Fat Stigma, Healthism and Eating Disorders

Published May 23, 2013 by Fat Heffalump

A little housekeeping first – the zine is still trucking along nicely, thank you to those of you who have already submitted contributions, (I’ll be in touch soon if I haven’t already) and to those of you thinking of submitting something, please do!  I particularly need artwork, even just small pieces to fill in around articles and break up the text.

Trigger warning on what follows: discussion of eating disorders, prejudice against fat eating disorder sufferers and rampant healthism.

Photo by Isaac Brown for Stocky Bodies.

Photo by Isaac Brown for Stocky Bodies.

Now, on to the actual topic of this post!  As you know, on Tuesday night I was proud to present at the UQ Women’s Collective Diversity Week event.  One of my fellow speakers was a representative from the Eating Disorders Association Inc (EDA) and she spoke on what eating disorders are, who is most likely to be affected by them, and what methods of treatments there are.  We had some robust discussion during the Q&A portion of the event in response to audience questions.  I only wish we could have answered more audience questions, but alas, we ran out of time.

Since then, I have had a LOT of thoughts swirling around my head around eating disorders and how they relate to fat people.  As you would have seen in my last post, I have been an eating disorder sufferer for most of my life, however I was in my 30’s before I was finally officially diagnosed with EDNOS (eating disorder not otherwise specified), which technically means an eating disorder that for some reason does not fit under Anorexia Nervosa, Bulimia Nervosa or Binge Eating Disorder (which has only this week been classified officially as an eating disorder).  In personal terms, for me it means that I have an eating disorder… but I’m fat, so I am excluded from being diagnosed with anorexia or bulimia, despite meeting almost all of the other criteria.  Yes, just being fat disqualifies you from having anorexia or bulimia regardless of your meeting all or most of the other criteria.

So it’s probably no surprise to any of you that I have issues with how the health care industry, most eating disorder support organisations and the general community of eating disorder sufferers treat fat people.  Particularly as it is mostly assumed that fat = binge eating disorder, which is nothing short of bullshit.  Can I put that in any plainer terms for anyone?  BULLSHIT.  Fat people are assumed to just be overeaters or binge eaters by way of being fat.  It is often believed that it is impossible for a fat person to have a restrictive or purging eating disorder, or to be involved in disordered exercise behaviours.  Even as much research (and anecdotal evidence/lived experience) there is out there showing how many fat people have engaged in these forms of disordered eating/activity, the medical profession and most eating disorder organisations still do not recognise it in fat people, and instead suggest that “denial” is one of our symptoms of what must be binge eating disorder.

What regularly happens to fat people who present with all of the markers of restrictive/purging/exercise mania is that we are told to “keep up the good work” instead of having our illnesses recognised.  Behaviours which are widely recognised as destructive, disordered behaviour in thin people, are considered a “positive lifestyle change” in fat people and actively encouraged.  It certainly was for many, many years through my suffering.

And it seems that hasn’t changed much.

So fat people are being failed by most eating disorder support organisations, the medical/health care industry and the general eating disorder community still.

The first question to the panel on Tuesday night was asking how we respond to the “But what about your health?!” demands.  As the fattest person in the room, it meant a lot to me to make it clear that my health, and in fact anyone’s individual health, is nobody’s business but their own.  That it’s not a subject up for discussion unless the person themselves wish it to be so.  You know, the “If it’s not your body, it’s not your business.” mantra.

The representative from EDA then added that she saw the situation differently, and while she started positively with stating that the same health messages should be given to all people, regardless of their body shape or size (which I agree with), it soon devolved into a lot of deeply healthist and fat stigmatising rhetoric about bell curves of mortality rates in body sizes, BMI, “obesity epidemic” and “weight risk factors”.  I was at pains to point out that as someone at one end of that “bell curve”, most of this rhetoric is deeply problematic as it has a risk of demonising and othering those of us who fall at either end of that bell curve.  It also implies that we require intervention into our health, and ignores the fact that “risk” in no way equals “certainty”.  It perpetuates an assumption that people at the ends of the bell curve are by default defective, rather than just the natural extremes of a diverse spectrum of body types.  It also perpetuates the assumption that very fat people or very thin people by default are inevitably going to suffer health issues and/or shorter lifespans that they are only statistically “at risk” for.  This is not an accurate assumption nor is it a helpful one.

I was grateful that it was also raised by someone in the audience (kudos to Amy if you’re reading this) that BMI is both an inaccurate and ineffectual measure of anything (other than ratio of weight to height) and that it is deeply triggering to not just fat people but also to eating disorder sufferers in general (which was many of the audience – since it was an eating disorders event).  BMI is often the stick that people with poor self esteem and body image, and eating disorders beat themselves over the head with.

Unfortunately, I have found healthist rhetoric like this is alarmingly common from eating disorder support organisations, and while they may be well intentioned, are causing the exclusion of many people based on body shape and size, as well as level of health.  The reality is, many eating disorder sufferers have other health issues or may be people with disabilities as well as those caused by or part of their eating disorders, and these already vulnerable people are often made to feel that they do not deserve compassionate treatment and support because they’re hearing the message that health is the most important factor in treatment and support.

We need to keep repeating the message that not only is health completely and utterly arbitrary, but it is not a moral obligation either.  Moralising health is a deeply ableist attitude.  We need to keep fighting for our personal agency in health care as well.  Yes, occasionally there are people who are genuinely unable to advocate for themselves, these are in the vast minority and most importantly, that cannot be determined by either their weight or their actual physical health.  I believe the ONLY way to assess the inability to self advocate is through thorough and compassionate psychological assessment.

As long as we as a culture continue to define wellbeing and human worth by weight and/or arbitrary health measures, we are engaging in both ableism and fat stigma, neither of which actually help people build better wellbeing.  And it’s not just fat people/people with disabilities who are affected by this.   The fear of fat and stigmatising, ableist messages about health trigger damaging behaviours in people of all sizes and levels of physical health/ability.  As long as people are afraid of being fat or place moral obligation on health, they will be engaging in damaging and indeed unhealthy behaviours to avoid being fat or unhealthy.  It is a vicious cycle of direct cause and effect that we have to break for any progress to be made, and that needs to start with the very organisations who are in place to help break disordered behaviours.

What we need an entire cultural change around health and weight and I believe that eating disorder support organisations and groups need to be at the front of this cultural change, not being dragged along by those of us on the margins.  They have a responsibility to make effort to include and support those of us who are most vulnerable to stigma and bigotry, not marginalise us further.


113 comments on “Fat Stigma, Healthism and Eating Disorders

  • THANK YOU !! (i had to say that first). i have been reading your blog for a long time & this is one of the best ones you have ever written. YES !! HEALTH IS NOT A MORAL ISSUE. thank you for saying it !

    my mother nagged me relentlessly about my weight from the time i was 10 years ago (i developed early & she had issues about that) & she nagged my sisters as well. i turned to drugs to stay thin & my sister became anorexic/bulemic. i still struggle with sobriety issues & am now just beginning to accept my hefty body. THANK YOU for writing about this because you really help me.

    if sobriety is not a moral issue (as bill wilson so radically suggested almost 100 years ago), then health in general is not a moral issue. it is curious that his reasoning … that nobody blames the person who has cancer & everyone is sorry for them … has now been turned completely upside down & if a person has this or that kind of cancer, everyone looks to the “cause” of the cancer & if that person’s “lifestyle” had anything to do with it. & there goes any compassion for the person.

    everything about you is FABULOUS. i just had to let you know. & THANK YOU. thank you thank you thank you.

    • silverapplequeen it seems to be something that has gone long unsaid, the way that fat people are dismissed by the eating disorder community (both professional and personal). And often our families are the worst offenders at encouraging disordered behaviour in fat people.

      I often say, if people are going to pull the old “but you caused it” bullshit, then they need to look at professional athletes, extreme sports enthusiasts, people who drive cars (one of the most dangerous things you can do) and all sorts of other injuries and illnesses that are caused by people’s actions rather than genetics or just bad luck.

      And thank you so much for your kind praise – it helps in the face of so many telling us that we’re unreasonable in standing up for ourselves.

  • There is so much here I want to reply to, but my brain is not functioning well enough this morning to coherently string the words together. Instead, I will thank you for posting this, for helping to give us a voice and for giving me food for thought.

  • Great post. During past struggles with eating disorders, I was diagnosed with anorexia at times, and eating disorders not otherwise specified at other times. Your points about EDNOS excluding folks who almost completely otherwise meet criteria is important not just culturally, but also extends to stingy insurance companies looking for excuses not to provide coverage for treatment. Further, I remember being so frustrated during my various years of struggle that people would take one look at me and make a decision about whether or not I was “fine” — let’s just say, many of those times that looked okay were not. The way we look doesn’t reflect whether or not someone has an eating disorder, and how severe it is. Thank you for posting this and giving us more to think about.

    • You’re welcome Erin. That’s it at the crux of the matter isn’t it – you can’t tell anything about a person’s wellness (or lack of wellness) by simply looking at them.

      But of course there are always those (as we saw by now deleted comments) who will come along and say “BUT NO YOU CAN’T BE ANOREXIC BECAUSE, WELL, BECAUSE FAAAAAATTTTTT!!” Unfortunately, that often tends to be fellow sufferers. Whether it’s because they feel the need to divorce themselves from fatness or because they want to maintain a sense of exclusiveness to certain ED’s, I’m not sure. But it helps no-one and while official criteria may say one thing, it’s time to CHANGE those criteria.

    • Yes, I know of one of those stereotypically “lucky” people who can eat “bad food” all day long and remain slender (and she has fine bones and is petite, so she “looks good” all the time). When she married in her 20s, she wanted to start having children early. After two years, she went to her usual doctor for an exam. He didn’t bother to do an exam. He said that she was “obviously” healthy and just had to have more sex. She got a second opinion: same thing. Third opinion, and past 5 years into this quest, and she finally got a doctor to sign off on tests. Whaddaya know, this “healthy” “trim” “fit” person had a somehow painless but long-established and continually worsening case of endometriosis so extreme that she required multiple surgeries to clear it all up. If she had gotten tests when she asked for them instead of (IIRC) 7 years later, she probably would have had multiple children already. As it was, she had to face the risk that the surgery itself would render her permanently infertile.

      You just can’t tell by looking!

  • My brain is not awake enough to say anything more cogent than THIS! SO MUCH THIS!

    The eating disorder community should be in the forefront of discussing how the behaviors are dangerous, no matter what the size, and that looking at how large or small a person’s body is gives little to no indication of how said body is fed.

    • It’s like this vicious circle Twistie. The ED community puts emphasis on health and weight, so people take up dangerous and disorderly practices to “lose weight” and “get healthy”. Disordered behavior screws up the body, and ED communities engage in more weight and health rhetoric. It’s not helping anyone, fat or thin or somewhere in between.

  • Fab Post and agree entirely. As a ‘larger’ person and a specialist eating disorder nurse, I spend the majority of my time thinking, reading, writing and talking about these issues. Fiona, you raise some very important points. Here in the UK we call the determining of a person’s ability to make an informed decision ‘mental capacity’ – we have the ‘mental capacity act’ which is used to assess a person’s ability. Always starting from the premise that a person does HAVE capacity unless or until proved otherwise and if so the health profession and / or nearest relatives / carers can ‘step’ in to help make those decisions. As you quite rightly point out and I have witnessed this myself, anorexia can present as psychosis and no matter how much a person is imploring that they want to die, from what we know about anorexia, we have to ask the question “but if you didn’t have this horrendous illness, anorexia, would you still want to die?” – the illness affects cognitive functioning so severely decisions are often too affected and manipulated by the illness. As health care professionals we wouldn’t be providing duty of care if we let the person in the grips of anorexia not eat, not drink and therefore die because that is what they say they want. Anorexia says that’s what the person wants – that’s something very different. Starvation as you say Fiona does affect our functioning, this has got to be considered and acknowledged. I suffered with Bulimia for 15 years, but never talked about it or sought support unfortunately. However, I have now been in recovery for 4 years. I still have disordered eating but am on a journey to help with this and to help others. Thanks for an interesting post and comments. Leanne 🙂

    • Thanks for this comment. I tried to kill myself, thought up loads of ways of doing it. All during my ED days. I believe I had anorexia, but I weighed more than 200 lbs. so no one cared. I usually thought that the world would be a better place without me, since I was a screwup.

      I’ve been in 1 yr recovery, all on my own, with the help of 2 friends. They’re both gay too. And I love them.

  • Oh boy. This is a timely issue for me.

    I’ve recently realised that I have an eating disorder and have tried to get help for it… unsuccessfully. I’m in my late 30’s now but it all started with my first diet when I was 15 (Jenny Craig). I felt I wasn’t losing enough fast enough so I severely restricted my eating. My ‘counsellor’ at JC knew, btw; she told me what I was doing wasn’t healthy and in her next breath praised me for losing weight. My parents found out and went ballistic at me (fair enough, I was wasting a hell of a lot of their money, money we just didn’t have) and I began to have periods of bingeing. As I’ve gotten older the starving/restricting has lessened and then stopped completely but the bingeing has continued and I’m fairly sure I have BED.

    But it turns out only anorexics and bulimics are ‘worthy’ of help where I live. I went through 3 GP’s before I found one willing to refer me to the eating disorder clinic (and the look of disbelief on the faces of the GP’s when I mentioned restricting was always helpful to see). But the clinic? It only deals with anorexia and bulimia and sometimes EDNOS. They suggested I try a dietitian and Overeaters Anonymous.

    I was so angry, and so frustrated, I cried. For pete’s sake – BED is not like alcoholism. The feelings that drove me to starve are the same as the feelings that now drive me to stuff myself. It’s not an ‘addiction to food’ it’s a *punishment* i visit on myself, it’s not a pleasure. But it seems even the eating disorder world sees me as just a fat pig who needs to put the burger down.

    I’m crying as I write this because… I feel so lost, and alone, and angry and out of control and there is literally no-one I can go to for help (my GP won’t refer me for general counseling either, and TBH even if she did I don’t know when/if I’d be seen, they’re over busy as it is).

    I’m sorry to dump this all here. But damn it I am sick of being seen as not worthy of help because of my size.

    • I know EXACTLY how you feel. I haven’t sought help for my BED for this exact reason. The fear that I’ll be dismissed as just having a lack of self control, or as not belonging or deserving the same care as people with “serious” eating disorders. It’s not fun, it’s not going overboard with treats or “just not thinking about what [I’m] doing”. It’s a compulsion that has nothing to do with lack of self control and makes me feel awful every single time. When I try to explain it to my partner I compare it to my anxiety disorder, in that it’s not a rational thought process that ends in me DECIDING to binge. He still seems to think it’s just a matter of self control, and that if I exercised more and ate healthier that would mysteriously cure me. Aside from how I have tried that already it just makes me feel like he’s completely missed the point.

      • Fox, I wish you the same strength and healing that I wish TANZ33. I wish I could make things better for all my fat family suffering in the face of ED’s.

    • I’m so sorry you are dealing with this TANZ33. You have every right to be angry and hurt and frustration at the failure of those who are supposed to care for you to do so. You are not alone, that’s for sure, many of us have experienced so many of the same things. I’m angry on your behalf.

      You ARE worthy of help, you ARE worthy and there IS a road out of this shit. I have never received help from those who are in the ED business, but I got it from an excellent GP and good therapy, but most of all I got it from my fat community.

      I wish you all the strength and healing in the world and just want to remind you that you are not alone, OK?

  • Reblogged this on The Cheese Whines and commented:
    As my mother lies in a hospital bed recovering from hip replacement surgery, she talks about how the nausea she is experiencing is actually “a good thing” because it will force her to lose weight. It’s sad that when recovering from surgery, the first thing that comes to mind isn’t “I hope I will get better soon” but “I hope I lose weight.” This is the result of the “war on obesity.”

  • Fiona, you can go read my piece AGAIN and actually absorb what I am saying, or if you couldn’t be bothered, here, I’ll cut and paste the sentences that are actually in the article above:

    “Yes, occasionally there are people who are genuinely unable to advocate for themselves, these are in the vast minority and most importantly, that cannot be determined by either their weight or their actual physical health. I believe the ONLY way to assess the inability to self advocate is through thorough and compassionate psychological assessment.”

    Please take the time to actually read the piece in full before asking questions like the above, it will save you a lot of embarrassment later.

    • I apologise to anyone who had to read Fiona’s bigoted drivel in her second comment. I have deleted it as 1) it is doing EXACTLY what I spent considerable time pointing out in the article above, 2) it is triggering to many of you who are fat who have suffered restriction/purging/starvation symptoms and have been repeatedly dismissed by those who are meant to help and support you.

      I spent the whole article explaining why eating disorder support organisations AND many of our fellow sufferers fail fat people by stigmatising us further, and she comes along and does just that. FUCK YOU LADY.

      She is no longer welcome to comment here and is permanently blocked from doing so.

      • Ha! We’ve never had your fucking support in the first place. That’s the whole problem, so it’s no loss to me or any of the other fat people with eating disorders who have suffered at the hands of eating disorder organisations and groups.

        Thank you for illustrating the entire point of this piece BEAUTIFULLY.

      • If you had perhaps taken the time to read what I was saying in the first place, before demeaning me and other fat people who have suffered because of the very attitudes you yourself showed, we might not be in this position. Perhaps, if you had given ME the respect of reading what I had taken some time and effort to write before commenting, instead of being so rude as to declare “TL;DR” (which I personally find the ultimate of disrespect to a writer – if you think something isn’t worth your time in reading, then move on, don’t be so rude as to declare so to the author.), you might have found you didn’t get what you deserved, which is an angry, hurt response to your rudeness.

        The problem is in ED professionals. But it is ALSO the general community of ED sufferers who treat fat people as though we are lower down on the scale of importance, or as though we are ignorant, or lying, or delusional, or even simply declaring that we don’t have the right to be angry at those who mistreat and misrepresent us. It is the problem of those who are too lazy to listen to us, who dismiss us and deny us our own experiences. Until this is acknowledged by the whole ED community, be it medical, organisational or fellow sufferers, then we are being failed by that whole community. Particularly when so many of our fellow sufferers who are not fat believe it is acceptable to use fat people as “inspiration” to perpetuate their own disordered behaviour by being disgusted at us.

        You were so rude as to state that I had “lost the support of the ED community in Brisbane”. I was unaware that you were the sole representative and spokesperson for that community in the first place. But the reality is I never had that support and I still do not, unless I purchase that support with my silence and subordination to those who believe that thin ED sufferers are by some means more valid than fat ED sufferers. But I will NEVER be told I and other fat people are unworthy of respect and compassionate care again. Not by you or anyone else.

        • Don’t you DARE come here and tell me how I’m rude in response to your shitty behavour. Don’t you DARE come here and lecture me in MY space how I should respond. Don’t you DARE come here in my space and threaten me with “loss of readers” or any other fucking thing.

          Seriously, shove your empty, bullshit apology up your arse and don’t you EVER comment on my blog ever again.

  • Amen, Cie. I am very sorry that your mother has completely swallowed the bullshit we are fed everywhere in modern culture. Her remark reminds me of the insensitive, clueless people who say to a cancer survivor, “Well, at least you lost weight”. Also, the idiotic so-called medical professionals who tell a young woman who has survived cancer at least 6 times, has half a thyroid gland, & is on medication for underactive thyroid that she needs to lose weight. (Not that it matters, but she runs 150-160 pounds at 5’5″, was bulimic in her teens, eats very little, & sometimes says she hates to eat & wishes she could live on liquids & vitamin pills.) I obviously feel no one should be urged to lose weight, but how can ANY sane person urge someone like this to lose weight?

    And healthism has for years been one of the major problems holding fat acceptance back. Far too many people are still apologizing for their fat, constantly trying to prove how ‘healthy’ they are, how they deserve rights because they are responsible & live a ‘healthy’ lifestyle, & even go on to think that the controlling, nannying ‘health initiatives’ politicians & other public officials, etc. want to force on our children are perfectly okay ‘as long as they do it to ALL the kids, not just the fat ones.” We are raising children who are afraid of food, their own bodies, & especially fat. We have little ones who should be thinking of having fun & being as carefree as it is possible to be asking the adults in their lives (my granddaughter, for whom I have cared a great deal since she was an infant, has started doing this to me since she started school) whether or not a particular food is ‘healthy’.

    I only know what I have read about eating disorders, since, contrary to popular opinion, I have never binged or eaten compulsively in my life, & my own disorder, which I know is still part of that spectrum, was always compulsive exercise. However, I do know that the way many people with eating disorders are treated does more harm than good. I also read enough of the ‘overcoming overeating’ type of books which were being published 30 years or so ago to know that the vast majority of people who treat eating disorders honestly believe that anyone who ‘normalize’ his/her eating will become thin. I read those books because the culture had me convinced that, even though I was usually eating half as much as many thin people around me, because I ate what I wanted & didn’t diet often, I MUST be a compulsive overeater. I came to understand that I was a pretty normal eater but a compulsive exercise, but felt for years that I must have something WRONG with me or I must be in denial about how much I ate because I was not thin, or, on the couple of occasions I got thin in my 20’s, I could not STAY thin. Our whole culture tells us that we should not have eating disorders, but that we must be thin. And my personal experience is that if you, like me, spend years exercising 4 hours or more daily, even if, as in my case, you have a physical disability & the excessive exercise is breaking down your joints, at least 90% of the people who know about it will congratulate you & urge to you to keep it up.

    • Healthism is why I no longer consider myself part of “fat acceptance” Patsy. I know people want to break stereotypes but the reality is that some people fit stereotypes and they deserve dignity as much as anyone else.

      I understand the compulsive exercise thing too – I did that for years and years myself. That is part of the spectrum of disordered behaviour that goes with eating disorders (after all, you’re actively trying to “burn off” more than you eat – they go hand in hand). And they’re all for the same reason – to get thin because we are taught that’s the only value of women.

      Binge eating and overeating are often misdiagnosed in fat people, because it is assumed that we must be doing these behaviours merely by way of being fat. To the point, as you say, that many people don’t know what “normal” eating is, and they think binge eating and overeating are just eating more than some diet forum or weight loss book tell you to eat.

      Both of these behaviours are actually extreme behaviour. It’s not eating a hamburger and fries for lunch, or having a second serve of dinner, or having snacks through the day. It’s eating everything in the fridge and pantry, or other vast amounts of food. It’s not a big meal, it’s eating EVERYTHING you can get your hands on uncontrollably.

      But of course we as a culture have such a fucked up attitude towards food that we have this idea that eating anything other than a small dressing-free salad and low fat yoghurt is sheer gluttony. Women have been taught that eating at all is greed and that we don’t deserve to eat.

  • Thank you for writing this, Kath. Too often I have heard that same kind of healthiest rhetoric from ED education and support people, who even while they are being kind and understanding are still deathly afraid of fat. I definitely think those involved in ED treatment and education need to get on board with fat positive philosophies quick smart. It was “fat acceptance” that saved me when the medical industry had pretty much ignored my eating disorder, and I agree that eating disorders are an inevitable outcome to the widespread fear of fat the “obesity epidemic” panic continues to foster today.

    I’m also in the situation of having been considered EDNOS purely because of my size – it would have been anorexia had I “managed” to become underweight, but honestly I probably would have been dead by that point. Basing eating disorder categories (and subsequently, whatever anyone says, how seriously other people take this illness) on weight is fucking absurd in the extreme given the nature of these illnesses.

    As a result of my size (even on 300 calories a day after years of severe restriction, I was 90 kilos at my lowest weight), every single medical and psych professional I have ever seen to try and deal with my eating disorder has made their main goal getting me “well” enough that I could return to dieting “safely”, because obviously fat girls need to lose weight, right? One told me I was ready to graduate from therapy when I agreed (after considerable bullying) to join Weight Watchers again, the very environment that had kick-started my obsession with calorie counting, eating as little as possible and gauging my success as a human being on whether my weight went down or up. Another doctor referred me to a psychologist who worked out of a bariatric surgery clinic. When I finally convinced her I was not interested in perpetuating my desire to lose weight and most DEFINITELY was not interested in weight loss surgery, she tried to get me into a specialist eating disorders clinic but at 25 I was “too old” for them. Because only teenagers get eating disorders, right? Well, it started when I was a teenager, but when you never get thin enough for anyone (least of all yourself) to think you need/deserve treatment these things tend to perpetuate.

    Like Patsy said, our whole culture tells us we must be thin, but we mustn’t “resort” to eating disorders. So when you are a fat person with an eating disorder you’re in the double bind of feeling all the shame that every eating disordered person gets – for “cheating” at weight loss, for being “vain” and “selfish”, for hurting the people who love you when that’s a drop in the ocean compared to how much you yourself are hurting – and feeling fat shame on top of that. Regular fat shame and the twisted disorder-related shame of not even being “sick enough” to deserve help. Because severe restriction, binge/purging and obsessive exercising are scary and dangerous in thin people, but in fat people they’re just the appropriate penance for daring to be fat.

    I think it’s incredibly important that you spoke at this event, because eating disorder discourse needs the voice of fat people in it, especially fat people who know what it is to have their own ED worsened by systemic fat hate. Both to reassure those with eating disorders or at risk of eating disorders that, really, being fat isn’t the worst thing that can happen to you, and to keep on pushing ED educators and treatment specialists to engage with fat positive ideas. They really can save lives, and I am living proof.

    • Sarah, your whole comment made me go YES!! YES!! HOW HARD IS THIS TO UNDERSTAND!?! I keep hearing so many commonalities in our stories, so many examples of the same shaming, the same encouragement of disordered behaviours, the same exclusionary bullshit… it drives me completely bonkers with frustration and anger. I’m sorry that you or anyone else has to go through this crap.

      Until those who are complicit in othering fat ED sufferers change their thinking and the entire culture around ED support and community, we will still be failed by them.

      I do get so frustrated but all I can do is keep speaking wherever I can get an opportunity and hope that someone, anyone hears the message.

  • Thank you for speaking out about this topic – wonderfully written and truly spoke to me, as always. The stigmatization of fat bodies in eating disorder communities is alienating and triggering to me. I have always felt much more healed by fat acceptance communities than by eating disorder communities even as an eating disorder survivor three years into recovery.

  • Thank you for this post; it is the story of my LIFE. I’ve only recently learned to advocate for myself against the assumptions of health care providers, and I’ve had to explain over and over again that I have a long history of disordered eating and that it never involved binge eating, but excessive restriction. I will never again count calories or carbs or “points” because I already know that road leads directly to obsession for me.

    I’m getting better at standing up for myself, but it still pops up whenever I see a new doctor. I recently saw a new neurologist for my MS, who immediately told me that getting to the gym once a week was “not good enough”. By way of redirecting the conversation toward positive advice rather than critiques of my current habits and abilities, I went through the whole spiel about my history. I told her that we could talk about specific dietary or exercise suggestions relevant to MS, but that I was not interested in dieting or losing weight. She countered with “You want to lose weight, I know you do.” Eventually she got the picture that I would not be discussing that with her, and she began to focus on my actual symptoms and ways to combat the crushing fatigue that keeps me from getting to the gym more often.

    I just got back from the pharmacy after picking up a scrip that’s generally used to treat ADHD, but can help people with MS overcome fatigue. The pharmacist asked if I’ve ever taken this before, and since I didn’t get to discuss it with the neuro, I asked some general questions about what times of day to take it to avoid insomnia, whether to take it with food, that kind of thing. He took one look at me and said, “It can help you eat less, so you might want to take it 30 minutes before a meal.” I was tired and distracted after a long work day (hello, fatigue), so it didn’t hit me until a minute or so later what he had said, and I didn’t confront or correct him. I wish I had.

    • Fantine I’m sorry you have to fight these same fights over and over again. I know how demoralising that is, and I know that some days you just don’t have the spoons to take on the fight. In those times, I turn to my fat community. I know there is always someone out there to listen, who understands and who sees the world through the same lens.

      You don’t have to take up the fight every time, that’s for sure. None of us are obligated to be “on” 24×7. But I understand wishing you had too. Sometimes you just want to verbally smack someone down for being douchey about your weight and/or health.

  • I have to say since this is my first time really reading and posting a comment that you guys are brave to continue to fight the good fight against all sorts of ED’s and for fat acceptance. Kudos to all of you! It’s sad that so many “medical professionals” don’t have a clue as to how to treat people, esp. fat people, cuz they’re so conditioned by societal expectations of how the “perfect body” should look. Seriously, where DO they get their license from? Compassion has gone right out the window! But that’s society today, unfortunately. The first post by Fiona had some good questions (I don’t know what her next ones were like since they were deleted, but my guess is the inner troll rose to the surface), and Fantine, if I had been the neurologist, I might have asked if you did other activities besides the one-day-a-week visit to the gym (such as a walk or even just putting on music and dancing around in your living room, only cuz I’ve heard it’s good to do something active 3x/week, which I could work on too, admittedly, but when you mentioned your fatigue, I would have changed my tune and try to help you with that, which is good she did that). In other words, they should help us the same way they help any other patient, cuz it’s true: we ALL deserve to be treated with respect and for the ACTUAL CONDITION we came in for, rather than our weight.

    • DizzyD, that neurologist told me she “expected” me to exercise 30 minutes a day, five days a week, and “wished” we went to the same branch of the YMCA so she could “check on me.” When I expressed the hurt and pain and harm that was caused by doctors ignoring my MS symptoms for four years (four years that I could have been on disease-modifying therapy, had anyone bothered to diagnose the disease), she told me bluntly, “You need to get over that.” Her whole attitude was one that I’ve come to expect from most doctors: they don’t believe what I’m telling them about my own body.

      Even though she eventually ended up helping me (through a prescription to fight the fatigue), her attitude and beside manner were the worst. I was severely depressed and unable to eat normally for weeks after that visit. I decided that I wouldn’t be able to work with her, and I left a very honest patient review about her on my insurance company’s website.

      Apparently she has since left the practice and gone to another state to teach in the neurology department of a medical school. Better for the patients if she’s not around them, but I weep for the medical students who are going to continue to be trained with that attitude.

    • How about instead of demanding an inventory of what activity fat people do, medical professionals ask us how we FEEL. Do we FEEL like we have energy to live our lives and get out and have some fun physical activity too? Do we FEEL like our bodies can cope with day to day life with some spare for non-essential activity? Do we FEEL good when we are physically moving our bodies?

      I know that in the times I’ve been really struggling, if a medical professional had concentrated on making me feel better, I would have been a lot more likely to do more physical activities. I know that when my doctor asked me yesterday “How are you enjoying that beautiful waterfront you live near now?” and I responded that work has worn me down lately her response was not to say “get out and exercise”, it was “How can we get your work stresses down so that you have the energy to enjoy your walks and bike rides again?”

      Just by talking to her for 10 minutes about how much I missed having the time and energy to spend time on my local waterfront without her casting judgement on me made me WANT to spend more time down there on my bike or walking with my music on.

  • I am so glad you brought the fact that one can have an eating disorder without reaching the official BMI criteria for said disorder. I do believe I was only days from death (teeth falling out, heart flutters) and I was still within the “healthy” BMI range, albeit on the low end. I cannot imagine how much harder it must be for people struggling with eating disorders who are larger than I was to get help.

    Much better than health would be a focus on happiness. Because I think that is what most of us really want, is the tools to be happy. It’s just that too often we use “thin” as a stand-in for “happy.”

  • Fucking hell, I can’t seem to get rid of this arsehole. For someone who is “done” with me, she keeps fucking hanging around like a bad smell.

    Yeah, I’ve never made an effort to hide my “true colours” and anyone who doesn’t like it can kiss my fat arse. I’m not here to waste time on people who turn up in MY space and tell me what I can and can’t do.

    For everyone else, I apologise, for some reason WordPress won’t let me block this douchebag.

  • Fantine – my sincerest apologies. I’m sorry that neurologist was such a dickwad, and I agree what a shame she’ll be passing on that BS to the next generation of doctors. She SHOULD have listened to you first, then worked out some regimen inc. meds and some form of gentle exercise, perhaps, that would have worked for you at your level of ability at the time, rather than what she THOUGHT you SHOULD be able to do. That was my thought – sorry if it’s coming out wrong. : (
    Hope you’re doing better!

  • Or at least some therapy, like you said, then gradually build from there, cuz I’m not really sure what all they do with MS. Maybe that’s better. I keep feeling like I’m putting my foot in my mouth! : p

    • DizzyD, I sense your good intentions, and if you are a health care provider, maybe this discussion is opening your eyes a little bit?

      A very big part of my offense to the neurologist’s comments was that *of course* I know that more exercise would be better, and I highly resented her implication that the only reason I wasn’t doing it was laziness or disinclination to take care of myself. I *know* that exercise helps reduce inflammation and can energize you. I KNOW THIS. All it would have taken to spin the tone of the discussion in a positive direction was for her to say, after finding out how often I go to the gym, “May I ask why you’re not doing more?” Instead, she said “That’s not good enough.” At that point, all I could say, through gritted teeth, was “It’s gonna have to be.”

      She’s an expert treating MS patients–she should already be aware that extreme fatigue is the most commonly reported symptom. If she had begun with empathy instead of judgment, we could have had a discussion instead of me feeling immediately defensive.

      • Fantine, Amen to that! And since I’m thinking of doing something in that general area, it’s good to know. So sad that many of these “health-care providers” can’t be bothered to show concern and empathy for their patients!

  • I’m shocked that this happens in this day and age, that is just awful. Everyone is entitled to get the health care they need when they need it regardless of what they look like, weigh, what religion, gender etc. We don’t discriminate against smokers for lung cancer or anything else smoking causes! We don’t go on and on about the fact that the majority of ER room presentations are people who have gotten themselves jacked up on drugs or drunk out of their brains and into some trouble – or the people they have hurt. We just treat them.

    Has anyone from here who has an ED and is experiencing discrimination tried something I wondered that might work – could you email or phone – somehow contact an eating disorders service or professional in your area without actually going in in person – and tell them you would like treatment for an eating disorder. And tell them everything, your behaviors like what you are eating or not eating, how much you exercise, any purging etc, physical symptoms like weakness etc – with no mention of your weight? Give them a clear picture of your situation. If they ask, it’s very easy for you to say you don’t weigh yourself any more, you avoid the scales, or you don’t want to say.

    I suggest this, because this gives them NO reason at all to discriminate. Ask them what they suggest given your situation. And then, if they offer treatment or referral, then it’s up to you where to go from there. I don’t see why anyone should have to say “Oh by the way, I’m fat…” when they are asking for treatment. It’s not what you are asking for treatment for. Doing it this way might also give you a way to directly say to them, hey, you are full of shit because you agreed I have a serious ED and I’m in dire need of your help, if they have a different view of things on learning the weight.

    I just can’t believe this crap.

    I don’t think changing the diagnosis will work – that’s been years and years in the making, a worldwide thing. It’s taken years just to get them to include BED. It’s not going to happen. It’s more about educating the ignorant and de-stigmatising fat anyway.

    Good luck and hope that things get better for those who are struggling.

    • NobodySpecial – if you think this is shocking, take a look at http://fathealth.wordpress.com/ and see just how fat people are treated generally by the medical profession, let alone fat people with eating disorders.

      And while contacting a ED group remotely is a useful way of getting information without discrimination, it’s not what we should be striving for long term. Fat people with ED’s should not have to hide themselves away, nor should we not be able to go to a health care professional or ED professional and be treated for our ED’s with dignity and respect. The ONLY way to solve this issue long term is to change the culture, redefine the diagnoses (defeatist attitudes like “but it took years to get BED included” doesn’t help either). We have been silent long enough, it’s time to make some noise and force some change.

      It is NOT more about “educating the ignorant than de-stigmatising fat” at all. De-stigmatising fat IS educating the ignorant, and until fat people can be treated as equals to everyone else, then the system is broken and needs to be fixed.

      • I will check that out, thank you. I AM fat as well as work in ED treatment in the private sector (which can be confronting for people) so I well know Thin privilege. Or lack of it. We get some normal weight people with bulimia in for maybe 2 weeks, we also have a day program which runs a few days a week that has included fat people – but I guess their rarity is because they don’t even that far (into treatment with an ED professional) in the first place. I actually would be interested in hearing your thoughts on what sort of treatment options would ideally be available.
        I’m sorry for the defeatist attitude, it comes from years of my own struggles and not seeming to ever get anywhere.
        I don’t also consider EDA a treatment provider. They refer and have groups of which I’m sure everyone is ALLOWED to attend.. just not sure who actually does attend – they advocate and educate – but I’m pretty sure they don’t provide treatment of any sort. I would love to know if I’m wrong, it would be another personal resource.

  • I came back to add. As someone working in the ED field in Australia – it is not just fat people who miss out on ED treatment. Part of the problem is that there IS NO treatment. The state of public ED treatment in Australia at the moment is, if you are imminently about to die, you are medically stabilised. If you need further monitoring, or if you weight is very low, (I won’t list the weight, but it’s ridiculous) you get transferred to a psych ward, a general one, and forced to gain weight. If you are lucky enough to have an ED unit in your public hospital you might get transferred there to gain weight. That’s it. At the moment, our ED units do weight gain and table support – you sit for your meals at the table with a nurse and they watch to make sure you don’t hide food and you eat every bite of it. Then you will spend at least 6 hours a day, an hour after every meal, just sitting to make sure you do not exercise or purge. It’s incredibly inane and boring. Therapy doesn’t happen – that’s for you to find and follow up yourself when you are out of hospital. Groups don’t really happen – there aren’t the funds or the staff. It looks good on paper, but it’s actually deplorable. There are only 2 beds for a program like this in NSW. 4 I believe in Queensland. Similar for other states. (Yes, I mean for the entire state.) THAT is why people miss out on ED treatment. It’s not just fat people it’s pretty much most people sadly.

    There are a few ED clinics in private psychiatric hospitals, but they are generally the same. Your best bet is to go private and get help for meal support and after meals, and to find a good counsellor or psych yourself. Also to present yourself at Emergency if you feel unwell physically, and get your GP to do regular blood tests and monitor things like your electrolytes. I’m sorry, but it’s a situation that has been at crisis point in this country for a long time and we still have a long way to go.

    • This is not quite true. As I mentioned above, this entire post was sparked by conversations WITH ED ORGANISATIONS who are failing fat people. Yes, the resources for ED’s in general are not what they should be, but they do exist, and they ARE excluding fat people.

      Please do not waste our time by dismissing thin privilege in this space. I will not warn again.

      • I’m sorry, I’m not dismissing thin privilege. I’m describing what exists as I know it, and I would be very grateful to know what I’m missing, as it would be more for me to add to my own personal list of resources. Another part of the problem is many don’t know where to turn for help when they are trying to find it.

  • Not a challenge, just a clarification: Do you disagree with making health a moral issue because our health is not ultimately under our control? Or, asked differently, do you understand moral obligation to depend upon freedom?

    Congrats on being Freshly Pressed!

    • Whether or not our health is under our control or not is irrelevant. A person’s health is theirs. Not public property, not the government, not the health care industry, not the media, not ones family… it belongs to yourself and yourself only.

      Not to mention that the moralisation of health in current society is completely arbitrary. All the tongue clucking over fat people’s health, and nobody says a word about sports people who screw up their bodies by pushing them to extremes. Nobody says a word about adrenaline junkies who injure themselves jumping off things or traveling at high speed. Nobody clutches their pearls over people who choose to drive a car and then get into an accident injuring themselves. I could go on to list dozens of examples of avoidable illnesses or injuries that are looked upon with compassion instead of the stigma that merely being fat receives.

      The ONLY reason that fat is marked as a “health choice” is so that people can legitimise fat hatred, a hatred that has been fostered and built by an industry completely created to subjugate women by making them terrified about their appearance.

  • Thank you for your post! I love the energy that your empowered and confident words spill onto my screen and the joyful gratitude which has overcome my heart. Thank you. I feel understood.

    You see, I recently met my inner binge eater which came on as an addiction like I had never known. I even used to be a smoker and that so-called addiction was nothing in comparison to the desperation I felt around food. Seriously, my life fell apart. I literally ate my whole paycheck each month. I wasn’t holding myself accountable for anything and all I could do was keep stuffing my face… Or stuffing my feelings down. The more I ate, the more I felt lethargic and sad. The more sadness I experienced, the more I ate… I was literally feeding my depression and avoiding the root issue.

    I know I’m lucky because my body doesn’t get fat. However, for me, or my normal size, I am really big…. I LOVE that you wrote, “my body my business”. You know, I can say till I’m blue in the face that, “I know I’m not fat, but for me, this isn’t healthy” and the response from others has been a terribly dis empowering, “You have distorted body image disorder” or, “you look healthier now”. They have no idea how much I eat and how much I hurt myself. They have no idea what it’s like to be in my body and they have no idea what it’s like to feel like a prisoner to food….. And how nice it would be not to throw judgement my way and just understand. It’s exasperating, really…

    So thank you. I feel understood.

    • Currie Rose – your story illustrates my point perfectly – that so long as we as a society are conflating health with thinness, everyone is being failed. To look at you and say you are free of ED issues despite your behaviour showing otherwise, is both dismissive of your experience and dangerous to your health.

      I hope you find peace and healing soon.

  • Great post, you covered a lot. “Moralizing health” is a great line, I’m gonna use that.

    As a former bodybuilder, I still laugh my ass off at the BMI, which declares most bodybuilders to be morbidly obese and ignores basic human musculoskeletal diversity. We just ain’t all the same. And thank goodness because how boring would THAT be?

    The elephant in the room regarding health is still money. All these statistics, all these charts and graphs and food pyramids and scientific studies exist because someone funded the research to produce them–someone with a lot of money, usually a big company that sells something. Did they do it out of pure love and concern for their fellow man? Well, that’s what their commercials would like you to believe. Moralizing health helps them perform that sleight of hand. No, they are doing it to make a huge profit. They are businesses, after all, not charities.

    Ever watch their commercials? They are the perfection of the marketing paradigm: First, you provide a fear, then you provide the cure for that fear, all in thirty seconds or less. You’ve got to keep your customers convinced that they cannot survive without your product. If you can hitch your wagon to an epidemic moral dilemma, all the better. If you can convince your buyer that not only will your product improve their life but make them a better person, it will become an addictive drug that soothes empty souls. And when the current ideal human condition is placed at odds with his or her natural instincts, when the moral high ground is to deny oneself food, rest, and peace of mind to achieve an impossible physical state, all for a fleeting social acceptance that temporarily assuages a pervasive loneliness and self-doubt that the commercials helped instill in the first place, the big companies just sit back in their chairs and laugh and laugh. They hit the jackpot: the machine is running itself.

    A few hundred years ago, curves on women signaled wealth because she could afford to eat all she wanted. Muscles on men signaled low wage laborers who had to slog it out in factories and farms. Now, the moral high ground has shifted. Denying oneself sustenance is advertised as feminine strength and bulging pectorals indicates a man who willingly denies himself rest. That’s a lot of denial. That kind of internal strife really builds up over time. No wonder they project so much anger and resentment towards those of us who say, “Screw that. I already have it all–beauty, brains, peace of mind, and the cupcake of my choice for dinner.”

    • Yup allthoughtswork – money is the reason we even have an “obesity epidemic”. That and subjugating women by making them terrified of others judging their appearance. But that’s a topic for another post. Or a whole bloody book! (Paul Campos’s The Obesity Myth does the job pretty well actually, if you are interested).

  • I am just going to simply say thank you for this post and thank you to the commenters who all shared their experiences. I am overweight, over 35 and have been battling bulimia since 1996, and anorexia before that. I got the courage in October 2012 to ask for help finally was told to eat less and exercise more.

    I wanted to say “Um, hi? I am not seeing you, Dr. Therapist, because of my weight. I am seeing you because I binge and purge.” but instead I sat in the parking lot after the session, crying and trying to decide if should even be here anymore. Luckily, I had two good friends that day who were there to listen via IM and I finally have a good therapist, but I still struggle everyday.

    OK, that was longer than just “thank you”, but thanks again for this and letting me speak up too.


    • I’m sorry that you were dismissed by the professionals that were supposed to help you sortaginger. I know that experience all too well. I’m so glad you found a good therapist, they are rare gems, that’s for sure.

  • Excellent post, bravo!

    I see what you mean, as I’ve been overweight my entire life, but I’m not really a binger or anything, except that I suffer from a serious amount of bodily disorders, so that when I manage to get one thing in check, something else invariable goes haywire…

    It’s funny how there’s so much ignorance surrounding the subject, and yet everyone seems to have their own (unsupported, factless and idiotic) answers.

    Thank you for posting this.

  • Thank you for this post. I hate that there is stigma in mental health, no matter what the problem, and stigma from within mental health treatments as well. One argument, which can help one person stabilize, won’t help everyone, and will damage many if it’s used improperly. Treatment should always be based on the individual and I totally agree with your statement: “I believe the ONLY way to assess the inability to self advocate is through thorough and compassionate psychological assessment.”

  • Its kinda like smoking. Smoking is known for being almost as harmful as being severely overweight. And Smokers also became outcasts.

    • Sort of but not quite Robert. Yes, smoking and fat have a lot of parallels when it comes to the way people are treated as inferior, and are lectured about their health.

      The difference between the two is, smoking is a habit and an addiction (which needs to be treated with compassion, not vilified) and being fat is neither of those things. Fat people are not fat out of habit, nor are they suffering an addiction. Some bodies are large, some bodies are small, and most bodies are in-between somewhere. Fat people in general are no more addicted to eating than they are to breathing – ie we need both to live. Of course like everyone else, there are some fat people who ARE addicted to food (who are eating disorder sufferers) and there are some thin people who are addicted to food (also who are eating disorder sufferers), and they need to be treated with compassion and respect too.

      That said, that doesn’t mean that either fat people OR smokers should ever be treated as inferior or as a burden on society – ALL human beings are valid human beings.

  • This post–THIS post. This is an amazing post that hits on so many things that NO one is talking about. LIke your first commenter, my mind is moving a mile a minute–I’m not even sure where to start. I think SARAHSARAH said what I wanted to say best:

    “Like Patsy said, our whole culture tells us we must be thin, but we mustn’t “resort” to eating disorders. So when you are a fat person with an eating disorder you’re in the double bind of feeling all the shame that every eating disordered person gets – for “cheating” at weight loss, for being “vain” and “selfish”, for hurting the people who love you when that’s a drop in the ocean compared to how much you yourself are hurting – and feeling fat shame on top of that. Regular fat shame and the twisted disorder-related shame of not even being “sick enough” to deserve help. Because severe restriction, binge/purging and obsessive exercising are scary and dangerous in thin people, but in fat people they’re just the appropriate penance for daring to be fat.”

    Thanks for writing such a thought provoking and awesome post. Kudos to you.

  • Thank you, you rock! I suffered silently with anorexia for over a decade. Even after a hospitalization (and unbelievably painful spinal taps) I couldn’t stop. I only hope that people will someday realize that their worth is on the inside, not what size their pants are. Keep up the good work!! =)

  • | myself am a little overweight, and I have suffered from Bulimia in the past. I remember when I was at the height of the problem I went to the doctors for a general health check, and he was running through the standard questions. When he got to “Eating disorders” he just took one look at me and said “Nope” and crossed the box off without even asking me. I wouldn’t have admitted it at that time anyway, but the assumption that because I was overweight I couldn’t have an eating problem was incredibly evident.
    Still a long way to go in this field I think!

    • gregschina – I question the term “overweight”… over whose weight? You are the weight you are. The ‘O” words, overweight and obese, are simply pathologisations of varied body types. Fatness is not a disease, it is simply a body type, like height or shoe size. Some of us are fat, some of us are thin, most people are in between.

  • This is definitely a eye opening post and I thank you for writing it. I am still trying to pull my head around it fully. I have to admit that I was one of those people that you spoke of: until this very moment I never really thought of how absurd it is to match health with morals.

    I suppose it is hard to separate if you were raised with a spiritual background, because you are taught that your body is the temple of Yashua and as it being so you should care for it. However, that line of belief has been magnified by society to such an extent that it is harmful. It is actually kind of a relief to have someone tell me that it is okay; even though it wasn’t meant for me at all- it helps.

    I was at a place before where I would get mad at myself if I didn’t get my exercise in. If I ate something unhealthy I would beat myself up, because “I know better” and “I should be taking care of myself”. But to get to the point where I feel like a bad person because I wasn’t being healthy is in itself not healthy.

    So, what I’m trying to say is, thank you for being the whisper in the dark that I need to hear.

    • Dream to Dreams, I grew up with a similar mindset. I have an amazing therapist, and we’ve discussed that I have a larger temple and that HAES is my way to tend my temple and maintain it.

  • This is a great post, and you point out a lot of important things about how each individual deserves respect and agency over their own health. A lot of assumptions get made about people, women especially, based on our body shape and size. However, I have to point out that a lot of the work to improve community health takes aim at the food industry that creates and markets such an array of cheap, junky food rather than making healthy, nutritious food affordable and easy to get. How many drive-thru’s are there for low-processed, whole foods? Zero. It’s not just about the individual and the choices they make… it’s also about what’s available in our food landscape, which is not arbitrary and is very much manipulated by corporations and government policy (or lack thereof). Just like the tobacco prevention movement has made strides by targeting the tobacco companies–not smokers–many of us are working to change what the food and beverage industry is doing to shape our health.

    Anyway, really good post, and I hope you don’t take my comments as a criticism but just as another layer to what it going on when people talk about the ‘obesity epidemic.’ Congrats on getting Freshly Pressed!

    • Food availability and class issues are something I am all too aware of Kylie, but they’re a subject for another post. This post is about how fat people are treated by the ED community, and I don’t want to digress from or dilute the importance of this topic.

  • I thought it was an assumption in my mind that overweight people are condemned of such fallacies. I never knew such bias actually exists. Shame that medical practitioners too think like that and before examining judge the person on weight. I know what the illness struck person feels (since am one of them). Your blog got me happier and am sure many would have felt so.
    Thank you for sharing and congratulations on being freshly pressed.

    • Yes moodsnmoments, such bias exists like you would not believe. Would you like to see just how vile fat bias in health care is? Take a look at First Do No Harm, a blog of experiences of fat people suffering prejudice at the hands of the very people who are supposed to care for them.

  • Great post. I have never heard of EDNOS. From reading your blog, I realized that’s what I had a few years ago. It’s awful and I can understand what you’re going through. Hang in there,

    {Photography and Wisdom}

  • Hi, there! This is the first post I’ve read from your blog, and I agree with what you wrote about BMI. That’s one stupid, twisted meter that causes unnecessary stress to many people concerned about their weight. I’m way underweight (BMI 14.1), but I think I’m just freakishly light-boned or something, because I’m perfectly healthy and don’t look skeletal at all, and people always overestimate my weight by a few pounds. We come in all sizes and shapes, and while some people have their health affected by their weight, there are many of us who are fine.

    As for EDNOS. My husband has it, and he has it bad. He looks perfectly fine, is of normal weight, everything. You couldn’t tell just by looking. He won’t talk to doctors about it. Who’d take him seriously? Especially because men aren’t supposed to have eating disorders, right, RIGHT? You got to fight it alone, which is really stressful and difficult.

    Anyway, good post!
    all the best

  • Wouldn’t it be wonderful if instead of trying to explain how we feel, we could load the feelings onto a data stick inserted in our ear and then stick that into the medical professional’s ear for them to feel what we felt. This would revolutionize diagnosis of so many things I think!

  • YES, YES, and YES. Our bodies are ours, for better or for worse. Our health is ours .And nobody should judge me by my looks (unless I apply for a job in their bed), by my health problems (those I have – but if you wake up at my age and nothing hurts you are dead – and those they think I must have, because I am fat) OR by my choice of food:

    Last summer those bubble teas spread all over town and I wanted to try one. Just to know what the fuss was about.
    I chose a small one. Instead of a meal. Quite responsible, if you ask me. When I wanted to share my (disappointing) experience the next day in office I got so far as “Yesterday I tried my very first bubble tea” – and then my (female) boss interrupted me and said: “You really should not drink those, you know!”

    HELLOOOO – it was my FIRST and LAST – because I did not even like the bubble experience. But just because I was fat I was obviously not entitled to form my own opinion about food. And she was entitled to lecture me about what I am allowed to eat/drink.

    • franhunne4u – even if it was your thousandth bubble tea, and you bought and consumed a super-jumbo-mega size, it is still none of anyone’s business but your own. You honestly don’t have to justify what you eat and or drink anywhere, least of all here with us.

      • I did not justify it there. Told my boss instead it was none of her business (there was another colleague present and I talked to her). And you are right, HERE I need not justify it. But that is society for you – impressing a beating conscience on the fat people just because we dare to eat.

  • Thanks for writing this, because I was suffering from Bulimia and just stump down starving myself and my boyfriend now husband had to step in and help me. Even while I was doing all that I only got down to a 12 and I was still thinking I am fat and gross. Today I am a size 16/18 and I love it, I have rolls and curves and I am proud, many people think fat ppl sit around all day and eat, actually I barely eat, I am more of a drinker. Food does not make me happy like ppl assume because I am fat, food just give me substance and nutrients.

  • Thank you so much for writing this. I seriously thought that I was the only one who struggled with anorexic behaviors without ever becoming thin. I have learned how to keep my weight steady to accept my body for it’s natural shape, but it has been a long and lonely road. Keep up the good work. 🙂

  • Thank you..I am new and I came upon your blog..I have been overweight all my life..I have been on every diet, pill and gone to nutritionists all my life to no avail. Even as a meth addict I did not lose weight. I also don’t have any health problems, and it really pisses me off when I have to be seen by someone other than my primary..they act like I am lying…”Are you sure you don’t have diabetes, high blood pressure?” I have finally came to a choice that I think is right for me. I believe you are right on…Discrimination against Fat people is the only socially acceptable form of discrimination…sad..so sad

    • One of the most horrifying things is that illness is used to shame fat people. Whether you’re fat and have an illness, or you’re fat and do not, either way the shaming is horrifying and not acceptable. Some fat people suffer diabetes (I do), and some suffer other illnesses. That doesn’t make them unworthy of dignity and respect like any other human being.

  • I really would like to thank you for writing such a topic. It is really hard to judge yourself, while it is easy to judge others. When you start thinking about what others think of you, then you trouble yourself. It is easier said than done, but what you look from the outside doesn’t matter, the inside reflects you. I lived in 2 different cultures and have seen how people think of themselves. The thing that everybody should realize is never feel inferior to others.I am new user to the blog thing, I really appreciate that there is such a blog like the one you have . I write mostly about cultures, but this topic really relate to culture of the society, as country becomes more developed the disorders increase.Thank you again!

  • Kath, just wanted to let you know that you have given me quite a bit to think about, and it’s very exciting! I am currently studying to be a dietitian and just finished a class called “Nutrition Through the Life Cycle” where we touched briefly on eating disorders. However, nowhere was it mentioned how to diagnose an overweight or obese individual with an eating disorder (except for the nutrition world’s mantra “Calories in, Calories out” which has always bothered me). I think this is an extremely important topic, and will definitely keep it in mind as I finish school. I really do believe that there is an entire population with eating disorders out there that is ignored simply because they are fat. Eating disorders are about psychological food relationships, no matter what your size is!

    On another note, I am extremely grateful to find like minded people who seriously have a problem with weight and health being a moral issue. It is not. There is absolutely nothing morally wrong with someone who “fails” a diet and exercise program because they are eating too little, and exercising too much. In order for you to exercise, you must FUEL your body! The more calories you burn, the more calories you body needs, not the other way around. It’s a problem with the system, and one I hope to effect change in.

    Thanks again for the food for thought (no pun intended!)!

    • That’s what I’m here for motivatedmaybes, to give people things to think about! May I recommend that you check out The Fat Nutritionist and Linda Bacon’s book “Health at Every Size: The Surprising Truth About Your Weight” for starters, if you haven’t already. Both are doing excellent work in breaking down the “calories in, calories out” dominant paradigm. From there you will be led to a whole world of thought on fat stigma, healthism and healing damaged and disordered eaters.

  • I went from “eating healthy” – more restrictive/ortho to binging…and bulimia. Binging/purging was/is an addictive, sad, sick way of life for me – and yet, because I have a full face and am pudgy now (instead of skinny like I used to be) – everyone thinks I’m “healthy and happy!” It’s twisted and makes me feel more ashamed for doing this to my body and self every night and still not being good enough or smart enough or right enough to at least get skinny from it…

    • Let’s just state clearly, attempting to “get skinny” is about the opposite you can do to be healthy. I hope you can find some compassionate help soon youwriteyou.

  • You are beautiful and you write with such passion! Im glad to have stumbled upon your blog 🙂 As a health coach I encourage women to take control of their lives by first LOVING and accepting their BODY! I am not going to lie, I am a fitness/health fanatic & I love living the lifestyle I do, but it’s mine & I don’t expect anyone else to want to live it if its bot their love too! Real health coaching and inspiration for me comes by supporting women in their unique lifestyle & wellness goals, which is not ( God lets hope its not ) skinny for every woman.
    I love what you said here, too, about not, what was it, ‘moralizing healthy living’? Sorry if I misquoted, but this is soo true! I believe that beyond love and compassion, there is no one moral code we must all meet & follow, but because we all have different beliefs and passions in life, we have different moral standards to hold ourselves too as well ( in staying true to ourselves ), and none are above the rest!
    I love your voice, it is so refreshing to see! You are a light for many I’m sure 😀 You’ve been mine tonight! Bless you lady ❤

    • Thank you. I personally don’t believe that people must (or even always are able to) love their bodies, but if they are able to, it’s a good thing. Sometimes people have reasons they’re not able to love their bodies, and that’s ok. Let’s help them value their bodies as they are, as a starting point. The love can come later maybe. It’s hard to love a body that may be in pain, or unwell, or not meet someone’s gender representation. But if we can all just work on valuing our bodies as the physical beings that propel us around the world, that enable us to live our lives, then we’re all going to take that bit better care of them. You can’t care for something that you don’t value.

  • Thank you for this blog! I find it very difficult to be taken seriously by the health profession because they can’t see past the ‘fat person’ and automatically assume that I over eat, don’t exercise and that my weight is from sheer laziness.

    Thank you for getting the message out there that people who are overweight do suffer from eating disorders as well.

    • The medical profession in general leaves a lot to be desired when it comes to their treatment of fat people. No, more than just desired – required. Several studies have proven that medical professionals believe fat people are lazy, uncompliant and greedy, that they don’t have any respect for fat people and many would rather not treat us at all. Until we can go to any doctor and receive treatment for what actually affects us, rather than handed another diet and a lecture, we are being failed by the medical profession too.

  • Hello, loved your post 🙂 I’ve been really thin through physical illness and through an eating disorder; i’ve been so thin it hurt to lie down on a regular mattress.. trust me, that is NOT healthy! I think this ‘rampant healthism’ is damaging to all sorts of people including people with long term health conditions like me.

  • first of all, i think you are very brave to be speaking to the internet about this topic, i always admire people who are so open about having something with such a severe, ingrained, negative stigma attached.

    however, you have only addressed this issue from the physical stance. sure, physical impairment is a huge factor, but it is a CONSEQUENCE of the the MENTAL disorder. an Eating Disorder is not a physical illness, it is a mental one that has physical ramifications. its is not your body that is making you use behaviours, it is your mind and your body is acting on them and suffering the results.

    i have been suffering from an ED, the opposite of what it appears you have. there comes a point when your BMI/weight gets so low that you are NOT able to think rationally for yourself. so actually it is a lot more common than you suggest for the decisions to be taken out of the hands of the individual.

    i do love how you are standing up for the Binge Eating disorder, i agree that it can be just as controlling to a persons life as the other way. i think it is because it is so much easier to diagnose a very skinny person as having an ED, which shouldn’t be the case. i also agree that someone’s health should not be measured on their BMI. I have a friend who is 6 foot 3 inches tall and weighs maybe 8 stone. yet i swear to god the kid does nothing but eat. if BMI were 100% an accurate theory, he would be hospitalised, like I was. Yet he is healthy as a horse.

    Great post! Hope you continue the good work 🙂

    • gemgemgoesglobal – I’m not sure you actually read my piece properly. Perhaps if you go back and read it again, and actually listen to what I am saying, you might see that a) you’ve implied a lot of false things by your comment b) I actually addressed the fact that ED’s are mental illnesses – that’s the whole point of my piece and c) it’s foolish to imply that you have “the opposite of what it appears you have” – because I have neither outlined fully my situation and you’re making assumptions based on my body type, which is EXACTLY what I call out in this article.

      If you don’t give me the respect to take the time to read my piece properly, please don’t waste my time commenting with false assumptions.

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