Fat and deserving: navigating the visibility and visuality of non-normative bodies in online medical crowdfunding

ABSTRACT Medical crowdfunding is an individualizing and privatizing response to healthcare inequalities, in which citizens use online platforms to share (written and visual) stories about health-related needs in order to elicit donations. We present data from a study of medical crowdfunding in Aotearoa New Zealand, drawing on critical theory and fat studies to analyze weight-loss-related campaigns, with a focus on visibility and visuality. We highlight the complexities involved in making fat (and otherwise non-normative) bodies acceptable, marketable, and deserving to online audiences. Through a reflexive thematic analysis of text and images, across nineteen public Givealittle campaigns related to intentional weight loss, we identified five main themes relating to how the fat body was presented. These themes include: unwell bodies, transitional bodies, active bodies, objectified bodies, and wretched bodies. We show that the ability of particular bodies to generate specific moral emotions (that can, through these platforms, be turned into care/healthcare access) depends largely on their relationship to normative ideas of the “good” body. Our analysis offers insight into how people negotiate hierarchies of deservingness, based on entrenched normativities, while living in non-normative bodies. More specifically, we show how people pursuing intentional weight loss use images to regulate themselves according to a wider anti-fat and neoliberal logic of deservingness. We explore images on crowdfunding campaigns as a form of both media labor and moral labor, highlighting the double-bind of the digital gaze upon bodies that are unable to access privileged states of health without being made visible to scrutiny.


Introduction
Medical crowdfunding is an individualizing and privatizing response to healthcare inequalities.Donation-based crowdfunding platforms (e.g., GoFundMe in the international context and Givealittle in Aotearoa New Zealand) host campaigns for people seeking financial assistance for a variety of medical needs that are not covered (or not fully covered) by the public healthcare system.This includes procedures related to intentional weight-loss.These sites thus become one place in which fat bodies are made publicly visible, through a marketized form of storytelling which may have high stakes for the recipients.Literature on fatness and visuality points to a paradox of invisibility, and hypervisibility (Gailey 2014).At the same time as fat bodies have been framed as undesirable, unsightly, and not worth being seen -marginalized, stigmatized, or erased to the point of invisibility in media, art, and public life -they have also been made into spectacles of public scrutiny (Gailey 2014;Orr 2022;Snider 2012).Much of this literature points to the moralization of fatness as "a self-inflicted and personal issue due to an individual's undesirable personal and moral characteristic" (Harjunen 2019, 175).Medical crowdfunding is also embedded in a competitive moral economy; with much of the existing literature focusing on "how deservingness is crafted, perceived, and institutionalized" (Berliner and Kenworthy 2017, 235).We highlight the complexities involved in making fat (and otherwise non-normative) bodies acceptable, marketable, and deserving, to online audiences of potential donors.
As they construct their campaigns, crowdfunders engage in tactics of self-positioning that are tailored to particular cultural values (Kenworthy 2019, 238;Paulus & Roberts 2018).This happens both through the "unconscious self-expression" of internalized cultural logics, and through "conscious self-promotion" as they learn to use both images and words to market themselves.At the same time, audiences learn to evaluate the deservingness of recipients based on the symbolic, narrative, and visual content of the campaign page (Berliner and Kenworthy 2017).Photographs are central to this, and yet there is little scholarly analysis of the way images are used in medical crowdfunding.This is also despite wider scholarship recognizing the prominence of visual culture in contemporary modes of relationality (Mirzoeff 2011).Some scholars have suggested that crowdfunding images are an important part of establishing credibility through photographic documentation (Pol, Snyder, and Samantha Anthony 2019), and others have emphasized they are key in making a campaign emotionally engaging (Snyder 2016).Statistical analysis has also shown that having a higher number of images can correlate with campaign success (Berliner & Kenworthy 2017).This speaks to the degree of media labor that is required to successfully participate in crowdfunding.For fat crowdfunders, this may be emotional labor as well as media labor, given that wider literature on fatness and visuality acknowledges that "for people who embody non-normativity, photographic representation may be emotional and affective work" (Barry, Evans, and Friedman 2021).
In the case of crowdfunding for weight-loss-related procedures, at every point in the process choices are being made (by the recipient themselves, or by a third party who is constructing the campaign on their behalf) about how to record, frame, and present, the fat body.What is less explored, is how the selection of photos for the campaign page, might relate to discourses of "good" or "bad" bodies.As Farnel (2015) has emphasized, there is a close link between marketable bodies, and bodies aligned with a capitalist ethic, i.e. productive bodies.This is mutually reinforcing of healthism, which places a moral imperative on the state of being healthy, and/or the pursuit of health (Gibson 2022).In this article we take this opportunity to explore, through a critical and interpretive lens, some of the ways in which fat people and fat bodies are presented, in a setting where they compete for sympathy and donations, alongside campaigns for many other types of medical procedures.We acknowledge the agency, strategy, and creativity that crowdfunders often use to navigate potential stigma and judgment while trying to meet their needs.We also recognize the relationship of aesthetics and the gaze to wider structures of power and governmentality, using our findings to illustrate how crowdfunders in Aotearoa New Zealand used images to regulate themselves according to anti-fat and neoliberal logics of deservingness.We assert that images in the marketized context of crowdfunding therefore form part of both media labor and moral labor.

Method
The empirical data analyzed in this article is drawn from one section of a larger (three year) study of crowdfunding in Aotearoa New Zealand.This multimethodological study sought to examine moral, emotional, and social aspects of medical crowdfunding.In this article we hone in on campaigns related to weight-loss; including bariatric surgery, and post-weight-loss procedures such as skin-removal.We discretionarily exclude campaigns focused on breast reduction, while acknowledging that these sometimes have a shared basis in ideas about the functional and/or aesthetic qualities of fat bodies.
In Aotearoa New Zealand, private citizens primarily engage with the national crowdfunding platform called Givealittle -which is similar in layout and function, to the larger US-based platform, GoFundMe, but functions as a nonprofit entity.The initial phase of the project sought to create a quantitative snapshot of who was crowdfunding, and for what, in New Zealand, by sampling all health-related campaigns on Givealittle in June 2020.Although this sampling period overlapped with the first wave of the Covid19, the timeline for data collection had been established prior to the pandemic, and all campaign pages sampled had been present on the site since before this time, so did not substantively relate to this context -though other parts of the study addressed this more directly (Wardell 2021).Out of 574 campaigns identified in total, 6 were coded at this time as being related to weight loss.In August 2022, when this was selected as a topic for additional qualitative analysis, another 8 campaigns were identified from those active at the time.In November 2022, a final 5 campaigns were added, totaling 19 campaigns to form this dataset .
As a first step, the main characteristics of the campaigns were recorded, including demographic characteristics of the recipients (where these were stated, or could be reasonably imputed).This established that 17 out of 19 campaigns were for women, and that the majority of recipients were white-presenting.Procedures being fundraised for included bariatric surgery, a "tummy tuck," and skin-removal surgery, with campaigns setting financial goals of up to $30,000 each.In the qualitative phase of the study, the content of the campaign pages was analyzed using a reflexive thematic analysis.All 19 campaigns were coding through NVivo using an iterative open-coding technique, and with a focus on presentation of the fat body in both words and images.Detailed attention to the type of photo (e.g. group photos, selfies, professional portraits, drawings, or illustrations), as well as the tone and visual framing, was given in order to identify repeated visual tropes.Analysis was conducted in the context of researchers' familiarity with wider crowdfunding practices in Aotearoa New Zealand -which, for other sections of the study, included interviews and case studies with individuals and families crowdfunding for other types of needs, and surveys of audiences of donors or potential donors.
The study was considered and approved by the University of Otago Human Ethics Committee (reference number 20/028).As the data informing this article were obtained from publicly-available web pages, the individuals represented on these campaign pages were not considered "participants."However, the researchers established additional ethical parameters for de-identifying individuals in any visual material presented for publication.The photos and screenshots in the following sections have therefore been altered to blur faces, and/or blur or remove individual's names and locations, where necessary.

Results and analysis
Through reflexive thematic analysis, we identified five main themes relating to how the fat body was visually and discursively presented.These themes include: unwell bodies, transitional bodies, active bodies, objectified bodies, and wretched bodies.The chart, below, shows in how many campaigns within the total dataset (n = 19 campaigns) each theme appears.Campaigns often offer multiple points of evidence for the same theme and most campaigns drew on at least two different themes.In the following sections, we consider analytic examples from both the images and the text of the campaigns, for each theme, but with the aim of showing how these worked together to mutually reinforce a particular framing of the fat body.

Theme 1: unwell bodies
Many campaigns related to intentional weight loss connected lived experiences of fatness to illness, injury, and suffering; consistently presenting fat bodies as unwell bodies.A key part of this was that a number of campaigns used the language of "obese" or "obesity" to describe their own embodiment.As one campaign page stated: And I am over weight, when I say over weight I don't mean a few extra kilos.I mean morbidly obese, shit that is scary to say.If you put morbid infront of anything it makes it seem a little more scary.And I guess that's true.Being overweight or obese is scary.
The term, "obesity," is part of a medical frame that narrows fatness to a condition related only to individual health -a "disease" or "disorder" (Jutel 2011).In the above comment, the crowdfunder emphasizes danger, risk, and crisis.She goes on to use the words "hurting" and "harmful" to describe her experience of being obese, as well as "painful;" stating that "I fear for my wellbeing and my life."This taps into a sense of urgency -a trope common in crowdfunding campaigns as part of establishing the moral worth of a cause (Paust 2020).
Illness and pain are also represented poignantly through photos.One campaign uses multiple images of a swollen healing foot, the recipient in a hospital bed, and a surgical site (see Figure 1).Another uses explicit surgical images, including uncovered wounds.
In another campaign, a young woman with complex health conditions shares a picture of herself with a tube inserted into her chest (see Figure 2).In one update, she writes about being "scared of dying," with the heading "Please help me stay alive."Although her health needs are complex, her weight serves as a barrier to accessing other surgeries rather than a direct precipitator of poor health.The combination of images and text nonetheless function to frame the fat body as a risk to life, health, and wellness.Many crowdfunders mention specific health issues using formal medical or diagnostic terms (e.g."fatty liver syndrome," Polycystic Kidney Disease (PKD), and Scheuermann's Disease).Some allude more generally to physical struggles.One crowdfunder writes that "the weight . . . is now causing me health issues."This crowdfunder has only two pictures on their page, the second features them in a wheelchair.
The campaign text offers no indication as to the reason for the wheelchair use, but the image still works to align the genre of the campaign with others on the Givealittle site.
Based on a snapshot of all campaigns related to health needs on Givealittle in June 2020, 71% were related to illness, 11% to accidents, and 6% to disability.This shapes online audiences' (of donors or potential donors) expectations as to the type of need, and type of narrative, they may encounter on the site.By using both medicalizing terms and images to frame their need around health crisis -emphasizing fat bodies as "sick," unwell, or suffering -these weight-loss-related campaigns work to establish the validity of their request based on the criteria of deservingness established by other types of medical crowdfunding campaigns on the platform.Images of fat bodies in this context therefore reinforce "healthist" ideas of the fat body as incompatible with health (Gibson 2022) which, in turn, links to Theme 3, where crowdfunders establish their moral worth (and therefore deservingness) through pursuit of well bodies that they currently do not possess.

Theme 2: transitional bodies
Crowdfunders often present their bodies as incomplete or unfinished; in other words, as transitional bodies.This was prominent in specific visual tropes used to show one's body as being "in process" of changing from one state of being to another, usually in the form of weight loss.This lines up with Orr's assertion the fat body is expected to always be in a state of "becoming" and, specifically, becoming less fat (Orr 2022).Weight is framed as something liminal or temporary (Harjunen 2017).In the following example (see Figure 3), the participant uses images to show how his body has changed over time, with a "before and after" comparison shot and photos from three different points on a timeline measured in weeks.
Notable also was the way that physical change was narrated as a marker of other forms of personal transformation or life changes.Campaigns frequently utilized the "journey" metaphor, framing the transition of their bodies as representative of movement from one phase of life to another, or from one version of the self to another (better, more idealized) version.One campaigner states: "I hope sharing my journey is helpful to others who will be going through the same as I did" (WL8).This also indicates a normative aspect, in the expectation that others will follow the same path.Such narratives suggest that there is a single, directional trajectory or path that fat bodies must change along.The idea of the fat body as transitional also plays out in interesting ways for those who achieved thinness, but are now seeking help with removing the visual markers of this journey, such as excess skin.One audience respondent, commenting on a campaign for skin removal, noted that they were "only half done," adding that "no one talks about the look after life altering weight loss it isn't attractive."This emphasizes that a thin person who still shows evidence of former fatness is still falling short, or still in a transitional part of their journey to a socially-desirable body.Despite having arguably "completed" a journey of weight loss, the goalposts are found to be a normative body, rather than simply a smaller one.Also significant is that crowdfunders emphasize change not only in past tense -via stories and photos that evidence previous bodily transitions -but also in terms of intentions or commitments toward ongoing and future change, as the following theme elaborates.

Theme 3: active bodies
Crowdfunders went to great lengths to present their bodies as physically active through photos and stories emphasizing physical exercise and effort.In Figure 4, the idea of being active frames the entire campaign, with text narrating (in detail) how the campaigner used walking to achieve and maintain her current level of weight loss.Harjunen (2019) writes that fat bodies may be particularly hypervisible in fitness spaces, with fat women in particular occupying a paradoxical position.Fat women are routinely discouraged from exercising in public (by negative social responses to their presence), but then condemned or shamed for not  exercising.In the campaigns we analyzed, which were also primarily those of women, images of people outdoors or wearing activewear were paired with text that laid out detailed timelines, information on specific achievements (usually via weight measurements), and information on the particular forms of exercise (the gym, walking, running).They thus offer proof that they have performed what Gibson (2022) calls the "three main duties of the good fatty," which include good health, healthy eating, and the will (and ability) to exercise.
This posturing offers evidence that one is proactive in their work toward weight loss, rather than passively waiting for assistance.It also aligns with medical discourses that strip fat bodies of agency, placing fat people as "victims" since no one "would ever choose to be fat" (Pausé 2020, 162).As such, crowdfunders had to navigate a fine balance between offering evidence of their urgent need for support (that is also typically medicalizing, as per the theme of ''unwell bodies") and avoiding the damaging stigma of being passive, by showing they are already active agents for their own health, and thus a responsible and worthy investment for potential donors.In this way the duties of the "good fatty" are situated within the duties of the good neoliberal citizen, who is responsibilized for achieving and maintaining their own health.Campaigns emphasizing the active body were able to frame the request for donations less as asking others to take responsibility for them, and more as asking others to equip them to continue a pre-established program of active, responsible attention to the pursuit of good health and wellness, via fixing or overcoming their fatness.

Theme 4: objectified bodies
Our analysis also showed fat bodies were often presented in an objectified manner.This was particularly prominent in the way crowdfunders dismembered their bodies through photography; breaking it down into smaller parts through cropping and framing.The trends of the "dismemberment" of women in Western advertising has been discussed and documented well over the past 20 years, with a focus on individual body parts (rather than the body as a whole), for the purpose of selling various products (Greening 2006).
Figure 5 is a selfie one campaigner took of their bare torso.Their face, arms, legs, and the rest of their body are cut off, isolating the part of their body they are identifying as a problem (and hoping to reduce or remove through medical intervention).Dismembering oneself through photography serves as a form of symbolic violence, where individuals enact and enforce wider social expectations for the purported purposes of personal health and well-being (Harjunen 2019).Campaigners indicate that this is not solely a visual practice, but is also echoed in other practices related to weight loss.
One crowdfunder literally describes her desire to dismember herself in order to meet the wider expectations put upon her body, stating: "I have done duromine pills, diets, starved myself, gyms and I have even once tried to cut my fat off" (WL7).The crop and focus of these photographs, many of which are selfies, establish that the recipient is aware of their own sociallyundesired and non-normative status.Photos invite a very public audience to gaze upon them, scrutinize them, and (ideally, in order for them to meet their funding goals) agree that they are unacceptable; not only as an abstract notion, but with enough force of moral emotion so as to impel a donation to help in "fixing" or resolving the purported issue.As such, these images are also an example of hypervisibility, in which rather than simply being acknowledged, bodies are "overanalyzed so that they become a spectacle" (Harjunen 2019, 176), with crowdfunders leaning into this property in their own use of images, to engage donors.
Participants also depersonalized and distanced themselves from their own bodies by cropping out their head, or removing their face from the rest of their body, as shown in Figure 6.
While this visual trope harkens back to Cooper's influential (Cooper 2007) post on the "headless fatty," which focuses on the dehumanizing nature of much public photography of fat people, it is again notable that in the case of Givealittle crowdfunding campaigns, the same trope is enacted directly by fat people, in images they have selected and uploaded themselves.The result is similarly dehumanizing or objectifying, functioning to separate oneself, as a person, from the seemingly-pitiable bodies they inhabit.This is, arguably, an important frame for photos that showed bodies that were still fat, and thus risk contradicting one's narrative of efforts to lose weight.
This assessment parallels and is supported by recurring stories of a "disobedient" or "unruly" body, that also use objectifying language, functioning to make one's (fat) body into an adversarial figure that has failed to transition to thinness (Theme 2) or failed to become active (Theme 3), despite one's best efforts.As one crowdfunder (WL11) writes: "My body just decided to gain absolutely everything and anything."The process of self-objectification functions to absolve oneself from blame, supporting their deservingness through efforts to tame, control, and ultimately be rid of their fatness.By deliberately turning one's abjected body into an object on which they conduct work, the moral stigma of fatness remains one step removed from the person seeking help.

Theme 5: wretched bodies
In our analysis, we also identify a trend in which campaigners perform hatred of their bodies or evince suffering because of their fatness, framing their bodies as "wretched."Just as physical ill health was a common emphasis (as per Theme 1), poor mental health was also commonly mentioned.In some crowdfunding campaigns, specific mental illnesses are listed and include body dysmorphia.Other narratives evoke mental distress or poor quality of life (e.g., describing being "tired and desperate" (WL15)).Campaigns thus lean into stereotypes about how bad fat bodies are and feel, by emphasizing suffering and sadness while occupying a body that does not adhere to social expectations of healthfulness vis-à-vis thinness or normative weight.
Photos in these campaigns serve as a sort of visual confession, where campaigners show their body in a way that emphasizes suffering, shame, and regret.In one clear example of this, in Figure 7, the campaigner presents herself in black and white, eyes downcast, and arms humbly folded.In an e-mail exchange with us, the crowdfunder shared that she had chosen this photo because she had recently been through a break up and her ex "was quite nasty about [her] size."Photographic practices that bring this painful personal moment, and her body (close up and with bare skin), into this public space, align with the trope of confession.
Confession is a stable genre of communication; representing, in many contexts, a form of public intimacy (Thomas 2008).Here, it has the strategic purpose of performing the shame of living in the "before" image (Kargbo 2013), showing potential donors that she, too, is regretful about how her body fails to meet the standards of a "good" body.By expressing moralized emotions that align one with anti-fat sentiments, campaigners enact relational labor and attempt to establish alignment or connection with audiences.
Campaigners confessed not only their own suffering, but the suffering or disadvantage that their fat body causes other people.For example, many of the campaigns mention motherhood or include children in the campaign.In Figure 8, which serves as the cover photo for this campaign, the crowdfunder is holding her daughter, who is pouting sadly while holding a lollypop.In the accompanying text, the campaigner states: "Unfortunately it's not just me that's suffering.My three year old daughter is also paying the price for my health issues, I'm so depressed and upset that I don't go out etc it's taking its toll on us both" [emphasis ours] (WL17).Not only does this crowdfunder utilize emphatic, negative language, but she is also confessing to her perceived failure as a motherpresenting herself as a bad parent, with a bad body -as a way of imploring potential donors to save her child from her fat body.Performing wretchedness is thus an act of moral positioning indicating one's commitment to pursuing normative ideals of thinness and persuading donors that they are a "good investment," via showcasing the force of both their need and desire to change; evidencing something Kargbo (2013) calls "transformational change."

Discussion
People seeking help through medical crowdfunding are caught in a doublebind.In order to access normative, idealized states of health and appearance, they must make their non-normative bodies visible to others in a very public way.In our wider research on medical crowdfunding in Aotearoa New Zealand, we have seen this apply in similar ways to those with disabled bodies, gender-non-conforming bodies, and cyborg bodies (e.g.those who rely on everyday wearable technologies such as glucose monitors).The ability of particular bodies to generate specific moral emotions that can, through these platforms, be turned into healthcare access, depends largely on their relationship to normative ideals of the "good" body.By careful strategies for moral positioning, crowdfunders create a version of their fat self that is relatable and sympathetic to an audience that privileges a certain type of body as morally worthy.Images are key, mediating fat crowdfunders' relationships to normative frameworks of (thin) embodiment.As such, in the following sections we argue that they are a tool reflecting not only media labor, but moral labor as well, acting as technologies of transformation in more ways than one.Borradaile and Reeves (2020) highlight significant connections between social networks and surveillance capitalism.They argue that forms of digital connection are often a means to commercial ends.The relational labor enacted by crowdfunders, including the production and circulation of images, aims to create sympathetic connections with audiences of potential donors.These, in turn, rely on visibly embodying positive traits or ideals.

Visibility, normativity, and the gaze
Fat crowdfunders cannot perform the moral goodness of being thin, yet.In order to communicate themselves positively to audiences of potential donors, within and against the stigmatized status of their current fat embodiments, they must adhere to narrow versions of "good fatness."To do this, they enact media labor to direct and control the gaze -evident in their choices of image content, crop, and focus, and in their framing of images through text."Seeing through a camera [. ..] is always already a position of analysis," as Ellis (2018, 14) writes.The availability of cameras extends the role of photography in everyday life, with the cellphone now acting as a "portable panopticon," according to De Saulles and Horner (2011).The gaze upon non-normative bodies can act to identity, regulate, and contain difference, creating specific hierarchies of what is visually acceptable and desirable (Ellis 2018).Nonconsensual public photography establishes a dehumanizing lens, isolating fat and other non-normative bodies as "symbols of cultural fear" (Orr 2022); objects arousing hatred and disgust, rather than fear and compassion (Cooper 2007).We read the labor of crowdfunders sharing images of their fat bodies through crowdfunding pages as a preempting or co-option of public judgment, a way to both invite and control this same gaze.Yet, the way crowdfunders do so often draws on hegemonic ideas of fatness, often visually framing their own bodies as a medical or aesthetic concern -as unwell, objectified, or wretched -as a shorthand for deservingness.Overarchingly, we argue that this establishes image-making and sharing as a type of moral labor; in other words, as part of efforts to perform certain versions of a morally acceptable or "good" self, for personal or economic gain.
While technically involving images selected and shared consensually by fat people themselves, crowdfunding occurs within a coercive context.Where the healthcare system does not provide adequate coverage for the procedures that individuals seek, and where private costs are higher than most individuals or families can afford, the option of crowdfunding may feel like a last resort for many.Many parts of our research affirm the awkwardness and discomfort that crowdfunding under these circumstances can cause; forcing people not only into a time-consuming type of labor, but also into a kind of "privacy calculus" (Gonzales et al. 2018) that weighs the cost and risk of sharing personal and potentially stigmatizing information against potential benefits of achieving fundraising goals.This is not only about self-presentation, it is also about self-shaping.The moral labor of image-making is part of the subjectification that happens for individuals who experience high levels of social scrutiny, as it is also not only the gaze of others that is tied to normative discourses of "healthy" or "good," but also the gaze of (fat) crowdfunders upon themselves as they produce and circulate these images for online publics.

Images as technologies of transformation and subjectification
In a study of fat photo blogs, Kargbo (2013, 17) suggests that looking is a form of doing, and part of what is done to the self . . .a way of "becoming otherwise."The images we analyzed in this study were "technologies of transformation" in more than one way.Firstly, as our results showed, their content emphasized themes of transformation -documenting bodies as they transformed, or marking specific goals or intentions for change.Secondly, as media technologies, they played a key role in capturing the attention of audiences who would ideally make donations, thus mediating access to medical technologies, specialists, and procedures, that would facilitate (medical) transformation.Finally, as we expand upon now, the process of taking, selecting, and sharing images, involve a self-regulatory gaze, where individuals enacted normative ideals upon their bodies in order to appear deserving; also having the potential to transform their sense of self.
Many of of the images shared on the pages we analyzed were selfies.There are particularly significant as part of both the act of self-surveillance and disclosure.Practices like the selfie act as technologies of the self -tools of subjectification -enabling users to subject themselves to the social gaze and self-regulate accordingly.Harjunen's 2017 discussion of the socialization of women, and how they check, self-surveil, and modify their bodies -contributing to self-objectification -is particularly apt here.Individuals crowdfunding for weight-loss surgery self-objectify and adhere to societal expectations under capitalism.They show they are both "good fatties" and good neoliberal citizens by cultivating reflexive awareness of their "issues" in order to take agentic and normative responsibility for being their most fully-actualized and healthful selves, and using photography as part of identifying the parts of their body they must work upon or change.They preempt the scrutiny of audiences, by scrutinizing themselves -or more specifically, scrutinizing and moralizing the fat bodies they separate from their self through processes of dismemberment and self-objectification. This, in turn, is tied to neoliberal capitalist structures valuing normatively productive, healthful, and aesthetically-pleasing bodies, as the bodies which they must (but cannot yet) present.

Conclusions
The connections between fatness, aesthetics, and emotion are bound up in "violent structures" (Barry, Evans, and Friedman 2021).Spratt's (2022) application of Judith Butler's notion of "grievability" to fat bodies highlights how certain bodies are subject to different formulations of biopower, based on their vulnerability, which then determines their value.In this way, those making their fat bodies visible to the public, as crowdfunders, are subject to questions not only of their deservingness of assistance to access specific procedures, but of who has a right to live, and to live well.In the case of crowdfunding, there is systemic violence in barriers to healthcare that speak to a complex biopolitical question about not only who is crowdfunding, but who should have to crowdfund in order to meet their needs.
The marketized context creates the need to show one's existing "bad" body in order to gain access to a "good" body, exposing oneself and one's body to public scrutiny by an audience that may not be sympathetic."The sad thing is, I struggled to find a picture to even upload as I hate having my picture taken," one person wrote on their campaign page.Visibility becomes a reluctant necessity, rather than something freely chosen, particularly given that crowdfunders have to be visible in particular ways, or through particular frames, in order to have a reasonable chance at generating the moral emotions that may lead to donations (without which one's visibility in this setting has little purpose).We thus argue that medical crowdfunding can be read as part of the outworkings of power upon fat people -interpellating them into labor in which they are not only complicit, but active, in enacting the violence of anti-fat discourses on themselves, through particular ways of framing, narrating, and visualizing the fat body.
It is important to acknowledge that there are many instances where fat people can and do practice resistance through image making, "opening up new ways of understanding what it means to be fat" (Gurrieri 2013, 207) and creating spaces of representation in which fat can become "thinkable, sayable, legible" (Kargbo 2013, 165), and doing good work by "disrupting normativities" in the face of subjugation (Barry, Evans, and Friedman 2021).However, there are often contradictions of resistance and restriction in this (Barry, Evans, and Friedman 2021).Our analysis similarly identifies tensions and paradoxes in the use of images for medical crowdfunding.On one hand, crowdfunders use images in these campaigns to advocate for (and actively seek to meet) their own needs and desires for medical care -aligning themselves with positive moral characteristics (i.e., as active, determined, and self-aware) in defiance of particular forms of stigma and moralizations of fat people (i.e., as lazy and/or victimized).At the same time, the way they do this draws very heavily from normative and stigmatizing anti-fat discourses.This is, again, less about the individual's intentions and more about the systemic context.In particular, the individualizing, competitive logics governing these platforms mean that crowdfunders' deviations from mainstream sociopolitical logics of deservingness may make it less likely that these same crowdfunders will secure a positive outcome.
This portion of this study was limited by a primary focus on the content of the campaign pages themselves, in absence of interviews or case studies that could provide direct insight into the experiences of crowdfunders.More data is needed to further understand the degree to which the normative and negative views of fatness represented through campaign pages aligns with crowdfunders' self-understanding.Additionally, it would be useful to expand the scope of this work to consider the visual practices of fat crowdfunders seeking resources for procedures not related to weight-loss.Despite these limitations, this analysis offers insight into how people navigate hierarchies of deservingness, based on entrenched normativities, whilst living in non-normative bodies.As such, we highlight the double-bind of digital gazes upon bodies for crowdfunders who are unable to access desired and privileged states of health and well-being without making themselves visible to potential public scrutiny.

Figure 1 .
Figure 1.Image of surgical sites from a campaign for gastric sleeve surgery (WL4).

Figure 2 .
Figure 2. Selfie photograph of a young woman with a permacath insertion site on her chest (WL6).

Figure 3 .
Figure 3. Week by week timeline of weight loss, used in a campaign for skin-removal surgery (WL14).

Figure 5 .
Figure 5. Close-up image of a woman's torso, in a campaign seeking funds for a "tummy tuck" (WL5).

Figure 6 .
Figure 6.A photo cropped to exclude the head, in a campaign raising funds for bariatric surgery (WL7).

Figure 7 .
Figure 7. Black and white image, with a sombre tone and downcast expression, used as the cover photo for a campaign for bariatric surgery (WL19).

Figure 8 .
Figure 8. Screenshot of the front page of a campaign, where the subtitle also emphasizes the quality of life of the campaigner's child (WL17).