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On being a fat therapist

on being a fat therapistWhen I was 18 and in college I had a terrific women’s studies teacher who was addressing media representations of women and the tyranny of thinness. In my reaction paper I wrote something about how every woman I knew wanted to lose weight and my professor wrote next to this in the margin, “Not me!” And I didn’t believe her because she was fat. Not just heavy (the euphemism my friends and I used to describe the not-skinny among us, which seems to have been replaced by “bigger girl” these days) but actually fat. Like the kind of fat we were scared of, the kind of fat we were all running from. I couldn’t think of anything worse than being that fat. But her words in the margin set me thinking. They came back to me through the years as my own body shifted and changed as I met other women who were able to accept their bodies and the bodies of the women around them.

Now I am fat myself, the kind of fat that used to scare me, and although I am sometimes a little thinner and sometimes a little heavier, I am pretty much fat no matter what I’m eating (or not eating) or how much I’m exercising (or not exercising). Which means that I am and will likely remain a fat therapist and in the same way that I assumed I knew something about my women’s studies professor just by looking at her so I know that my clients assume they know something about me just by looking at me.

I have talked to other fat therapists about this because we are all aware that there are some clients who quite simply won’t be comfortable having a therapist who is overweight. They may assume that I don’t know what I’m doing because they believe fat people couldn’t have it together (otherwise they wouldn’t be fat). They may assume that I myself have low self-esteem or cannot control my eating or don’t understand the value of exercise or a thousand other ideas that many of us have about fat people and these things may get in the way of them being able to feel comfortable working with me.

So what do I think about that?

Well, I don’t think anyone ought to work with a therapist who they cannot trust so I understand that I’m not everyone’s cup of tea (that’s why there are lots of different counselors in the world — to meet the needs of lots of different people). If someone comes to me and doesn’t feel comfortable with me for any reason (because I am fat or because they don’t like my office decor or because they don’t like the music I play in the waiting room) then I will help them find another therapist. It’s why I have a rolodex. If I can’t help someone who needs help, I don’t want to leave them hanging.

But I also think that there is a lot of opportunity in being a fat therapist. I think we need more fat role models who are happy and healthy and loved so I am proud to model the acceptance of bodily diversity in my acceptance of my own body. My personal and professional philosophy is one of Health at Every Size.

I’m writing about this because I think it’s important that we talk explicitly about our experiences in a world that has a limited view of how a woman (and increasingly how a man) should look and so I try to talk about my experience. I also bring it up as a way to let clients and potential clients know that this is a discussion we can have together. I am happily and willingly opening that door.

22 Comments

  1. This is interesting to me, because my long-term therapist is very thin and I have found it difficult to talk about weight issues with her because it is easy to assume she can’t relate. But, she does have the redeeming feature of being poor with her time (running late, etc) and I like that about her because it is easy to think she has it all together. And who does. It’s funny to be writing this because I haven’t seen her in over a year, but I met with her every week for 3 years, so I definitely still consider her *my* therapist.

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    • Someone emailed me off-blog to talk about how this goes both ways; I can definitely relate!

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  2. Thank you for this! As a therapist whose body tends to be on the thin side, I find that my clients assume (rightly, sometimes) that I won’t understand their experiences with their bodies. I have a number of go-to articles on body acceptance that I refer people too, and this is now one of them!

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    • Christine, I would love to hear your thoughts as a thin therapist who may be working with fat clients in regards to Margaret’s comment above. Maybe you could do a blog post and leave the link here?

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  3. I found her comment ,”I don’t want to leave them hanging” kind of distasteful when talking about clients seeing a therapist–am I too sensitive to this or does anyone else see a possible suicide reference in that statement? Most likely not intentional–still, kind of weird to me.

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    • Thanks for your feedback. It was certainly not intentional but I appreciate you letting me know that some people might find this offensive. I will be more mindful of that in the future.

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  4. I love this because its so wonderfully transparent and that’s only helpful for all of us. It also made me think about the women’s studies prof who taught me about body image/dismorphia/hatred and eating disorders and ultimately had a big effect on my healing. Seriously, someone should conduct a study to see how many women have been positively influenced by a women’s studies instructor in terms of how they view their bodies. I’m guessing a lot.

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    • I would love to see a study like that, too. And I wish I could go back and talk to my classmates then and see if they had the same epiphany that I did there.

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  5. I appreciated reading this and it mirrors my own concerns. I spent the last 8 years as an addictions counselor and often wondered if my patients would find me less effective because I was overweight. Applying the same recovery concepts to my eating patterns as I was teaching them to apply toward addictions did help me lose some weight, but as you say, I am pretty much fat anyway. I’ve come to the same conclusion that you have, in that our patients can benefit from seeing an overweight person happy with their lives.

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    • Thanks for your thoughts, Vicki, and I know that *I* always appreciate fat & happy role models so I’m glad you are out there doing good work in the world. :)

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  6. I’m sorry, but the words “fat” and “healthy” do not co-exist. If you are fat, you are unhealthy. “Denial” and “fat” co-exist quite well.

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    • Hi Melissa — you are certainly NOT the only person who belives that a person can’t be fat and healthy but the research bears it out. Weight is just one way that a person’s body lives out genetic heritage, lifestyle, diet and fitness so none of us can know just by looking at someone which of these aspects are most at play. I appreciate your concern and hope that concern will lead you to look beyond the headlines to the scientific research. It’s interesting stuff!

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  7. I have been thinking about this subject a lot lately, as I’m going back to school to become a therapist. So glad to read someone else’s thoughts on it. It’s very reassuring.

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  8. I love this article and your attitude! I am a year away from graduating with my counseling degree & think about this topic often. I am a plus size woman, short and fat– and often worry how clients will perceive my overall health (mental/emotion&physical). What I am finding in my intern experience is that people in crisis or needing guidance judge me based on my centeredness, knowledge and willingness to help. I think my own issues with my size are more my issue than that of the clients I work with..

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    • Kay, congratulations on being so close to graduation! That’s so exciting!!

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  9. I really liked reading this article but from a patient viewpoint I have been very scared/ nervous to talk about my problems with bulimia and how I feel about my weight to my therapist who is plus size. I don’t want it to be awkward nor hurt her feelings.

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    • Rosemarie, I totally understand. And probably it would feel awkward because we’re conditioned to be sensitive to weight discussions. But this isn’t a casual conversation you’re having; it’s therapy and therapy is a place to throw out conventions and get real. While I can’t speak for your therapist I can tell you that I wouldn’t feel hurt by a client who wanted to be thinner than I am or needed to be able to say that a certain body type (like the one I possess) is not attractive to her. I very much understand that my client’s lives are THEIR lives and my life is mine. I would no more be hurt by that discussion than hearing from a client that to practice a certain religion (that I might practice) or vote a certain way (that I might vote) feels wrong to her. I hope that you are able to feel safe bringing it up because you deserve to have whole hearted, full support and not feel that certain topics are off-limits in your counseling sessions.

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  10. Hi, and thank you for this. I am also about a year away from graduation, and am about to begin seeing my first clients as an MFT trainee. I am a big guy, and while it is high on my list of priorities to lose this weight, I am currently a little terrified of how my new clients will react to sitting down across the room from their big, fat, new therapist. I found this piece somewhat fortifying, and while I realize it is essentially nothing I did not already know, it was very reassuring to find I am not the only one who worries about this. The weight really bugs me though. If I could shed these pounds I would feel a whole lot better.

    Matt

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    • Congratulations on being so close to graduating, Matt! I think sometimes when we are understandably nervous about something new (clients!) that we can go right to our weight because it’s a familiar place on which to hang our anxieties. The truth is, your clients will not be sitting down across the room from their “big fat new therapist.” They will be sitting across the room from YOU, their compassionate, prepared new therapist — who is feeling a little nervous. I would also like to share the Fat Nutritionist’s site with you: http://www.fatnutritionist.com/ There is so much terrific information there and I hope you will find it encouraging and if you haven’t clicked the Health At Every Size link above, I hope you will here: http://www.haescommunity.org/. Weightloss may or may not be part of your future but right now at this very moment you are just fine and you will be a blessing to your clients. We therapists don’t have to be perfect — far better that we’re not, I think. And as we become better at our own self-acceptance and self-love, the more we can bring that to our clients in every session. I will be thinking of you — let me know how it all goes! :)

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  11. Thanks Dawn. The resources you provided were great. I am just beginning this awesome journey (been in school for a decade though), and I’m grateful I stumbled across your site. :)

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  12. Hello, I know this post is old but I would like to know how you help peopl with weight problems? My therapist is overweight and trying to loose weight, he tells me during our session what he is doing but how he cheats also or dont go to they gym. So can he really help me in my struggle to loose weight because of my emotional eating? He is 60+, divorced i think and overweight, can he be a good therapist? Even asked me if I have cute friends to introduce him…..I think I need to change therapist but I feel I will make him feel bad…

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    • Hey Cici — I don’t know anything about helping people lose weight because it’s not a focus in my therapeutic practice but this guy sounds like he has some *really* bad boundaries. Ethical therapists don’t joke with their clients about their clients fixing them up with “cute friends” or talk about their weight struggles. As far as making him feel bad, you are employing him and if he’s not helping you than you’re not getting your time and money’s worth. It’s not your job to make your therapist feel good. Please please please see about getting another therapist who specializes in disordered eating (if in fact you feel your eating is disordered). If you contact me via my form and tell me where you live I’d be happy to scare up a referral for you.

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