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Being fat is not a sign of mental illness

So why do some therapists list ‘obesity’ as a condition, asks Louise McSharry

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By Louise McSharry on

After a hectic few years, I recently bit the bullet and decided I should get some therapy. I’ve been putting it off. It’s hard to be vulnerable and honest when you’ve been neatly compartmentalizing your feelings for an extended period of time. Finding the right person to do it with is essential, so when a friend recommended someone I went straight to their website to initialize Operation Sort My Head Out.

There, alongside anxiety and depression, I saw obesity on a list of mental health conditions they “can help with”. I was horrified. I’m a fat woman, who lives within the “obese” category, and while I have my mental health issues like everyone else, obesity is not one of them because obesity is not a mental health condition. Yes, for some people obesity is symptomatic of a mental health condition or trauma (as Roxane Gay recently wrote about in her memoir Hunger), but many people are simply obese because they are obese. They are not mentally ill. Maybe they are on medication that causes them to gain weight. Maybe they have a medical condition. Maybe they just really like food (of course, we’re the worst kind – people can almost tolerate the idea of people being obese as a result of some sort of condition, but greediness is not acceptable, unless you can be greedy without gaining weight in which case it’s a “cute” or “charming” foible of your personality).

How could I, as a fat woman, possibly feel comfortable making myself vulnerable with someone who had already decided that I was mentally ill before I’d spoken a word? How could I be sure that my actual issues were going to be dealt with if I know that the person in front of me is wondering how to get to the root of my very obvious mental illness, obesity?

Being obese is not a mental health condition, but putting your life on hold ‘until you’re thin’ probably is

This may come as a shock to some, but many fat people do not view their very existence as a problem that requires a solution. The fat acceptance revolution has begun, and rather than thinking of ourselves as works in progress, many of us are choosing to accept ourselves as we are. Why? Because the alternative isn’t working. Living your life believing that there is a thin person trapped inside you waiting to get out is miserable. You put everything on hold, waiting for the time when the glorious thin you can experience things fully. You don’t go to exercise classes, because those are for thin people. You don’t go to the beach on holiday because you’re not thin yet, but on your next holiday you will be so you’ll do it then. You avoid sex, because this fat body isn’t good enough, but soon you’ll have your thin body and you’ll have loads of it then. Being obese is not a mental health condition, but putting your life on hold “until you’re thin” probably is.

Here’s the thing – most of us will never have that thin body. Sure, some of us will diet for an extended period of time and get to our goal weight, but ninety-five percent of us will gain the weight back over the ensuing one to five years. Diets don’t work. If they did, Weight Watchers and Slimming World would be out of business. So, if you are on the dieting train, you’ll lose weight, gain it back, lost it again, gain it back, lose it again and gain it back, except most of the time what you gain is more than you lost. So rather than resulting in long-term weight loss, diets actually cause long-term weight gain. You’ll forgive us if many of us are choosing to get off that train.

Fat people often have to bolster themselves before entering into situations thin people don’t give a second thought to. If they’re going to a hairdresser, they have to consider whether or not the cape will fit them, and if it doesn’t how the person in the salon will react. When flying, they have to hope that the seatbelt will close, that the flight attendant will be kind if they have to request an extender, and that the person they’re sitting beside doesn’t make it obvious that they resent sitting beside a fatty. When going to the doctor, they have to accept that it is probable that the doctor won’t actually hear them when they describe their ailment, and will instead suggest losing weight as the solution whether it’s relevant or not. Fat people are vulnerable in almost every situation they put themselves into, so to think that the professionals whose job it is to make them feel safe in the most vulnerable position a person can put themselves into is making a judgment before they open their mouths is horrifying. We are not temporary structures, we are human beings, and we deserve better.


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Mental Health

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