The Pain of Having an Eating Disorder When You're Fat

Treatment is often one-size-fits-all: "One questionnaire asked if I felt fat. I thought: I am, being fat is not a feeling."
October 9, 2020, 8:41am
liza, meike and katla
Liza, Meike and Katla. All photos by the author.  

This article originally appeared on VICE Netherlands.

I first binged on food when I was ten. I used my pocket money to buy a family-sized bag of crisps, a box of cookies and four croissants. I sat on a bench in a deserted park and ate it all. I’d always been fat, but as soon as the binging started I ballooned. At 12, I was admitted to a weight-loss clinic because my family didn't know how to deal with me. When I asked the dietician at the clinic about the binging and my difficult relationship with food, she simply said, “Once you lose the weight, that problem will solve itself.”

In seven months at the clinic, I did shed the kilos, but once I moved home I went back to my old ways. I know now that losing weight doesn’t magically solve the underlying issues of an eating disorder. I wish the medical professionals treating me had known that too.

TV shows and documentaries often serve up the stereotypical eating disorder sufferer: young, white and very thin. As a fat person, I’ve encountered several doctors and other professionals who didn’t take my eating disorder seriously when I asked for help.

When you're fat, you often get belittling comments and useless advice, like: “Just eat less and exercise more.” But for people with an eating disorder – no matter their body weight – there is nothing easy about eating. And the simplistic approach isn’t only annoying, it’s harmful. I spoke to three others about the difficulty of getting help for an eating disorder as a fat person.

Meike. Photo by the author.

Meike. Photo by the author.

Meike, 26

I’ve been going to therapy for my eating disorder for about three months now. It took a long time for me to take my eating disorder seriously. I always told myself to stop complaining, that it was my own fault that I was fat and had such a difficult relationship with food. I’m really glad I finally went to therapy.

But there are still obstacles. Personally, I’m very much into body positivity: I try to accept my body as it is and let go of the idea that I have to lose weight, no matter what. But doctors will say things like, “As soon as you stop binge eating, you’ll start losing weight.” It’s difficult for me to hear, because I don’t want to walk around with false hope, and most importantly, I want to stop being so obsessed with weight loss. All it does is trigger deeply rooted, unhealthy thoughts associated with my eating disorder.

They don’t realise I’ve spent my whole life trying to be as thin as possible – like people who are in recovery for actually being too thin. For years, I restricted my eating and would go through phases when I barely ate, though you wouldn’t be able to tell by looking at me.

People think only skinny people need quality care. You can even tell that therapy rooms are meant for skinny people: the chairs are too narrow for fat people and have arm rests. I even had to fill out a questionnaire that asked if I felt fat. I thought: ‘I am,’ being fat is not a feeling.

Liza. Photo by the author.

Liza. Photo by the author.

Liza, 27

When I was a teenager, I went through cycles of restrictive eating, excessive working out and binge eating. Once I started therapy at a special clinic for people with eating disorders a few years ago, they diagnosed me with binge eating disorder. That didn’t encapsulate it for me, because I wasn’t just binging. There were times I barely ate at all.

When I broke up with my partner and dropped a lot of weight, the doctors thought there might be something else going on. That led to the diagnosis of atypical anorexia, which means you check all the boxes for anorexia, except being underweight. My destructive and unhealthy behaviours – like restricting food and working out excessively – just happened to be the things we encourage fat people to do.

Group therapy was difficult. I was the only fat person in the group and felt like my body shape was the living nightmare of every person in the room.

I was never asked by any of my therapists how this felt. Six months later, I started individual therapy – luckily my therapist and I connected.

But there were still challenges. They made me step on a scale once a week, for instance, as a part of the programme. The idea is to develop a more neutral attitude to the number on the scale, but it just triggered unhealthy thoughts about dieting. I mentioned several times that I didn’t want to get on the scale, because the effect it had on me was so severe that it stood in the way of my recovery. They told me that rules are rules for a reason.

This ultimately led me to quit therapy sooner. But I also felt I’d recovered from my eating disorder. When I left, the therapy team told me they were worried about my health, because I’d gained weight. But that made perfect sense to me: for the first time in years, I had started eating normally.

During one of our last sessions, my therapist suddenly started talking about the health risks associated with being obese, even though she knew how triggering that was for me. I was so upset, the sense of safety and happiness about my recovery were wiped away. This is what happens when caregivers use a one-size-fits-all model designed for thin people.


Katla. Photo by the author.

Katla, 31

My family moved from Paris to the Netherlands when I was nine. That was when I started having issues around food and the way I saw myself and my body. It must have had something to do with control, because I didn’t feel like I belonged at my new school.

As a teenager, I secretly used my pocket money to buy food – mostly candy – to eat in secret. When I hit puberty, I sometimes went through phases where I would barely eat, but I never managed to keep that up. So in my early twenties, I started using drugs and laxatives to suppress my appetite. I didn’t like eating in front of other people, so I wouldn’t have a lot when I went to dinner with friends, and then stuff my face as soon as I got home. My weight fluctuated incredibly and I always wanted to be thinner. It was destructive.

At 20, I started therapy because I felt depressed. I brought up my obsessive relationship with food with my therapist. I thought I might have an eating disorder. The therapist asked how much I ate when I binged – she didn’t think the amounts were enough to be diagnosed with an eating disorder and receive treatment.

Other therapists didn’t listen either. A college psychologist said, at my age, I should be focused on physical fitness and that, if I hit the gym, I’d be fine.

It feels like your problem needs to be communicated by the shape of your body, and lots of people don’t take my issues seriously because I’m not very fat or very thin.

I’m currently in treatment for burnout and a traumatic experience, but still there’s no attention on my issues with food. Everything inside of me screams that it needs to be addressed, because I can’t deal with it on my own.