taken is often a routine part of a doctor’s visit. However, you have choices on how – or if – you step onto a scale. “Don’t weigh me” cards, which you can order from More-Love.org, are one way you can communicate to your provider you don’t want to be weighed unless it’s deemed medically necessary. But you can also ask whoever is taking your vitals at the beginning of the appointment not to read the number on the scale out loud, or tell them you’ll be facing away from the scale.

If you feel like your weight or size is becoming the focus of your health care visit, and there’s a pressing matter at hand (because there usually is when you’re seeking health care services), don’t be afraid to say so.

Stanford offers a direct example of how to change directions. Something like: “I hear you’re bringing up my weight, I have an ax in the middle of my head,” she said. “I’d rather focus on getting the ax out of my head. It hurts – I’d really rather be able to keep my eyesight.” Then, you can suggest a follow-up appointment or actionable resource if you would like to discuss anything related to weight.

If your provider keeps pushing weight loss as a topic against your will, take a page from this post from writer Virgie Tovar on tips for medical self-advocacy: “Doctors have a specialized field of knowledge that you are employing them to use – like the way you’d hire an electrician to deal with something electrical.” They should treat you for what you’re paying for.

In a 2019 post, the blog ComfyFat recommends asking your doctor to make note of requests for care you might have, such as specifics for urine samples. This way, another nurse or doctor at the practice will have the note in your file and can save you from having to repeat yourself.

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Remember your rights

“As a patient, you have rights,” janzen said, adding that there’s a strong power dynamic in a health care setting when doctors are expected to have all the answers and also control access to medications.

“They’re the ones with the keys to your treatment, to your care, to your prescriptions,” they said. For this reason, it can be really frustrating – demoralizing, even – to be in a setting that’s hostile to you and your needs. But that doesn’t make it right, or something you have to tolerate. You have the right to respectful care, and the right to choose your provider.

“As a patient, it is your right to navigate your health and your health care the way that you want,” janzen said. “The idea of body autonomy is incredibly important in the provision of health care services.”

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.