Do as I say, not as I do... Confessions of a Health at Every Size therapist

I am so grateful to be a leader and a supporter for people learning to accept and advocate for their bodies.

I love the moments when I see the “click” in my clients eyes. That moment when they realize that they have been hating and punishing themselves their entire life. The moment when they decide that enough is enough. The moment when they start feeling empowered and advocating for themselves.

But I admit it, I am a fat therapist who doesn’t always follow my own advice when it come to living the Health at Every Size philosophy.

I was inspired to write this confessional following an appointment with a gastrointestinal doctor. I had previously lived with a damaging bacteria and ulcer for over five years because doctors did not take my symptoms seriously. Can you guess what my treatment was? You guessed it, lose weight. So over the past three years the symptoms have returned and I avoided going to the doctor as many fat people do.

Going to the doctor for a fat person is an exercise in humiliation, shame and self blame.

Thousands of fat people are misdiagnosed and do not receive proper health care every year because of their size. Doctors are less likely to take their symptoms seriously or give them treatments that they would offer their thin counterparts. They are lectured, shamed and placed on diets that are 95% likely to fail. Can you blame us for waiting until a health crisis to go to the doctor?

I had a plan, but it did not go as planned.

Prior to my appointment I obsessively thought about and worried how it would go. Would I cry? Lose my temper? I often practice medical self advocacy with my clients in session so I literally know what I need to say. The problem is that my own internalized fatphobia keeps me from being a true advocate for myself.

I gave him my history and sat there, heart racing and sweating from anxiety.

He was a kind man. He brought up my weight in a way that seemed like he was trying to not hurt my feelings. “Has anyone ever mentioned how your weight affects this issue?”. Uh… yup. Yes. Definitely. He pushed it further, citing studies until I interrupted him. I told him that I was in recovery from an eating disorder and that any restriction would damage my mental health. I stepped into “fawn” mode, a traumatic reaction causing someone to people please and make themselves vulnerable when they feel threatened. He listened to my story and was compassionate and moved on.

Afterwards I was exhausted and angry with myself.

I didn’t owe him any explanation! I deserve medical care without having to open all of my psychological wounds and expose my trauma! I should be empowered, not pathetic! I wanted to go back there and respond to him as I planned. I replayed the appointment in my mind, only this time I asked him to give me whatever treatment he would a thin person. I would politely, but firmly redirect him and let him know that we can discuss health behaviors but my weight is off limits.

Why couldn’t I do what I empower others to do?

It’s because I am human. I am flawed. I am damaged in some ways that are so deep it will take many, many years to repair. Just like you, I am the sum of ALL of my parts and the part of me that is a true advocate for myself with doctors has not fully developed.

I will remind myself that I have come a long way…

Yes, I am struggling in that particular area, but honestly I have come a long way. I stopped dieting and wanting to change my body. I advocate for myself in other situations that are in some ways more of a challenge, like with people close to me who continue to judge my appearance.

On second thought, do as I say AND as I do.

Stand up for yourself when you can and forgive yourself when you can’t.

Be proud of how far you’ve come and have compassion for times you hold on to the past.

Know your worth and shout it from the rooftops when you can and rely on your supporters when you feel like you have nothing to offer.

This is not a perfect or linear process. So do as I say and I do and let’s all remember that we are works in progress.