If you have to eat/break the fast for medical reasons, it actually becomes a mitzvah to do so. Now, obviously it’s not something that’s taken lightly- that’s why most people who are unable to fast are told to do “shiurim” and even that is only allowed under the most pressing of circumstances, but because the halacha is that one who is ill enough must eat, doing so is actually following halacha. A person who goes in knowing they won’t be fasting from the get-go is not sinning (assuming they have consulted with a competent halachik authority), so there is no issue of “sin and then do teshuva”.
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