Anti-fatness, COVID blame, and Competent Care

Yesterday, I tested positive for COVID-19. It’s been something I’ve feared for the past twenty months, especially working in a place and a profession where there are high volumes of people everyday. I am lucky to be twice vaccinated, and live in a state that takes vaccination really seriously among its residents.

Ever since the claim that higher-weight people are at higher risk for COVID-19 was established early on in the pandemic, I along with many other fat people in the United States have felt the burden of moral panic attached to this virus. The weird irony is that, presently, over 75% of America is considered “fat.” So wouldn’t that mean the risk applies to most of us?

It feels like just another way to blame us for our condition.

It’s a tale as old as time: any abuse, discrimination, outright prejudice, or hatred aimed at our bodies merely for existing is met with “If you don’t like it, then lose weight.” In chapter four of her book, Aubrey Gordon discusses the ways in which the relationship to anti-fat bullying plays out like abusive relationships: “it’s for your own good”; “but your HEALTH!”; “I wouldn’t treat you this way if (your fat body) didn’t make me do it.”

The association that has been made of fatness with COVID brings into play the fact that our misunderstanding of correlation and causation is still being taken advantage of by media and other industries–or that we are just so afraid of and disgusted by fatness, that we are willing to ignore that correlation between COVID and fat is not the same as causation.

As I continue to recover from my symptoms, the thoughts swirl: “if I weren’t fat, would I be sick? Is this my fault?” With the added messaging from the White House about the vaccinated vs. unvaccinated and the winter ahead, the moral panic of even getting COVID is compounded more heavily for fat Americans. Just like when we are mistreated by systems, people and society, we are expected to shoulder the blame of our own existence if in fact we do find ourselves positive with COVID-related illness. Our fat bodies are seen as a burden on the healthcare system, even without the added bonus of needing hospitalization or greater care for potential virus symptoms.

The bottom line? According to our culture, fat people aren’t supposed to exist – and if we do, we will be reminded at every turn that our existence is burdensome, grotesque, and unworthy of compassion and care. And we are doubly worthy of the abuse, blame and burden we feel if we dare to exist in fat bodies without apology.

All this to say, however, that when I got tested, I received some of the most affirming and compassionate care that I’ve ever encountered in a doctor’s office. The doctor focused on my positive test result and the outlook of my recovery, which she said was good given my numbers and my health. She mentioned that, “you, like me, are on the higher end of body mass index, which could qualify you for infusion therapy, but you are likely too healthy to get it at this point unless you downturn–which I’m not expecting will happen. I think you’ll make a good and quick recovery.”

Despite leaning into the BMI, a flawed measure of health, she 1) implicated herself as also being a fat person and 2) did not associate the BMI with my health status. My oxygen was well above healthy levels, my blood pressure within normal range. She focused on my health status and my behaviors as being healthy. Not once did she mention in any direct terms my BMI or my body being a risk on its own.

It’s unfortunate, though, that this kind of care in our country is not the norm. I am tired of a system that simultaneously tells fat people that their bodies, their existence, their very being is wrong, while expecting them to have the resources and motivation to aspire to ‘health.’ I’m tired of systems that gaslight and abuse us on a regular basis. I’m tired of the family that I love bullying me and calling it “just trying to help.” I’m tired of being expected to maintain my health while being told that that’s impossible to do in this body. I’m tired of people, industries and systems misinterpreting scientific findings for their own profit or convenience.

Fat people deserve competent and compassionate care, regardless of their body’s shape, size or even their health status. This virus cannot and must not be used as leverage to continue fear mongering campaigns against fatness.

Lizzo’s cleanse isn’t the issue; the way we discuss bodies is

If you are active on social media the way that I am, you have probably seen the latest in Lizzo tea.

Yes, she went on a juice cleanse. Yes, she, a grown ass woman, had to defend herself for her choices. Yes, the internet lost their collective shit about it.

I scrolled through the criticisms and supportive comments alike to get to the situation, but mostly relied on Lizzo herself to put the pieces together.

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A post shared by Lizzo (@lizzobeeating)

After all, it is her body.

People said she was promoting starvation and disordered eating by going on a juice cleanse after returning from Mexico. In her videos explaining and dealing with the fallout, she mentioned that she ate a lot of spicy food that messed up her stomach pretty bad (I know from experience, YAY IBS!) and that she drank a lot (presumably meaning alcohol) which also leads to not feeling so great. And we’re in the middle of a pandemic, too, so mental health morale in general is pretty low–and that takes a toll on the body (again, I know from experience).

Her exact words: “I detoxed my body and I’m still fat. I love my body and I’m still fat. I’m beautiful and I’m still fat. These things aren’t mutually exclusive. To the people who look to me, please don’t starve yourselves. I did not starve myself. I fed myself greens and water and fruit and protein and sunlight. You don’t have to do that to be beautiful or healthy.”

The problem isn’t her ten day juice cleanse (which she explicitly said she supplemented with sound nutrition), but the way that we think to police fat women’s, Black women’s, and women’s bodies in general.

When thin women engage in diet culture, however, they are sick enough to warrant attention, sympathy, and treatment.

When fat women don’t want to shrink, we are socially punished. When we do things in the name of health, we are laughed at, as if the effort is wasted or futile. So how do we win in a condemned body?

We need to begin by changing the way we talk about bodies.

The idea of a “cleanse” is itself diet culture. There is nothing “dirty” or connotative about food, no need to “clean” our bodies into submission. Food is just food is just food. Lizzo used the word detox to describe her recent endeavor, and I think this frame is one that acknowledges that for some of us, certain things we put into our bodies are in fact toxic depending on the person. My mom has celiac disease, which means gluten is quite literally toxic to her body. People who cannot safely drink alcohol, any alcoholic drink is literally toxic to them. If it results in you not feeling well after having done it, it is probably toxic (the same way that some relationships are, too!)

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A post shared by Lizzo (@lizzobeeating)

When I was recovering from my eating disorder, I came to understand that the language taught to me by dieting and OA and other programming was to “cut things out” and “avoid certain foods”, and I realized that this didn’t help. Deficit models don’t work. Instead, I chose to frame it with “I am adding nutrient density to my meals.” This is exactly what Lizzo did.

Lizzo’s recent controversy had me thinking about my own experience. Last June, I had my first colonoscopy, which was used to rule out Crohn’s disease. I had to drink this god-awful salty mango drink and hug the toilet for 16 hours. It got rid of EVERYTHING–and I mean everything.

I, like Lizzo, was doing this for my health, mental and physical, because I deserved to figure out why my stomach had been doing backflips every day since high school and what it was doing to my stomach.

Not just to figure out what was going on with my intestines, but for my mental health as well. My IBS is 100% anxiety driven, and it has torn my stomach apart for the near part of a decade now. Clearing all the stuff out of my colon was the only way to figure out I didn’t have an autoimmune disease. Did it absolutely suck? Yes. Did my belly also feel more at peace than ever after I came out of it? Double yes.

Some criticisms of Lizzo indicated that the before/after photos encouraged disordered thinking/eating/behavior. While it’s true that this is the case when there are visible differences that quantify the ‘after’ (usually thinner) as “better”, I would agree. However, as Lizzo stated and as is observable to anyone with functional eyes, she was still fat after juicing. She is still fat and will still be fat and that’s more than okay. She didn’t ask anyone to congratulate her for shrinking, think herself better for being smaller, because she didn’t shrink. And even if she did, ain’t no one’s business.

Sometimes when I look at pictures of myself from the past, I can remember in my mind exactly what I was thinking or feeling when the shutter went off. What if we normalized ‘before’ and ‘after’ photos of our emotions, our states of being, our soul-level selves, rather than focusing on the shape, size and appearance of the body in the photo? What if we acutely paid attention to how Lizzo said she felt different, rather than assuming that it’s about her appearance?

In short, it’s because we are obsessed with bodies. With telling women what to do with their bodies. With telling fat women and Black women what to do with their bodies. The misogynoir and double standard laid into Lizzo as a result of her decision reflects these oppressive paradigms. When Adele lost weight, people congratulated and praised her and wrote entire magazine articles about the gloriousness of her new thin body (about which I will hold my opinion, because other peoples’ bodies aren’t about me; see how simple that is?) The choice to do what you want with your body is reserved for some, and in the eyes of diet culture, the only choice you have is to get and stay small no matter what it costs. Side effects be damned.

The same people telling Lizzo that her actions are triggering or that she is promoting diet culture are the people I wrote my last post, “It’s Your Responsibility to Unlearn Fatphobia” for. Telling fat women what is and what is not body positivity reflects a tone-deaf misunderstanding of who body positivity was made by and for in the first place.

What’s triggering is being told by sidewalk doctors that you are going to die in 10 years, having Jillian Michaels, who has no medical credentials, diagnose you with pre-diabetes in an interview (keep Lizzo’s name out your mouth, Jillian), and being snickered at at your own show by thin white women who are “body positive” but “wished you moved around more” while you’re LITERALLY TWERKING AND FLUTING AT THE SAME TIME FOR 90 MINUTES (as per Rachel Wiley’s 8/19/2019 IG post @dangerouslyinchub).

Even the world of eating disorder recovery is in many ways fatphobic, and there is so much layering and unlayering to be done when discussing the ways that thin women benefit from body positivity in ways that fat women like Lizzo do not. Just ask me and my friends about their experiences with ‘anonymous’ programs, about restriction being a prescription for bodies like mine, and what my first psychiatrist said to me when I revealed my exercise bulimia. (Spoiler alert: my first “treatment” for my ED was Prozac because it would help “suppress my appetite.”)

As Rachel Wiley so eloquently put it, it’s us fat women who have wiped the spit (of thin people) off of that crown that is ours to (re)claim. And if we want to reset our colons along the way so we can continue being a bad bitch, then so be it.

Unlearning Fatphobia is Your Responsibility, Full Stop

Around two years ago, I was still in graduate school, still in semi-early recovery (again), and still trying to navigate support groups and fat acceptance all at once.

As a recovery practice, I began getting comfortable with using the word ‘fat’ as a self-descriptor around in my shares at group and in conversations–until I was called out and told not to come back until I could figure out my language and how to stop saying ‘fat’ because it was triggering to others.

I understood that. I understand that for so many people, fatness is a fear, and that fear can coexist with a mental illness (like anorexia, bulimia, or body dysmorphic disorder).

But I was also grappling with the fact that societally, fat is set up to be an insult, and I was tired of that dynamic, especially in ‘recovery’ spaces. I wanted to reclaim the word and remove its pejorative use from my consciousness. So I did, in my speech, shares, and writing.

Fatphobia is insidious in virtually every corner of our culture, because it prioritizes the politics of desirability over health. This happens even in spaces that are meant for people in recovery.

Fear of fat or becoming fat is not a diagnostically supported symptom of body dysmorphia; it is a socially constructed symptom of diet culture that has trained people to value aesthetic desirability over health. Fatphobia still comes in so many forms, even in spaces that claim recovery. It sends the message that recovery from an eating disorder is possible, but only if it’s done while in a specific body.

There are still so many recovery spaces that support the sentiment that it is okay and valid to not want to look like me. These same spaces are the kinds that have historically validated the notion that “fat” is an emotion, as if it can be removed from one’s consciousness embodiment the same way that sadness or contentment pass. My body type isn’t an emotion, and I can’t just get rid of it; in fact, I spent over half my life trying to do just that…and it was called an eating disorder. 

yourfatfriend is the best ok

Nobody wanted to call it that, though, because for most of my active illness I was in a body deemed aesthetically acceptable. How I got that desirable body wasn’t investigated, it was just assumed that I must be doing something right because my body was “right.”

The endless calorie deficit spreadsheets and the six to ten times a day I would weigh myself suggest otherwise. 

I have learned and come to the conclusion that I am under no obligation to assuage thin peoples’ insecurity about the possibility of looking like me. I certainly have compassion for where they are and the ways that diet culture has manipulated them, but at the end of the day, my fat body will not be used as an example, will not shrink itself to make space for bias, and I do not and will not ever be responsible for the ways that someone’s triggers are justified at my expense.

It’s not anyone’s fault that they learned that fatness was evil, bad, immoral, lazy, or undesirable. At the exact same time, it’s not my job to soothe the deep-seated hate for my body and others like it. It’s that person’s job to unlearn, question, shift and not project what they were told about fat bodies, and theirs alone.

Fatphobia comes in the form of silencing, health concern trolling, food policing, making spaces inaccessible (and much much more), and ignoring that Health at Every Size is more than a movement; it is and has always been a well-documented and valuable scientific approach. Do not mistake Health at Every Size for HealTHY at Every Size (Thanks M for that one), because not every single body is healthy.

Thin bodies can be diabetic, have heart problems, or high blood pressure. Fat bodies can be anorexic, have osteoporosis, or be poorly nourished. No disease is exclusive to a body type. My weight alone does not guarantee that I will get sick, just like thinness alone does not guarantee health. My body has a GI disorder that is entirely genetic, and correlated to my mental illness (anxiety), also genetic.

What’s more, I don’t owe anyone in the world receipts for my health in order to claim recovery. I had to unlearn fatphobia completely on my own, just like I learned it from the beginning both blatantly and subliminally. The ways that it is STILL pushed upon me are an unnecessary burden, and inevitably do harm, but it is solely my responsibility to make sure that I don’t project that harm or that burden onto other bodies.

Same goes for fatphobic conditioning, comments and advice you may think is rooted in health. Unless that person is paying you for advice, save it. And even then (because some doctors literally get paid to fat shame people)–THINK–is this thoughtful? Helpful? Important? Necessary? Kind? The ways that fatphobia is expressed onto bodies, often (almost always) without their consent. What people fail to understand is that fatphobia and weight stigma itself is health-compromising, “good intentions” be damned. 

If my body or the words I use to describe it are triggering to you, that has little to do with me or with disordered eating, and a whole lot to do with the potential work needed to dismantle anti-fat bias. Look within and examine unconscious stigma. What’s so terrible, scary and disgusting about being in my body? All I see when I watch this play out among fatphobic people, unconsciously or not, is that what they’re truly afraid of is losing is 1) their perception of thin as superior, 2) the indignant self-righteousness of “health and wellness”, and 3) their ability to feel power when they make anyone over a size 16 feel shame. 

It can be really hard and terrifying for someone to come along and burst what’s familiar to you, but get used to it. It’s not my body or the fact that I say FAT that makes them uncomfortable, it’s the fact that the same science that privileged thin existence for all of the 20th century is just now concluding that I am capable of health and deserving of recovery.

Regardless of your fear, my body is still here and I still love it for what it is; in fact, I have done more health-promoting behavior holistically (mental, spiritual, physical, etc.) in this body than I have in my entire life. If that’s a threat to your joy or your pursuit of desirability; that baggage ain’t mine. Stay mad. 

xoxo

 

How and Why I Quit Therapy

Therapy is magical.

Seeing a therapist has been part of my life and my story since I was eight years old. I started in a small office in an old, two-story Victorian style house a few towns away when my parents got divorced. We’d get Wendy’s on the way there right after school. Mostly, my therapist Barbara and I played board games and drew about my feelings. I wrote poems. I talked about not feeling like I belonged at the Catholic school I went to, and the confusion of all of it happening to me at once.

In fourth and fifth grade, we had a group at school called “Banana Splits” where we met weekly or monthly during my lunch time and ate together and talked. It was a group of kids whose parents were going through a divorce or who were already divorced, and I actually found a lot of peace there. I don’t know the logistics of how I was enrolled, but I just remember it being safe and helpful to me at a time when I was so, so lost in a new elementary school and still maladapting to my parents’ being apart. 

I found a therapist in middle school who I saw up until my high school graduation. She got me through episodes of depression, anxiety, bullying, self-harm, (then) undiagnosed, eating disordered behavior, coming out to myself, ending my relationship with my biological father, and recovering from what I knew at the time to be an addiction to self-harm and self-imposed destruction.

I saw her through my diagnoses of depression and anxiety at age 17, and there were so many instances in which I can say she saved my life. She’s passed on now and someone else lives in her house (which also used to be her office); but I am so grateful to her for how much she helped me in the seven years I sat in her office baring my broken soul all that time.

Throughout college I had a few episodes of suicidality, in which I was recommended on mandate to the University Health Center Psych Services. Their intake crisis counselor became my therapist outside of school, and she would get me through four years of college and phone sessions until a year after that. She was like the mom I needed, the one who didn’t nitpick my outfits or police my food–she nurtured me.

Doc M saw me through unhealthy coping mechanisms and even unhealthier codependent relationships, coming out to my family, navigating college with anxiety. After a major breakup and a year of graduate school, I was managing okay. It was mutually understood that I was ready to move on.

In December 2018, I sought therapy again for the first time in a few years, immediately following a relapse. The first thing I did was look up “eating disorder specialists” on my insurance website, as well as on Psychology Today.

 

I found a therapist with Friday appointments, who took my insurance, close to my house. I had also at this point started drinking again (which most of you know, I don’t do) so I knew this was yet another bottom I’d need picking up from, with more than just an app and a text to the crisis line acting as a de facto “treatment team.” 

This person’s profile also contained the usual client-focused questions that tell a person seeking their help virtually nothing about their experience with specific issues. The video I linked above is a really good comprehensive primer about how to find a therapist who will do a better job for you by asking the right questions and demanding the right level of care for yourself through a series of “what to look for.” (Note that it’s pretty new-agey/weird Portland OR specific; maybe I should make one for the Long Island area).

This therapist, according to my insurance website, listed eating disorders as a specialty.

This was not the case. 

I will say, this therapist often gave a lot of really good feedback and didn’t let me stew in my own sh*t longer than I needed to. I got a lot of what I needed, not wanted, to hear, and was always tasked a lot of reflecting to do. But I’d never experienced a therapy session in which 90 percent of the talking was done by someone who wasn’t me for an entire hour, where specific issues that I had been clear about addressing were forgotten about in favor of talking about this person’s politics, and where conversations that just mentioned my LGBTQ (particularly transgender) friends were taken as a challenge and a debate in which I was asked to educate this person about those issues. They also frequently made jokes about scheduling appointments not too far apart so they could get paid, and then inserted “for continuity of care” as an afterthought. It was…weird. In hindsight, it was probably a huge red ethics flag. 

Most significantly, I never really got the help that I needed, and asked for, for my eating disordered behaviors. Those continued. And in their office were books about the keto diet, gluten free fad literature, and other triggering and unhelpful things that signaled to me that this person was indeed not the therapist who could or would help treat my eating disorder, despite their best intention and the fact that my own insurance company said they were qualified to help.

I saw them continuously for about nine months before ghosting them entirely. Since then, I rely mostly on my brilliant and amazing psychiatrist for therapy. I’ve been seeing him for three years this spring, and there has literally never been a session I haven’t left with a smile on my face. He even told me to give that therapist a shot and not “break up” with them…but I’m actually faring really well with just my psychiatrist’s help for the time being.

Don’t get me wrong, it’s really difficult to maintain executive functioning sometimes without a weekly and frequent therapist. But that’s why I’m so grateful for all the skills and ideas I have learned in therapy up to this point, in the past 17 years since I started in and out of a therapist’s office. I also am so grateful for different apps like Sanvello, Recovery Record (which, admittedly, I need to use more often!) and the cultivation of a spiritual practice that involves regular ritual, community, and openness to learning.

Breaking Up Is Hard to Do

Breaking up with a therapist is never easy–heck, I ghosted mine. I guess I did this for a few reasons a) saying outright “you’re really transphobic and I want to recover and this isn’t helping me do that” is a mouthful of awkward, and b) I didn’t really feel like I owed this person that explanation or any at all. I felt like “do no harm” was not happening for me, no matter how well-meaning this professional was; which solidified my need to survive first and cut ties with this person without much communication.

I haven’t been back since September, and I’m okay with that. Has my journey with ED been bumpy at times? Absolutely, especially now at a time when health stressors are high for our entire culture and I’m navigating a potential chronic digestive illness.

But I’m managing, and actually, this time away from my work has allowed me more time to self-care and make time for the things that I don’t get to do ritually for my mental health. So I’m feeling grateful, despite not having a formal “treatment team” or never really having been to treatment despite likely needing it.

Self Advocacy is EVERYTHING.

Especially when it comes to eating disorder recovery and other specific diagnoses within the mental health field, you have to know what to ask for. I am no longer afraid to ask potential therapists what their experience is in eating disordered behavior and treatment, and whether or not their approach involves HAES.

A list of questions (that you are absolutely entitled) to ask a potential therapist for your ED:

• What is your training in eating disorders?
• How do you understand eating disorder recovery?
• Would you give the same mental health advice to a thin/fat person?
• What do you know about HAES, and do you align with the philosophy and science that supports it?
• What is the efficacy or effectiveness of Overeaters Anonymous? Do you recommend this program to everyone who you believe has an ED?
• How do you treat the twofold illness of disordered eating and body dysmorphia?
• Can I count on you to avoid weight talk or weight bias?
• What is your approach to treating anorexia?
• What is your approach to treating bulimia (conventional or exercise bulimia?)
• What is your approach to treating binge eating disorder? (if their answer is weight loss as a primary treatment, get a second opinion)
• What is your approach to treating orthorexia?
• Do you believe that a person can fully recover from an eating disorder?
• What resources are you connected to in case I may need a higher level of care? Will you support me in accessing that higher level of care if necessary?

(A note to therapists: involving diet culture, weight loss or other fatphobic approaches when treating folks with ED will NOT help them recover–promise).

I think it’s important to look FAR beyond what the insurance company website says a person specializes in, and straight up email/ask them yourself. If they spent a weekend doing a seminar or crash course at a Renfrew, that’s not eating disorder specialized. If they diet regularly and subscribe to the culture that renders some bodies more deserving of help than others, that’s not eating disorder specialized–that’s food/disorder fixated.

Find a therapist who spent time doing LONG rotations at ED clinics, reading up on and taking continuing education courses in the specific manifestations of disorder you are looking for treatment in, someone who knows the harm that diet culture does and is at least able to recognize the HAES framework. And don’t stop asking questions about what they have done to prepare to treat and empathically understand the FULL scope of your illness in the here and now. The only boundary I would say is off limits is outright asking them about their personal experience with eating disorders–that’s not your story to hear; it is only their story to tell, just like yours is your own.

Wondering out loud here for you, my LI/NY followers–would we like a video similar to the one I shared above, for New York based treatment options for those of us with ED? Let me know. 

Stay safe and healthy out there, everyone!

A Shout-Out to My Gastroenterologist

I recently went to my gastroenterologist for a consulting visit before my scheduled procedure in April and I was so honestly happy with the outcomes.

When I began the process of seeking out treatment for my stomach issues (which are related directly to my anxiety, have been persisting for years, and likely were made more difficult due to my ED behaviors), I was really nervous and didn’t know what to expect. A family history of GI-related illnesses (Crohn’s, celiac disease) runs in my family, and I had been experiencing symptoms for the past few months that were indicative of something needing to be done.

At my first appointment, the standard thing went on–conversation about symptoms, family history with the help of my mom who came with me to the appointment, but a minimal discussion of my mental health conditions and my history of an eating disorder. I got a few tests spread out over those next few months–an MRI that came back normal, despite not feeling normal and often having nausea and other issues.

So I scheduled an appointment to meet with my doctor during a week off and I went alone to discuss the unaddressed issues of my eating disordered behavior in a more complete way.

She didn’t take my weight at all, validated my mental health symptoms as a likely cause of my gastrointestinal issues, and gave me a recommendation for medical food that would help.

We discussed Overeaters Anonymous and the fact that it’s unnecessary and unhelpful for me (something that doctors, in my experience, never feel, especially when fat patients are sitting in front of them), discussed my family’s relationship with my disordered behavior and my lack of ED treatment (due to weight stigma and denial that what I had was an eating disorder at all in the first place), and she reviewed my previous tests and came to the conclusion that my ED has had no long-term adverse affects on my body.

It is likely that I do have IBS, and she noted that I may benefit from biofeedback so that I can get better at aligning my hunger and fullness signals with my executive functioning.

Because after a few years of binge-purge cycles, I learned how to recover, but my anxiety is a persistent issue. I still struggle with executive functioning, and sometimes will get so busy or bad at time management or just be too anxious to eat, and my hunger signals will go ignored and eventually shut off until they are no longer in my awareness.

It sometimes would result in me skipping meals for hours, and bingeing once I can no longer ignore the ghrelin entering my stomach and telling me to eat, causing me to double or triple up on food, as a way of answering for my missed meals.

I left this appointment having articulated all of this to my doctor, and feeling heard and validated in that understanding of my behavior as it relates to my GI function. And none of it was attributed to my fatness, I was not asked to answer for my weight or reduce it, and I am so grateful for that.

This comprehensive understanding and being able to talk to a doctor about my eating disorder history and be understood and not stigmatized for my weight all at once was probably the best experience I’ve ever had with a medical professional since realizing that I needed to recover from BED/OSFED.

It is difficult enough to be a fat patient in any medical office, but when that doctor visit has to do directly with your eating behavior and the potential for weight stigma is higher than normal, bracing yourself for both subtle and not-so-subtle fatphobia is stressful and traumatic.

I didn’t think finding a doctor who was understanding of my history of eating disorders across the spectrum WHILE also actively not being fatphobic would happen for me. These small things add up for us folks who deal with weight bias from virtually all other corners of life in this world. Thank you so much, Dr. S!

A Discussion About Rule 62

An open letter to men in recovery: stop using “Rule 62” to dismiss women, comorbidity and intersectionality.

To ring in 2020, I spent New Year’s Eve with my friends who are sober–most if not all of whom are qualifying members of Alcoholics Anonymous (I am not; however, I understand the fellowship and framework quite well).

I was discussing sobriety with a man I had just met upon walking in the door to my good friends’ house on the water on the south shore of Long Island–the designated gathering place for 50+ sober people at any given time on a holiday such as July 4th, MDW, and this year, NYE.

I mentioned the unfortunate lack of consideration for folks with eating disorders like myself in the program of AA–especially considering that so many women (approximately 50%) experience comorbid symptoms of eating disorders and substance abuse including alcoholism.

The man in question simply said, “Rule 62,” and looked at me blankly.

Rule 62. 

Don’t take yourself so damn seriously. 

Rule 62, for those unfamiliar, is a rule that has found its way into recovery circles as unspoken tradition.

The backstory, from what I understand, has to do with tradition four (“Each group should be autonomous except in matters affecting other groups or A.A./E.D.A/whateverA as a whole.”) in anonymous programs, which discusses the  idea that individual meeting groups can operate on their own volition without involving or compromising the integrity of the fellowship as a whole.

When AA was expanding, a group attempted to be “all things to all people”–they resolved to take care of meetings, residential treatment, and other facets of recovery life all under one roof–and realized that their goal was way bigger than they could manage in the context of the AA program.

This group came up with 61 rules and sent them to AA as a manifesto or proclamation for beginning their ambitious program. Then, they realized just how daunting a task it would be to take care of every single person’s needs in the realm of addiction treatment–and before scrapping the idea, they came up with rule 62. 

So, what about it? 

Last week, I read a really powerful and thought-provoking opinion piece in the New York Times about the patriarchal foundations and history of AA as an organization. We all know the names Bill W. and Dr. Bob, two men who were alive during the first world war and became alcoholics due to a perceived spiritual malady that they believed had to do with an inflated ego and sense of self, as well as a lack of presence of a higher power in their lives. They were their own higher power for the duration of their relationship with alcohol and drinking–which, as the NYT article suggests, is the essence of white male privilege. 

They sought to recover from this sense of ego, but did it also heal their harmfully separatist sense of rigid gender roles and toxic masculinity?

Alcoholics Anonymous itself has, seemingly ironically tried to be all things to all people; opening itself to women, people of color, people with doctorates, average folks, and everyone in-between, but how can it do that if it still holds itself in the principles, practices and ideas of a world that was designed by and for white men? How can a fellowship with such a marginal number of women attending compared to men even say that “anyone can do it” if they have the capacity to be honest? 

The problem is, this claim is dishonest in and of itself.

Rule 62 was meant to be an ego-check on a group of alcoholics who thought (mistakenly) that their individual group’s program could be a one-stop shop for recovery. When they failed, they wrote this rule as a way of softening the ways that their ambitious and admirable mission had not gone to plan. Well intentioned? Maybe.

In this conversation in my friend’s kitchen, Rule 62 was used to dismiss my very real concern about the harm still being done to people like me in the rooms who are not having their eating disorders addressed–a problem backed by statistics, as I shared before.

I know, I know. If AA were to take on eating disorders too, they wouldn’t really be AA anymore. But this is 2020; and we really need to start accounting for the more than half of the fellowship that needs access to a safe place to express the comorbidity of their alcoholism with other issues like disordered eating and, in the case of my region, opioid abuse. By not being sensitive to issues that clearly and empirically intersect with the problem of alcoholism, there is an imminent danger of making full recovery inaccessible to so many members and potential members.

“At least you’re not drinking” (I hear this one a lot, too!) isn’t good enough anymore. Eating disorders have an unbelievably high mortality rate, especially anorexia nervosa. And I’d venture to say that MOST eating disordered alcoholics can relate to the feeling that alcohol sets off their ED, and vice versa. This is serious.

Food is available at tons of AA meetings without supporting the people for whom food might be a trigger. With over 50 percent of addicts and alcoholics also having an ED–it seems a little insensitive not to address this, and to tell those who are authentically worried about it “not to take themselves so damn seriously.” 

It’s not really a coincidence or an accident that this “rule” is probably most often bestowed upon women, as it was done unto me.

Having an ego and unwarrantedly flaunting your ability to quote a book that is, dare I say, just as fallible and subjective as we all are is…confusing, and honestly, a form of gaslighting imo.

Women don’t need to be powerless, and we don’t need to be told not to take ourselves so seriously. The world outside of those church basements and sober gatherings already does that to and for us. 

Now, I know that this individual’s use and interpretation of Rule 62–like the fallible interpretations of a lot of things in AA and other anonymous groups–speak to the person, not to the fellowship as a whole, hence, the fourth tradition. Hell, Rule 62 was created so that a bunch of people who created a plan and failed, like any human might do, could laugh at themselves and not be bummed that they hadn’t succeeded. We all need a little of that in our lives, certainly.

But I wonder how many times this rule has also been used to drive women into silence about the things that bother them about the world that they live in; things happening inside and outside the rooms. Because the fact is, we absolutely need more power in the world at large and in the daily context of our lives, not less.

And that’s not going to come to us when we are told that the realities of the things we face–pay gaps, the motherhood tax, harassment, assault, violence, dismissal, diet culture, body shame, objectification, legislation made against and about our bodies, repeated interpersonal abuse and marginalization–aren’t serious, problematic or important enough for the men who claim to be united in recovery with us (while, might I add, segregating themselves OFTEN) to take seriously.

I’m a member of a recovery fellowship that isn’t AA, but since AA laid that foundation, I’m addressing it directly, I guess. Any if not all of my closest friends are members of AA. Some of them may cheer me on for saying this, and some might not. That’s okay. However, if anonymous recovery groups, and recovery as a whole, isn’t the same boys club that it says it “used” to be, I’m going to need some of the recovering men I see, know, and love, to start proving that. In fact, I demand it, because (gasp!) I take myself seriously. Out of nothing more than self-respect.

 

So, I joined a gym: Week 1

During and after college, I used to be an avid attendee at my local Planet Fitness. Then exercise bulimia got in the way.

I would often go to the gym twice a day, especially after bingeing on dining hall food to the point where I would make myself sick. Exercise became a punishment, a compensation, a labor.

I took this behavior home with me after graduating from college, too, even when I started to recognize my eating disorder for what it really was–a disorder. I was obsessed with my body and food and unwilling to compromise with myself. I slowly began to resent the gym and movement pretty much altogether, and was restricting enough so that the gym wasn’t necessary for compensation anymore. This led me down a dangerous path.

I was also a track and XC kid from 7th to 10th grade, when my knees wouldn’t let me run distance anymore and I had to give up the sport. I used this, as you can probably guess, to my full advantage when creating my elaborate eating schemes and compensation behaviors. I ran and ran and calculated each mile ran or walked down to the 1/10th of a mile. I did crazy sprint drills on the bleachers at my high school (when I was home for the summer) and strength exercises like the football players do in movies.

 

Until one day just before my college graduation, after a really memorable experience of feeling so disgusted with myself on an elliptical that I couldn’t keep going after fifteen minutes, I swore off exercise machines for life.

What I didn’t realize then was that it wasn’t the gym’s fault that I had this attitude; it was my intention and (over)use of the gym itself that created an association with disorder, misery and self-consciousness in my own head.

Now, I was born with a displacement in my hips; one is a few degrees higher than the other, and it makes my right knee joint work harder to reach the ground (knee pain), AND, to top that off, I have flat feet.

So basically, from the waist down, I’m pretty prone to a lot of clicking and pain in my hip joints. I feel like one of the Golden Girls and I’m only 25 (if I were a GG I’d absolutely be Dorothy btw).

Recently, I re-joined a gym for the first time in about three years. I’m back at the same Planet Fitness I used to belong to in college and would visit frequently on my breaks from school and weekends home. Except I signed up with a new goal in mind–health and strength first.

My hip pain motivated me to go get stronger, and I’ve since been doing that. Often times, fat folks get diagnosed as fat when they’re in pain–and it’s not always incorrect, because there are certain joints in our bodies that bear weight (load-bearing joints); and to stress them out creates mobility compromises for some folks. But for me, my knees have always been jacked up, fat or not–hips too.

But just as often as fat people get told to lose weight to improve their health, thin people don’t. Thin people with the same joint problems I likely have will be told to stretch more, strengthen and work out more–but I guess when it comes to fat folks, it is assumed that we can’t, won’t, or aren’t already doing those things for our health or to maintain strength in the areas that cause us pain.

So I went to the gym telling myself “I’m going to make my left hip pain less frequent and severe,” and that’s just what I did.

So far, I’ve been there twice since signing up, and I did two weight circuits, a stretching sesh, and some specific leg training stuff like lunges. I even made time for the stair climbing machine of death that I used to be terrified of because I fell off once. I went on for only five minutes because it was like reaaaaaaaallllly hard, but I took what I could and didn’t do it past my threshold of enjoyment. That’s what exercise is all about, I’m slowly learning–our intention and the ways we plan to connect with and interact with our bodies while we move them.

To extend this bada** gympowerment thing even further, I told my mom not to comment on my appearance or physical activity and especially not to connect it to weight loss since that’s not what I’m there for–and so far, those boundaries have been maintained which is so tremendously huge for me. There is nothing better than to be seen and heard and respected all while getting to improve my health in a way that has nothing to do with weight loss, and to receive the recognition that there is worth–and health–beyond my weight.

Stay tuned for more updates from the gym!

I Wrote a Book! Royally Incomplete is now a full length book

What an exciting summer it has been!

 

Y’all know I’ve been writing a book–and that book is finally HERE! I’ve poured my soul into writing and editing Royally Incomplete for the past three years; we’ve been through life changes, brand changes, name changes, and body changes. I’m so proud to present my blog, in book form, plus a little extra.

 

I’ve been working with Eliezer Tristan Publishing, an indie publishing house that focuses on mental health narratives and stories. I am so grateful to have been writing this blog for the past three years, because it flowed so seamlessly into a book. The timing, the energy and everything that went into this was all just perfect, and it has produced something that I’m really proud of.

But it hasn’t all been because of me. My editor, Leighanna, designer Michelle, and the CEO of ETP, Sarah Fader, have been so valuable to me throughout this process. In my publisher, I have made a new friend, so many connections, and I’m looking forward to even more as this comes to true fruition.

This book is more than just my blog on paper; it contains some never-before-read essays and poems by me: including “The Calculator in my Brain”, “Skipping Meals Can Make You Relapse” and “Attacking a President’s Weight Isn’t a Valid Way to Be Political”, as well as a workbook-style comments section for readers to engage with the writing and the content. It’s meant to be for anyone who is trying to garner a better understanding of body acceptance, using the questions and experience that I’ve had to grapple with in my three years on this journey. It’s just about what’s worked for me and giving people those same tools so that they can heal too–regardless of whether they have a clinical ED diagnosis.

The paperback is up for preorder on Amazon this week, too!

That’s not it!

Summer has had me busy on social media, too! I started the Body Love Book Club, a discussion group that meets monthly on Instagram to discuss a book related to fat studies, body acceptance, recovery, body image, or related topics. This past week was our first meeting, and we discussed Linda Bacon & Lucy Aphramour’s Body Respect; the conversation was small but super successful and I had a great time moderating the discussion! Stay tuned for future book discussions and dates by following my Instagram or Twitter.

I was also published as a guest writer on the Mental Health at Home blog, in which I discussed the possibility of “overdosing” on self help/self care and how it impacts and impedes recovery. Check it out and let me know what you think! And if you’re a mental health recovery blogger in need of guests, I’d love to write for you! I’m also looking for collaborations and interviews (maybe you have a really cool recovery or MH podcast???) to engage with in the coming months pending my book release. Contact me!

Right now, I’m waiting on the paper copy to come out so that I can sign and send a few to those who want them in the near future; and I’m looking for people to read and review the ebook/Kindle edition on Amazon! If that’s something you’re interested in, definitely head over to the link, purchase and download, and review the book!

Have the best weekend everyone!

Fat acceptance helped me recover from my eating disorders

What is the ‘fat acceptance movement’?

There’s a lot said about it on many corners of the internet. Recently on Instagram, there’s been a lot of discussion on fat acceptance–particularly due to the release of a controversial indie ‘documentary’ that has solicited, harmed and pissed off fat and/or recovering content creators alike on various platforms.

 

 

There are so many opinions, ideas and even myths about what the fat acceptance movement truly is at its core–and even more speculation and bias regarding how it helps people. I can only speak to my own experience, but I hope that in sharing that experience, I help those who have strong opinions and maybe not all the pieces put together to understand why this movement is so important to me and so important to thousands of people who use social media to recover and feel validated in a world that can often be so cruel and judgmental to everyone in it, regardless of size (but especially to fat and plus-sized people).

There are entire accounts on Reddit, Instagram and Twitter devoted to harassing and targeting fat bodies, and posting things laden with logical fallacy about the folks in those bodies. Yikes.

More than body positivity

Almost everyone on the internet is aware of the hashtags #bodypositivity and #effyourbeautystandards (started by Tess Holliday); and these hashtags have conceived movements that fight back against conventional beauty standards in a general way. But the fat acceptance movement and its related hashtags take it a step further–allowing people who live in bodies beyond a straight size (that is, larger than 16 or XL) to celebrate who they are, as they are right now.

But apparently, this makes some people absolutely raging mad. 

 

 

The fat acceptance movement has been around for quite a long time–and it’s based solely on the idea that fat people should be accepted and deemed worthy by the society we live in and receive all the same dignity and care that anyone else gets. This includes in retail, the medical and healthcare industry, and all other institutional areas of life that a person may interact with in their day to day.

It makes people raging mad because it’s considered to mean that we, those who believe that fat people deserve dignity and respect without having to shrink as a prerequisite, are “gLoRiFyiNg oBeSiTy” (yawn).

First of all, let me hit you with this revolutionary idea–‘obesity’ is a construct.

Literally, fat people have existed for hundreds of years. Obesity as a medical term has existed for far less time than that–and the numbers and charts that supposedly quantify obesity are questionable, as are the motives behind them. The Center for Disease Control acknowledges that weight is influenced LARGELY by factors that exist outside of a person’s behavior (social class/elements, environment and genetics make up some of the total ecology). In fact, our body types–everything from how much we weigh to how that weight is distributed–is 60-70% determined by things that AREN’T diet and exercise (Bacon & Aphramour, 2014).

A conundrum I often like to reference in this case is the idea that fat people don’t work out or that they became fat because of their own habits. Often, fast food and “junk” and laziness are associated with fat people; yet I’ve done my own data-collection research that actually found that thin and fat people eat the same amount of fast food in a given week. Images of soda, burgers, sugar and fat bodies are juxtaposed, especially in American culture–the assumption is that all fat bodies got this way by those means. This just simply isn’t the truth.

Random thought addendum: Those who believe that fatness is a universally unhealthy state of being might (and do) suggest that fat folks need to get off the couch and exercise more–yet, those same people are the ones who make it the most embarrassing for fat people to engage in movement in public. So, with this logic, fat bodies are supposed to work out to get un-fat–but only if they do it in secret?????

Fat acceptance means exactly what it says–that we acknowledge, honor and love all bodies as they are, including and especially those who face the largest amount of hate, gatekeeping, and bias from a culture that demands thinness in exchange for validation in many forms. Fat acceptance insists that we don’t demand a set of behaviors from fat people before we deem them valuable to our culture and in our lives.

Fat acceptance does not mean that every body needs to be a certain weight, or under or over that weight or perceived weight, to be seen, heard and unconditionally accepted. Fat acceptance IS body acceptance; because we have to accept and love the most vulnerable with extra care and kindness.

Much of FA is operated on Health at every size (HAES)-related principle, which is a scientifically supported movement that looks at cross-referenced and intersectional measures of health. Back to that term total ecology; it takes into account not only a person’s physical health, but their mental and social health as well, in determining the overall health behaviors of an individual. HAES does not suggest that every body is healthy at its current state; it merely suggests that those bodies who have been deemed unvaluable because they are not thin are also capable of health.

Fat to Thin–and back again

Though I realize that there are limitations to anecdotal and personal evidence, I think my story and my voice in the discussion about fat acceptance and eating disorders being so inevitably and inextricably linked is a resonant one–and I don’t believe for a second that I am alone in this experience. 

When I was in the throes of my eating disorders (plural), my weight was relatively normal most of the time, save the fluctuations for water and binge/purge cycles, etc. My eating disorder started when I was really young as emotional eating in response to trauma, but eventually opened up into compulsive calorie counting, serious restriction, chronic dieting, exercise purging, followed by periods of bingeing to offset the fact that my body was starving and trying to scrape together any energy it could to keep me awake, alert and alive.

 

I watched my weight jump down then up then down and back again for a number of years–sometimes, I’d weigh myself more than five times a day. No amount of controlling the number on the scale could save me from myself.

I was obsessed with making ounces go away and exercising through any free time I had–I could calculate the amount of calories burned while simply standing.

When restricting finally became unsustainable and unappealing, bingeing won over and became my primary behavior. But of course, I had to find a way to get rid of it so that I could maintain some sense of invisibility for my disease; I remained a normal weight by exercising for hours on end and keeping up with this compulsive behavior like it was my religion.

At seventeen, when I finally sought some kind of formal assistance for my mental health, my “diagnosis” was a psychiatrist who looked at me and told me that a certain medication would help me lose weight–but he did this without really hearing what my behaviors were or how I really felt about myself.

This was the essence of what fed my disorder for just a few more years–instead of treating my behavior, a mental health professional treated (and helped maintain) the vain and sick part of my eating disorder–keeping me believing that as long as I didn’t look sick, I wasn’t.

It also helped to keep my fear of ever being “too fat” alive–and didn’t stop me from doing all I could to prevent that from happening, no matter what the cost was to my physical safety (sprains, muscle strains, and more) or my mental health.

I entered a twelve step treatment process on my own that only served to keep diet mentality alive. I celebrated the success of losing 26 pounds in three months. Which, retrospectively, I did by restricting and keeping up the same fear of becoming as fat as the person I am now. Fatphobia, in its most literally defined form, kept up my ED and allowed it to be insanely loud. I was afraid of becoming fat. This is a known symptom of body dysmorphic disorder, a common sub-ED common in most anorexic folks. It was alive and well in my brain and in my life, even in the absence of thinness. 

And guess what? I gained the 26 pounds back and then some.

Years prior, while in this cycle, I had so many unidentified gastrointestinal issues that were, looking back, a result of being between states of malnourished and bingeing, all while exercising without enough energy to sustain me during periods of activity. My eating disorders were what gave me this fat body–from years of abusing it past its limits in the pursuit of thinness no matter the cost. And now that I’m blessed with recovery, I truly do love this body.

When I found the fat acceptance movement, it was through a series of blogs and books and instagram accounts that I really looked up to. I didn’t know how to stop yet, but I knew I was tired of hating my body and eating so erratically. At the beginning of this journey three years ago, I saw bodies that were more diverse than mine, who looked like mine, who loved themselves the way that I hoped to love my body one day.

I learned what radical acceptance was, long before fat acceptance–and fat acceptance honestly saved my life. I learned so much about set point, about restriction and about “last supper” eating and how that was all damaging my brain-body connection and causing stress (which is a factor in weight instability). And most importantly, I learned that trying to control any of these things about my body wasn’t going to get me the relationship that I saw so many people from around the world already having with themselves. 

Being able to accept my body as it was allowed me to not notice or care when I lost a lot of weight as an unintended side effect of eating what I wanted when I wanted–because I wasn’t stressed out about never being able to eat what I used to see as my “cheat foods” again.

As soon as I trained my brain to realize and understand that I could have Dairy Queen, pizza or other fear foods whenever I wanted them–I stopped wanting them as much as I craved them when I was in the disordered eating cycle. As a result, I stopped driving myself crazy–and I stopped weight cycling. And I didn’t care what the scale said because I learned so much about how weight isn’t a concrete or absolute health determinant.

BTW–weight cycling is a known cause of heart disease and other diseases that are often wrongfully attributed as having a causal relationship with fatness. (Say it with me: correlation isn’t causality. Correlation isn’t causality.)

Fat acceptance, as a concept and as a movement, has a lot more to it than people are willing to give it credit for. There is an entire subset of academia surrounding the idea of fat liberation and fat politics and policy, and it’s something that everyone who is interested in equality should take an interest in.

Immersing myself in fat studies allowed me to find something else to do besides count and hide food and feel shame and live in my head. I have made the most invaluable connections and done so much healing work on myself and been a voice for others. I have been called upon to check my own motivations, conditioning, privilege and learn from some of the most incredible people; Marilyn Wann, Deb Burgard, Cynara Gee, Jes Baker, and so many more. 

Fat acceptance IS body acceptance. Fat acceptance is weight neutrality (for me–and for me, being weight neutral is recovery). Fat acceptance is body love, body positivity, and all things that make all bodies accessible to the people who live in them as they are at this very moment and always. I wouldn’t trade my allegiance to the fat acceptance community for anything–because it brought me recovery and an understanding of this body that isn’t rooted in constant confusion, starvation, deprivation, rigidity or hatred. I love this body, fat or not. I love this body, forever and today and always. Fat acceptance helped me to truly see and fully live the idea that none of us are free until each of us are free.

Thanks, fat acceptance.

Body Love Bookclub — Beginning this Month!

I am so excited to announce this!

Me, a few registered dietitians and influencers on Instagram are starting a BODY LOVE BOOK CLUB!!!!

 

We are going to be reading a book monthly, in the realm of fat studies, fat acceptance, body love, body acceptance, weight science, and anti-diet culture.

 

This month’s book, which I chose to kick us off, is Body Respect by Linda Bacon and Lucy Aphramour. I chose this book as a starter because it so clearly and concisely discusses the nuances behind dieting research, myths about weight science that have been perpetuated by several industries across the last century, and much more. You can find it on Amazon, Google Books, Kindle edition or at your local library and join us for our discussion at the end of the month!

We are going to meet on Instagram LIVE on August 22nd at 8:45 pm EST. Follow @theinbetweenqueen for updates and more!