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  • Writer's pictureMeg

On Being A Fat Therapy Client

Updated: Jun 13, 2023

About ten years ago I was sitting in my psychiatrist Dr. S’s office listening to yet another lecture about my weight. I was too fat, it was bad for me, it harmed my mental health, it made it hard to medicate me, it was awful and I was awful too.

About eight months before my psychiatrist’s weight related meltdown, I stopped working with a therapist in his practice, D, because she was too fixated on weight. Sometimes it was direct, “Meg we need to talk about your weight,” but it was also smaller things. She started eating during our sessions which I didn’t mind, but it was always these complicated salads and salad wraps. She’d wax poetic about how delicious they were and how healthy they made her feel and sometimes she’d give me specific instructions on how to make them so I could start eating them myself. She’d talk to me about her exercise regimen. She’d talk about new clothes she had bought and it was great she could find her size so many places. It was too much. I wasn’t radicalized around weight yet but I knew what she was doing was fucked up and I hated it. So I summoned up all the dregs of courage and self-respect I had at that time and I fired her.

Two months later she saw me in the waiting room waiting for Dr. S and she stared at me. Then, according to Dr. S, she talked to him about how horrible I looked and about how he should be addressing weight with me more often. That’s when the badgering started from him. He was always direct. He told me about the dangers of being fat, about programs that could “help,” about how his wife is responsible for people being able to eat unlimited fruit on weight watchers, and more and more. I stayed with him because he was a genius with my meds and I fully credit him with not only saving my life but also giving me the kind of life I want to lead. He was abusive but I didn’t know how to walk away when some things were so good. I thought maybe I would have to take the abuse to get to experience the good. I didn’t stay forever, but I stayed for at least a year after the weight stuff started.

A few days after Dr S’s worst haranguing I sat in my new therapist’s office and described the incident. I cried. I could barely look up from the floor. I felt awful and needed support.

And then she said “You know, that lecture that Dr. S gave you is exactly the lecture I want to give to one of my other overweight clients.”

I was stunned. In what universe does one respond to a story about harm done to someone with the fact that she wanted to do the same harm? She had agreed we would not discuss food or weight. I had a brilliant and wonderful nutrition therapist to handle my eating disorder stuff and L and I had agreed that L wouldn’t touch the topic.

I called her on it and she said I brought it up when I brought up the incident with Dr. S. She went on to talk to me about how part of her practice is dealing with “Food and Mood” (yes she got out the book), She’s mindfulness based and that automatically includes a certain amount of eating stuff (it can but it is not mandatory). This stuff was too integral to her practice and she wouldn’t/couldn’t practice differently.

I went into a very calm place, locked everything inside, and started to dissociate. I told her we should terminate.

I never looked at her face again. We had a lengthly termination conversation during which I fixated on her carpet. My memory tells me she was sort of this disembodied voice saying terrible things. At the end she told me it was the healthiest termination conversation she ever had and she thanked me for it.

I stumbled out into the sunshine and despaired of ever finding someone good.

Being a fat client has meant intense anxiety with every new provider, it has meant crying after sessions, and it has meant not feeling like anyone was safe for my fat body. Being a fat client has meant sitting through endless lectures, endless micro aggressions, and the terrible belief that even when I pay someone to give a shit about my mental health I still can’t escape deliberate shaming.

I kept trying.

It was damn hard but I got really really lucky.

My current therapist is amazing on weight. As I have been radicalized around my fatness she has been too (okay I know that she might not actually be radicalized but she does a damn good job of meeting me where I am). She has occasional missteps but we address them and there is repair.

My current psychiatrist promised me during our first phone call that weight wouldn’t come up. He said “I don’t think that’s a very productive use of our time anyway” and he has kept his word.

They are both straight sized people.

Good clinicians of all sizes are out there but they are hard to find and the sheer volume of clinicians who are shitty about weight is overwhelming and disheartening. To my fat brethren, keep looking, don’t accept shitty treatment, you deserve good care and mental health providers who see you and who hold you in high regard. I see you. I hold you in high regard. My heart is with you. If you live in Massachusetts come work with me, I'm taking clients.

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