In this article we explore the issue of what it means to be “fat” for women in Western (British/North American) society. Contemporary gendered biomedical discourse currently dominates attitudes toward body shapes and sizes (Bordo, 1995). Further, under the rhetoric of “health,” a large body size has come to be symbolic of self-indulgence and moral failure. In this article we argue this may lead women to question both their sense of self and their rights to adequate health care. Our aims are threefold: first, to challenge rigid hegemonic biomedical perspectives on “fatness” and the oppressive unequal power relations they may create; second, to examine the process by which such perspectives come to be the only legitimate discourse; third, to consider the impact of pathological medicalised definitions of “obesity” on women's perceptions of their bodies and experiences of health services.