In this episode of Dr. Marianne-Land, I speak with fat activist, TEDx speaker, author, DEI expert, and podcast host Vinny Welsby (they/them) about anti-fat bias in healthcare, weight stigma in medicine, and the real-world harm fat patients experience when seeking medical care. Vinny, who shares extensively about fat liberation, weight-inclusive care, and dismantling diet culture on Instagram at @fierce.fatty, brings both lived experience and data into this conversation.

This episode centers on Vinny’s survey of 270 fat people, in which 99.25% reported experiencing weight-based discrimination in healthcare. These findings expose how common medical weight stigma, anti-fatness, and provider bias truly are, and why so many fat people delay or avoid healthcare altogether.

Weight Stigma in Healthcare: Survey Data and Lived Experience

We break down what those survey results actually mean for patients. Vinny shares stories of medical dismissal, misdiagnosis, delayed treatment, and humiliation in healthcare settings, including being told to lose weight instead of receiving appropriate medical evaluation. We discuss how weight stigma shows up through provider assumptions, lack of size-inclusive equipment, routine weighing without consent, and dismissive or dehumanizing language.

This section highlights how anti-fat bias in healthcare leads to worse physical health outcomes, increased medical trauma, and deep mistrust of medical systems.

Medical Trauma, Nervous System Effects, and Avoiding Care

We explore how repeated experiences of weight stigma activate the nervous system and create medical trauma. Even scheduling an appointment can trigger fear, shame, and exhaustion. Vinny and I talk about how this chronic stress contributes to people avoiding preventive care, delaying diagnosis, and experiencing worsening health conditions as a result.

This conversation connects anti-fat bias, mental health, eating disorders, and healthcare avoidance, naming how the system often blames fat bodies for the very harm it causes.

Intersectionality: Fatness, Gender, Queerness, and Neurodivergence

A major focus of this episode is intersectionality. Vinny shares how anti-fatness intersected with being trans, nonbinary, queer, neurodivergent, and disabled, and how shame around body size limited access to identity exploration and self-expression. We talk about how weight stigma compounds oppression, especially for people with multiple marginalized identities.

We also discuss how white privilege can reduce some harms while never eliminating weight-based discrimination, and why weight-inclusive healthcare must address racism, transphobia, ableism, and fatphobia together.

What Weight-Inclusive Healthcare Actually Requires

We challenge the idea that good intentions equal good care. This section explores what weight-inclusive healthcare truly requires, including provider education, consent-based weighing, size-inclusive furniture and equipment, respectful language, and accountability when harm occurs. We discuss why many providers believe they are weight-inclusive while continuing to practice weight-centered and stigmatizing care.

Unlearning Anti-Fatness, Shame, and Diet Culture

We close with guidance for beginning the process of unlearning anti-fatness. Vinny shares how shame thrives in isolation and how bringing it into the light reduces its power. We discuss diet culture, binary thinking, and how critical thinking helps people question harmful beliefs about weight, health, morality, and worth.

This episode invites listeners to ask who benefits when people are taught to hate their bodies, and how compassion, curiosity, and community support healing.

Who This Episode Is For

This episode is for fat people, eating disorder survivors, clinicians, healthcare providers, and anyone who wants to understand how weight stigma in healthcare causes harm and what needs to change.

About My Guest: Vinny Welsby (They/Them)

Vinny Welsby is a fat activist, DEI leader, TEDx speaker, bestselling author of Fierce Fatty, and host of the Fierce Fatty Podcast. They work with individuals through Fierce Fatty and with organizations through Weight Inclusive Consulting, providing education and training on dismantling anti-fat bias in healthcare and beyond.

You can find Vinny at fiercefatty.com and on Instagram at @fierce.fatty.

Related Episodes

When Doctors Harm: Medical Weight Stigma & Eating Disorders on Apple & Spotify.

Having Anorexia in a Larger Body: Navigating Medical Anti-Fat Bias & Lack of Care with Sharon Maxwell @heysharonmaxwell on Apple & Spotify.

Content Caution

This episode includes discussion of medical trauma, weight stigma, eating disorders, healthcare discrimination, and systemic oppression.

The harm described in this episode is real, widespread, and systemic.