Fat and Eating Disorders

One of our favorite bloggers, Ragen Chastain, recently shared this piece with some important reminders about the ways our assumptions about weight impact our treatment of eating disorders.

“I have taught dance and movement at a number of eating disorder treatment centers. At one that worked almost exclusively with patients who were very thin and dealing with eating disorders. I happened to come in the day that they got a fat patient, one of the therapists said, “I’m glad you are here, (first name) really needs to exercise.” I asked her how much exercise she had been doing previous to starting treatment and she responded that she assumed none. I insisted on a work-up. It turns out that the girl had been over-exercising for a long time and, based on her profile, had she not been fat they would have immediately recommended a period without exercise. I’ve also had a Binge Eating Disorder specialist tell me that, in her “vast experience” there was “nobody who got to my size without suffering from BED.” I pointed out that her experience of people my size involves them coming to her office for treatment for BED.

…But I think this goes deeper. I think that this is what happens when society tells people incessantly that you can and should make assumptions about what people eat and how much they exercise just by looking at them.

Eating disorders can be deadly so we have to get this right. Eating disorders happen independent of weight. There are fat people who have bulimia and anorexia (or, rather, would if the diagnosis didn’t include weight), there are thin people who have Binge Eating Disorder. There are very fat people who do not have an eating disorder. There are some very thin people who do not have an eating disorder. Calling someone “anorexic” is not a substitute for calling them very thin, and while we’re talking about this how about we just stop making judgments about other people’s body sizes altogether.”

This quote is valuable as we work together to turn weight stigma on its head:

“The future belongs to the curious. The ones who are not afraid to try it, explore it, poke at it, question it, and turn it inside out.” – Skillshare, Inc.

To challenge weight stigma in healthcare settings requires us to allow curiosity to BE our expertise, instead of relying on the distancing and often harmful “expert stance” which typically fails at creating understanding and connection.




trainingtopThe Be Nourished Training Institute provides training and support in the Art and Science of Behavior Change Counseling. We know the conversations that occur between health care providers and their clients are powerful ones, capable of supporting or inhibiting the innate change process that is alive in all of us. We also believe helping professionals do the work they do because they want to be agents of change. Our institute, which is grounded in the empirically validated treatment modalities of Motivational Interviewing and Health at Every Size® can help you create well-balanced, meaningful relationships with your clients.