This Major Research Paper conducted an institutional ethnography of social work practice with fat service-users in medical settings, exploring the resistance or conformity taken in clinical settings to medical discourses on fatness. Using a voice-centered relational method, three social workers were interviewed on their experiences working with fat- identified clients within medical settings. The interviews explored the role of social work in medical settings, the operation of power structures and cultural discourses that restrict or limit social workers’ capacity for engagement
from social perspectives, and the resistance practices workers use to navigate their practices to maintain anti-oppressive social work practice. It was found that there are significant issues with the medical model’s engagement with fat service-users and that, while there are significant barriers to fat positive social work practice, it is through the use of language, client- centeredness, teaching moments, and advocacy, that anti-oppressive social workers navigate these spaces.