The Unique, Painful Struggle of Being an Overweight Woman With a Mental Disorder

According to the National Alliance on Mental Illness, approximately 18.5% of adults in the United States experience mental illness every year. That's a significant portion of our population—one in five people—yet the stigma and misunderstanding that surround mental health remain rampant. That's why in honor of Mental Health Awareness Month, we put the call out to our readers to share their own experiences with mental illness and other conditions: their victories, their struggles, and what it's really like to negotiate a society that makes misguided assumptions about who you are based on an arbitrary definition of the word "normal." Our series My Life With highlights the raw, unfiltered stories of women who deal with anxiety, bipolar disorder, postpartum depression, and more, all in their own words. Below, Madison Fritts shares a heartbreaking look at the unique stigma overweight women face when it comes to mental health.

I am a very fat woman.

In medical diagnosis terms, I am “morbidly obese.” I have also suffered from depression and binge eating disorder for 11 years. I have been in therapy for five years, and my last therapist stayed with me for two of those years. A couple years ago, I was admitted into a partial hospitalization program at an eating disorder treatment facility for three weeks.

I was the only fat person in the unit I was placed in. No one really knew what to do with me. It felt like the direct care workers and therapists and doctors were winging my treatment. The group therapy sessions were constructed around a model that treated restrictive and compensatory eating behaviors. A select few of the many patients in the facility tried their best to learn about my unique struggles and the rest either ignored me or did not care. Although this facility claimed to be well versed in my specific eating disorder, I was not taken seriously as a whole by the facility, and my insurance dropped my funding despite my being very mentally ill from my eating disorder.

My story is one of many that fat women tell of not having their mental illness taken as seriously as it should because of their weight.

As a fat woman, when I tell people I have depression and an eating disorder, many folks erroneously assume I am lazy and have no self-control and that my mental illnesses are cover-ups to these perceived character flaws of fatness or just a direct result from my fatness. I have been the recipient of many comments along the lines of “Why don’t you just lose weight? You’ll feel better when you do.” Raise your hand if you’ve ever heard that gem of wisdom. We don’t blame straight-sized people for their mental illnesses, so why are we doing it to fat people?

It is because little care is given to fat people.

Fat women are categorized as lazy and incompetent beings, as individuals without self-control or a desire to “be better.” A 2012 study found that 24% of nurses thought fat people were unsuccessful and 22% thought they were lazy. Societal beliefs have taught people to conflate fatness with junk food, sedentary lives, and failure. These stereotypes have extended into the treatment plans of fat individuals with mental illness.

Doctors, friends, family, and strangers have all told me I can drastically help or cure my depression and eating disorder with more exercise and healthy eating. The issue with this “concern trolling” is that they automatically assume I don’t exercise or eat a balanced diet (beyond my ED behaviors). They also classify my mental illness as something that can be treated differently than a straight-sized person simply because of my weight. Therefore, it must require a different treatment methodology.

Unfortunately, even some ill-informed readers of this article will deny the truth I tell about being fat and experiencing mental illness. This is something all fat women prepare for when speaking on their own fatness. I like to call it “fat gaslighting”: Even when I present the facts of my mental illness along with the acceptance of my fatness, my reality of which I am most certainly informed is denied by someone on the internet saying, “Maybe you should stop eating so much and then you’d feel better.” These types of idiotic comments are nothing new to fat women. We face it every time we speak to new people about our bodies when someone claims to know more about ourselves than we do.

These comments can be invalidating for fat women. The fat existence is already so heavily steeped in shame and erasure. We are told by the media we are not worthy of love, beauty, happiness because we do not match the ideal of the perfect, thin woman. This shame and erasure can be even stronger for fat women who don’t meet the standards of the “beautiful” fat women— the “thick” one with hips, a big butt, large breasts, and the absence of a FUPA. A woman like me, the untraditionally beautiful fat woman with a big belly and FUPA, smaller breasts, and flatter butt, can often get lost in the shuffle of ideals that never lands on idolizing the body type she has.

Many fat women are already at greater risk of developing a mental disorder or illness because of these beauty standards. The vulnerability factor of having an unattainable beauty standard thrust in her face can add on to a woman’s risk of developing mental illness (if she has one) from genetics, environment, etc. This vulnerability factor stemming from weight discrimination cannot be experienced by anyone but fat people.

Studies have suggested a positive relationship between weight and suicide attempts. Another finds that BMI is a predictor for suicide and that those with “extreme obesity” attempt suicide more compared to those with lower BMIs. These results (among many other studies) suggest a link between fatness and suicide. We know that preventing suicide is much more than a prescription for more exercise, so why do we, as friends, family, doctors, and peers of fat people, tell them they can fix it this way? This is a great injustice that will no longer be tolerated.

So what needs to be done to help break the stereotyped mentally ill fat person?

We must come up with more compassionate social scripts when responding to a fat person’s remarks about their mental illness. Instead of giving tired, unsolicited advice, the listener must think compassionately and respond with something like “How can I support you?” If the fat person does not say their fatness is a factor in their mental illness, then the listener needs to accept that and cease to bring up the speaker’s fatness. You are not their doctor. The fat person knows infinitely more about their own body than you do. You must accept that in order to be as supportive as possible.

Straight-sized individuals, especially those who have never been fat, need to realize that the fat existence, even one without experiencing mental illness, is complex, emotionally challenging, and oftentimes discouraging. The straight-sized individual will never know firsthand the mental endurance it takes to be a fat person, and more importantly a fat woman, so to learn they must speak less and listen more. Straight-sized advice based on the straight-sized experience isn’t asked for because it oftentimes isn’t applicable or helpful for fat people. Straight-sized people need to be allies, not vanguards, in the fat community.

Compassion is the key. If you can’t empathize or relate, you must look through a compassionate lens that doesn’t assume, imply, or discriminate. Only through this can we truly break the toxic societal beliefs that continue to hurt mentally ill fat people.