Dear Susan: How do I express concern for my friend without fat-shaming?

“Dear Susan:

One of my good friends, an awesome lady in her mid-30s, is severely obese. Walking down a single block or flight of stairs causes her to hyperventilate to the point where it’s terrifying; it generally takes several minutes for her to recover. (Suffice to say, she drives everywhere.) From an emotional standpoint, she is severely depressed, places no value on her worth and engages in emotionally-abusive/negligent relationships with fat fetishists that leave her feeling even more worthless when they’ve ended. (Not generalizing the entire fetish community, just the ones that my friend interacts with.) There’s a clear correlation between her size and her happiness, but she refuses to do anything about it. Her dinners tend to be in the extreme – it’s not uncommon to see her consume two Big Macs, fries and a milkshake in one sitting, then grab a bag of chips at home – and gentle suggestions that perhaps she could start walking in little bits and build up to that one-block stroll have been immediately shot down. It’s a tough situation – my friends and I are at a loss as far as how to approach it without coming off as fat-shaming. I mean, we’re all about fat acceptance, but she’s so visibly unhealthy/unhappy. Any thoughts?”

I love to concern mousepad
Mousepad available at, for those of you who love to concern.

I wish I could tell you what you want to hear. I cannot.

There are three separate issues which need to be teased apart. You are concerned, because 1) your friend’s physical health is in danger, 2) your friend’s mental health is suffering, and 3) your friend is fat. We must separate these out from the get-go; although you see them as inextricably intertwined, they aren’t. They are not.

One of our duties as friends, partners, family members, and loved ones, is to care for those that we love. And that’s what you feel like you are doing – being caring, and trying to make her situation better. I think your heart is in the right place, but I also think you are very much in the wrong.

Fifteen years ago, when I came out as bisexual, the buzz word was “tolerance.” I have always hated that word, although it is touted by many as being something admirable. The reason I hate it is because the very idea of tolerating somebody different than you is just gross. The term is dripping with condescension, laden with a sense of superiority. Tolerate. Yich.

I bring this up because, to be honest, this is how your fat acceptance feels to me. Yes, you believe fat shaming is wrong. And you are concerned about her health. But your concern is covering up what you really feel, which is that she is fat, she is at fault for it, she is and should be suffering for it, and that you can fix it by pointing it out to her. I imagine that as you read this, you think that I am mistaken, that you simply want the best for her. Take a look back over your words.

“She refuses to do anything about it.” “Her dinners tend to be in the extreme.” “She’s so visibly unhealthy/unhappy.”

Let’s start with the last part. She’s so visibly unhealthy. Health, as much as we believe it can be, is not something that can be measured visibly. It just isn’t. You have mentioned other effects – the hyperventilation from walking down the stairs – which may be an indication that something is wrong. Something like asthma. Or allergies. Or it could be correlated with her size, although if so, it is more likely correlated with exercise, which has absolutely nothing to do with how much she weighs. The problem here is that illnesses that are correlated with fat are just that: correlated. Not causal. Fat has not been shown to cause health problems. Correlation is not causation. Correlation is not causation. Correlation is not causation.

So what you are really trying to say, I think, is that she is physically unfit and you are worried about her. Let’s take size out of the equation, though. If she were thin and wheezing, would you assume that this is a problem she should be doing something about? Would you feel an urge to talk to her about her habits? What if it is asthma, and not something that she can easily control?

Because, even if it is related to her size, it likely isn’t something she can control. Studies show again and again that those who attempt to “do something about it” fail, and that constant attempts to lose weight are bad on the body. So your “gentle” words of encouragement, should she take you up on them and realize that what you think is important is a small body, will actually be detrimental to her health.

But let’s pretend that she’s unhealthy because she is fat, and that she can change that at any time if she wants to. These are not quantifiably true, but even if you pretend that they are: health is incredibly personal. If it’s not something she wants to talk about with you, it’s not something you should bring up. Even if you care about her. Especially if you care about her. It’s just not your business.

Which brings me to the part of your letter that has made me feel physically ill for a few days. Your friend sounds like she has a low self-esteem, and you feel like it is connected to her size. In a way, it is, but not because fat people are inherently depressed.

It is because of you.

Not just you, of course, but I have your attention, so it’s a good place to start.

We are constantly, constantly fed messages about how a certain size has worth and anything above that size does not. Fat people are ruthlessly shamed, as you well know, because you mention wanting to avoid it. But shaming doesn’t just mean “making fun of.” Shaming means scrutinizing somebody’s meals, acting like their body shape is a moral failing (that they “refuse to do anything about”), and relentlessly pitying a person based on their size. I know that you think you aren’t doing any of this, but I urge you to think about how you really feel, and what kind of messages you are sending to your friend.

I’ve eaten two Big Mac meals before, and then topped it off with chips. I generally do it when I am feeling really worthless, and need to fill up my body with calories, to try to fill the empty place where self-esteem is supposed to live. As I type this, my face is flush with shame, thinking that some of my friends might be watching me, counting up what is going into my mouth, using it as evidence that they need to intervene. You don’t need to intervene. All of your concern is reinforcing the idea that if she wants to have value as a human being, she has to become thin. Which is impossible for the vast majority of people who attempt it. What you are saying to her is that she needs to change, and if she can’t, that only makes her feeling of worthlessness grow. The logic is that she is depressed because she is fat, and that she is fat because she won’t change. Thus, it is her fault that she is fat, and it is her fault that she is depressed.

And telling a person in the grips of depression that it is their fault is nothing short of cruel.

She’s seeking out abusers in her relationships not because she is fat, but because society has taught her that fat people are inferior. Your gentle nudging is a part of this. She cannot gain self-esteem while there are people around her assuming (with no clear evidence) that her health is failing and that she needs to “do something about it.” She cannot be loved by others until she learns to love herself, and she cannot love herself as a fat person while her friends are judging her for her body shape.

I do think that you mean well. I urge you to read this article. If you don’t have time, here are a few suggestions from the article for how to talk to somebody you are concerned about:

“Are you OK?

You don’t seem like your usual self, is everything all right?

Can I help with anything?

If you want to talk, you know I’m available for you, OK?

How are you coping with [insert illness or injury they have told you about here]?”

It is wonderful to be concerned about those who we love – that is what our social fabric is made up of. But in this instance, trying to convince a fat person that they should change for their own good is cruel, and feeds into feelings of worthlessness. It’s not like your friend doesn’t know that she’s fat, or that exercise is good for you. If you want to be there for your friend, be there for your friend, and let her know that you love her as is. Otherwise, stay away from her, because you are only making the problem worse.

By Susan

I am old and wise. Perhaps more old than wise, but once you're old, you don't give a shit about details anymore.

94 replies on “Dear Susan: How do I express concern for my friend without fat-shaming?”

This is a prime example of concern-trolling. The biggest question you should ask yourself is, “do I honestly think they don’t know they’re overweight?”

When you’re overweight like I am, you are constantly, CONSTANTLY reminded of it. You’re reminded of it when a friend (who’s already thin) talks about losing more weight, about going on a diet. You’re reminded of it when shopping. You’re reminded of it when being scrutinized for what you’re eating. You’re reminded of it every single moment of every single day. The last thing they need is one more ‘concerned’ person nagging them about it, because it’s not going to motivate them. It’s going to drive them into or deeper into a depression, and you’re likely to lose their friendship.

If you honestly, honestly think that they don’t realize they’re overweight, you don’t deserve their friendship, because you aren’t paying attention.

I appreciate this answer, though I might have approached it in a different way.

Letter Writer, are there coherent reasons why your friend might not be able to address her health concerns? Does she have insurance to cover the cost of asthma meds, for example, or sessions with a therapist if she is suffering from mental health issues like depression? If not, is there anything you can do to help with this? If so, I don’t think that there’s necessarily anything wrong with offering your help. If you can’t, nagging her about it will only increase her anxiety and make her feel like she has lost you as a support structure, which will worsen the situation.


You are completely correct.  However, let me lend some of my perspective, as we share the belief of health at any size, and as we share experiences in certain issues which you have previously discussed.

Has the person writing the letter ever thought that the depression could be the issue?  Depression maniTfests itself in funky ways depending on the individual.  Has the person in question gone through some really fucked-up experiences?  If anyone has watched early eps of “Dr. Phil” or “The Biggest Loser,” sometimes that’s what happens, particularly with women.  Food can be used as a very messed-up coping source.  And here is the caveat: Something that can be enjoyed and used to fuel the body is used as a way to fill up an empty void within.  Not everyone is great at articulating what they are going through, so food becomes a coping mechanism.

So.   Have you ever thought that extreme obesity and shitty relationships with shitty men could be a result of  depression?  The depression needs to be treated first.  It’s one thing to tell a friend, “Look, I think there’s an issue.  These guys keep treating you like shit, and I hate seeing you get burned like that.  Can I help you with anything?  Do you want to talk about anything?”  It’s another to say, “You’re fat, and all your issues are from this.  Let’s help you lose weight!”

Help with treatment of the source first, then be supportive if she wants to get to a healthy weight,

Thanks again Susan.  I think about smoking, and how telling a smoker smoking is bad for them (which they already know) increases anxiety and makes them smoke more.  I am also reminded of Deborah Adele in The Yamas and Niyamas saying worry is a form of violence, it suggests a person is not capable of taking care of themselves and that the worrier has a better sense of life than the person about whom they worry.  I know I have a lot of work to do on this: it is sad how much I assert my ego on others through worry and “concern”, and in the process only alienate them.  This goes back to part of the acculturation study you referenced in the “What I actually do” takedown: perceived discrimination toward an element of our identity only makes us more loyal to that identity.  So we do what the Dalai Lama said today on his facebook page: we don’t just assume education brings peace, because without warmth and welcoming it is absolutely useless. 

We simply cannot assume our way is the only way, that our path is the same path everyone else is on.  For me, I am pathologically incapable of gaining weight: my partner is convinced I have a worm.  The letter above would suggest that I am just more disciplined and concerned for my health than the person for whom they are concerned.  That is not something you can know by looking at us.  Somehow, despite being skinny, I have engaged in some very self-destructive practices…

My best friend is overweight, and I know a lot about it because before puberty hit me in full swing I was too. I benefited from rugby and from being at a private school where I was eating meals with fixed portions regularly (without much recourse to snacking because I was a scholarship kid and the tuck shop was expensive). She, on the other hand, did not.

When I met her, I could obviously see she was fat. But I know, and she knows, and now we know together, that there is one fundamental fact of weight loss;

if the person doesn’t want to lose weight, they just won’t.

It really is as simple as that. Gastric band, you say – surgery, you say – well, frankly, people have to seek those out and choose them. Or they choose to lose weight. And I didn’t talk to my friend about her weight until she expressed concern and a want to lose weight. Which is how it should be. Quite frankly, even if being fat WAS inherently causal of medical problems, you would still be as annoying as people who constantly harp on smokers, except with even less of a point because smokers harm the people around them.

People have the choice to make unhealthy decisions. They just do. So not only is it unhelpful for people to intervene where they haven’t been asked, it’s also majorly overstepping the mark as much as “Girl, you shouldn’t smoke” is.

As for I and my best friend, there are extra complications. Even when somebody’s invited you in and asked you directly (as she did) to help them with their weight and go along on weight loss with them, you can still be an obnoxious fucktard, which I’ve had to learn. For a very short while I made all of our conversations about weight, which is very unhelpful (which I knew, but didn’t do, because I hadn’t been on that side of it before). We eventually settled into a pattern where she defines the terms of her weight loss; we have a schedule, which we keep to, and so far she’s lost a stone (probably more, because we only weigh once a month to mark long-term progress better). Outside of our schedule, we don’t talk weight loss. She makes her food choices for herself, I’m not allowed to give her looks (self-imposed rule), and more than that, we try and make going to the gym (which I do with her) fun. We talk and we listen to good music and silly music, and though it took her a while she exercises without any self-consciousness now.

There’s another, more positive thing I have to say, which applies to all overweight people who want to lose weight and feel intimidated at gyms;

The vast majority of people who are gym-going will admire you for going to the gym and exercising. Really, over 95%. I’m one of those gym-going people now, and you don’t know how awesome it is to see all kinds of people coming and exercising and eventually enjoying themselves. I’m a part of a group which eases people into exercise and the first thing we say when people come into the group (it’s a young person’s thing so people are usually nervous and uneducated about gym going) is “Well done.”

As soon as you start, well done. And that’s not a weight thing, it’s a general exercise thing.

*steps off soapbox*


Hi there,

I completely agree that the letter writer does (wrongly) conflate the idea of being unhealthy and being obese.  She judges her friend, pushes her when in the depths of depression, etc.  No argument.  I agree with calling her out for this.

But.  As someone who just lost a very close family member because of overlooked extreme wheezing, inability to walk up stairs without stopping, etc, I have to say, and agree with some other posters, that close loved ones must push people to speak to professionals and to find help.  In terms of cause, my  family member’s death was unrelated clinically to her obesity.  She avoided going to the doctor out of fear of fat shaming and a fear that the doctor would tell her she was sick (like all of us do!).  Fat people get sick and have major health problems unrelated to their weight, this is true.  But in a culture that refuses to separate the two, that places this incredible weight and shame on people who might be sick,  how do we support people who are sick and who are fat?

While the writer was judgmental and already guilty of fat-shaming, that does not change the fact that terrible wheezing of the magnitude she speaks, inability to exercise and depression are all major warning signs (ahhhhhhoooooogaaaa) that someone, SOMEONE, has to get this person to a doctor.  The person herself does not seem capable and if  there is anything seriously wrong, which it sounds like in a very real physical sense (and I do count depression as a physical illness) someone has to get her to the doctor.

However badly the writer has behaved, she is trying to understand more clearly how to support her friend.  She should know the truth, that yes, you were being a jerk, but if this friend has no other support system perhaps the friend was looking for ways stronger than the vague questions at the end of the article.  Those could help at first, when things really have just changed, but this does not seem to be the case here.

What do we do in that situation?  I wish I had known 2 months ago.

Thank you! It’s good to have the perspective of someone who has personal experience being in the same place as the letter writer.

You know, I didn’t even factor in the depression. Depression makes it almost impossible to change, so while originally I was thinking that the friend should leave her friend alone, now I’m wondering if you’re right that she needs someone to push her. Sadly, those who push are usually considered assholes, even if it’s for someone’s good. (Says the woman who pushed her brother and was “ex-communicated” …and then he did what I pushed for, but was still mad at me. Was it worth it? I’m still not sure.)

Yes, thank you thank you thank you.

While I agree that everyone’s health is their business and their business alone… I’ve had experience battling concern for a loved one who refused to see a doctor to avoid fat shaming.  It’s frustrating.  So so so frustrating.  My mom avoided doctors for over 15 years due to her weight.  When I learned this I was inwardly horrified – Not because of her weight, but because I am all for preventative medicine, both of her parents had a slew of medical conditions that can be genetic, and she was showing several concerning physical symptoms.

I began encouraging her…then hounding her to go see a doctor.  And while I was truly concerned about her health, from her standpoint I was fat shaming her.  She was convinced I wanted her to see a doctor due to her weight, it didn’t matter what I said otherwise.

I’m sad to say it damaged our relationship a bit because things got a bit ugly.  The summer after my sophomore year of college I found a lump in my breast.  My doc recommended surgical removal and a biopsy.  So that’s what I did.  It was thankfully benign, but I had a few days of worry.  During this time I begged my mother to at least get a mammogram (she was 50 at the time and had never had one done).  She refused, saying that she wasn’t ready to see a doctor yet.  I could hardly speak with her.  I was so infuriated.  I don’t hide my emotions well, she knew I was mad.  A few days later, after the results came back she approached me.  She told me she was planning on seeing a doctor, but she wanted to lose weight and I needed to be patient with her.

I let the matter drop.  I told myself I didn’t care anymore, that she was an adult and that it was not my responsibility.  But two years later, when I found ANOTHER lump in my OTHER breast and she still hadn’t seen a doctor, I lost it.  I completely lost it.  I began hounding her again and she gave me the same line she had always given me – Not until I lose weight.  I don’t remember what I said, but I ended up giving her the biggest fucking guilt trip.  She cried and sobbed, but guess what, she finally went and saw a doctor and has gone every year since.

Was it worth it?  I don’t know. Probably. I wish I would have been able to do it in another way.  I wish she would have responded when I initially reached out to her.  But here’s the thing about my mom.  She’s stubborn and has this innate ability of redirecting conversations off of her and on to you.  My 22 year old self didn’t see any other way… and the thought of watching her ignore her health was just too unbearable.

But I wish I knew what the right answer was to your question because I have heard many stories of individuals avoiding the doctor out of shame.  :(  How do we change this?

I’m reminded of the first chapter of Bossypants, in which Tina Fey stated that she writes people off as assholes when they comment on or ask about her facial scar before she brings it up herself or it plays contextually into a story that she is telling.  She says that those people’s future actions almost always bear out her initial judgment that they’re lousy people.

I’m usually a little wary of fat-acceptance articles (I’ve noticed that recently there’s a little too much sensitivity to real medical issues and such when they do pop up within individual narratives), but the woman who wrote the letter very clearly is fat-shaming her friend.  Most people in this modern age really don’t exercise regularly.  It probably wouldn’t be very hard to find an off-topic comment thread on this very site about drinking a whole bottle of wine and eating an entire pizza and isn’t that awesome and wacky LOLOLOLOLOL.  There’s nothing in the letter mentioning that the friend’s size and fitness level are affecting the friendship or preventing them from doing things that they used to enjoy together.  She’s really just grossed out by what her friend is eating and the guys that she chooses to date.

Thank you for writing this, Susan. I sympathize with the letter writer in that I understand that it is sometimes difficult to keep one’s opinions regarding what one personally considers to be the best interest of a close friend to oneself. Especially when that person is concerned about the overall well being of that friend. The line between concern and concern trolling can be incredibly fine. It is important to remember that the friend’s body size is an issue that the friend deals with every single waking second.  Supporting that friend may, in this case, just mean being a friend. Saying “I love you.” Including the friend in activities, even if that means moving a little more slowly than usual. In short, if you think she’s depressed, try to help with the depression. If you think she’s too fat, and that’s why she’s depressed, try to help with the depression by being a friend.

“…gentle suggestions that perhaps she could start walking in little bits and build up to that one-block stroll have been immediately shot down.”

Her friend isn’t interested in her concern trolling (even though it may come from a good place).

She’s fat…and I’m sure she’s aware of it.

Logically, what can you do? You can’t force her to make better choices.

You can only be there for her. Be supportive. Ask her how she’s feeling. Let her know she’s loved.

It’s all you can do.

I was once visiting home and meeting up with an old friend who said to me, “Kortney, I’m really concerned about your weight and health. Have you been doing anything to take care of yourself?”

1. I was mortified. 2. I was pissed because it wasn’t any of her damn business. 3. She DID shame me by questioning my life choices. 4. I honestly didn’t want to see her again (it was about 7 years before we talked again). 5. Her comment supposed that she cared more about my body than I do that that’s uncool because no, she doesn’t. 6. She assumed I don’t do things to take care of myself which is also wrong because she isn’t in my life daily, she doesn’t live in my home, she doesn’t get to see every meal I eat!

I’m not saying these kinds of comments are 100% ineffective but they do hurt 100% of the time and more often than not they leave the friend feeling depressed rather than motivated and confident of their ability to change. Your article was harsh but true: telling your friend to ‘fix’ herself is ineffective when compared to making her feel loved and supported. If depression is part of her weight problem (and lets face it, we all know depression makes most of us gain and leads to lots of other health issues), then comments like these will only worsen the cause. She doesn’t need a constant reminder of what her problem is, she probably just needs friends that will make her feel good and accepted when she’s around them. If I had friends who just made me feel fat and unhealthy every time I was around them, I’d stop seeing them.

A friend’s job isn’t to be a doctor. Let medical professionals discuss her weight with her and if she says to you that she wants help, then you help her by going for walks together and inviting her to healthy dinner parties. But even then, you don’t get to comment on her weight or ask her what she’s been doing–that’s her business.

“I’m not saying these kinds of comments are 100% ineffective but they do hurt 100% of the time and more often than not they leave the friend feeling depressed rather than motivated and confident of their ability to change.”

Nail. Head. You hit it. That was a damn astute thing to say and I completely relate to that. I’ve got 95% concern-trolls in my family, and when decided that I wanted a change for myself (mostly because I wanted to run a zombie-infested obstacle course), concern trolls congratulated themselves on my success. In my head, I know I don’t have to let them take ownership of my body in such a way, but in my heart I always felt that the love was conditional on my pant size.

I have to say I disagree with your approach, Susan. This person may have gotten it wrong, and I think you’re right that the way to approach the friend is to ask the more general questions that you give examples of at the end of the post. But this writer was looking for your advice as to how best help her friend, and while you gave her some of that, you also blamed her (partly) for her friend’s problems, wrote a lot about fat acceptance+HAES (which it seems she already knows about and could have been dealt with with a few links to previous articles here and to other sites), and  told her she made you physically ill.

Again, you may be right about the writer’s bias, but this didn’t read like you kept the person who wrote to you – or her friend –  in mind.

Thanks for the feedback.  I guess the reason why I approach it from this point of view is that I don’t think that the person who wrote the letter should try to “fix” the “problem.”  I think that the best way to help the friend is to stop trying to help the friend, frankly.  Especially if the approach is to critique her “extreme dinners” and say that she “refuses to do anything about it.”

I have said this in other comments, and I will say it again here – I started out with an entirely different article, but every time I tried to give advice to the letter-writer about helping the problem, it felt to me like by supporting this attitude (that fat = unhealthy, that fat = unhappy, that fat should be fixed) was making the problem worse.

I think she *does* know about HAES, in theory.  But not in practice.

But – I definitely agree that there is more than one way to take the letter, and I took it rather harshly.  One of the reasons I hesitated to link to too many HAES articles is that the ones that I have read regarding concern trolling (which I personally think this falls under) are much, much harsher.

Also – I hope my comment above didn’t come off as defensive or dismissive, I am not trying to be either.  I am in a bit of a rush, though, and my thoughts are splashing across the keyboard somewhat disjointedly.  I wanted to reply to your comment, though, so I figured disjointed was better than nothing.

The long and short of it is that I appreciate your feedback, and you raise good points, and this article probably isn’t helpful to the person who wrote the letter – but I don’t feel like I can, in good faith, support the concern.  It feels to me like it is coming from a bad place, even while the letter-writer feels that it is coming from a good place.  To support the concern and give advice on how to help the friend is, in my opinion, validating the concern – which validates the idea that fat in and of itself is wrong.

Not at all – I realise we disagree on this.

  To support the concern and give advice on how to help the friend is, in my opinion, validating the concern

True, if her only concern was her friend’s weight. But you yourself identified three things the writer was concerned about (her friend’s health, depression/low self-esteem, and weight) but then focused on why the third one wasn’t a problem per se (i.e.: not the One Problem to Rule Them All, if you see what I mean) without offering much advice about the first two, which I think we both agree are more significant. It’s difficult to see how the writer can read this and feel like she (a) realises she may have approached this from the wrong place, but (b) now feels that she has some ways to help her friend with the more significant depression/self-esteem/abusive relationships issues.

You are absolutely, 100% right.  I got caught up in the realization that the friend was actually doing more harm than good, and didn’t talk about the good that can be done.

Also, clarification, although I’m not sure it matters: when I said that I felt sick, it wasn’t because of what the letter-writer was saying/thinking/doing – it was because it made me feel sick to have to put it into words that I thought she was part of the problem.  Which should have been much more clear.

Qos, thank you. Without getting into too much, I agree with your statements. I also agree with those other commenters that said, “She already knows. Just support her as a friend.”  Personally, I don’t think that telling the letter writer that she’s part of the problem, when she’s already stated that she doesn’t want to fat-shame, was very helpful. She’s asking for good information, not a berating about how bad she is.

Sorry Susan. I’ve enjoyed your articles in the past and on this we’re going to have to agree to disagree.

I didn’t intend to berate, although I’m sure that’s how it came across.  I do think that “gentle nudgings” and discussions amongst mutual friends and being critical of what she eats is part of the problem.  I can’t give good information, because to me, explaining positive ways to express concern about people being fat, no matter how positive, no matter how helpful, makes the problem worse.

Saying you don’t want to fat shame isn’t the same as not fat-shaming, is what I’m trying to say.  I appreciate your feedback, and I’m glad you spoke up, but I think you are right about agreeing to disagree.

I think where I’m coming from is that this woman clearly doesn’t have a clue. We can both agree on that, at least! However, she was asking for help and this was a “teachable moment” to gently nudge her in the right direction. She was open to positive suggestions and, now, probably isn’t.

As an analogy, if you have a puppy piddling on your carpet, you take the puppy and put it outside and then praise the hell out of it when it does the right thing. Yelling at it, on the other hand, will just a) confuse it and b) teach it to try to hide from you. If I were the letter writer, I would never ask you for advice again. Sorry.

Anyway, I do want to thank you for keeping the discussion civil. This is an area super-fraught with emotion and it’s far too easy to go off the deep end.

She says she doesn’t want to fat shame, yes, but many of her later comments in the same letter ARE FAT SHAMING. So it seems to me, that she either doesn’t realize it or thinks that because she understands the concept, she can’t possibly be doing it. I am really glad that Susan pointed out to her how harmful the things she was saying are because she probably has no idea. She thinks that because she’s an open minded liberal, she can’t possibly be part of the problem.

As a fat person, I can’t tell you how many times I’ve gotten into conversations with people who are supposedly fat accepting (including plenty of other fat people) who say something completely counter to the idea of HAES. The notion that fat = unhealthy is so pervasive in our society that it is extremely hard to completely rid yourself of such ideas. This letter writer CLEARLY has not and I think Susan was 100% right to point it out to her.

Rachel, for what it’s worth, I’m overweight as well and have had those conversations where you want to hit the other person with a brick. However, I will say that, although I don’t think shaming anyone into anything, ever, is the right answer, I don’t think that being overweight is ok either. I should say that I define overweight as “unable to do things that you’d like to do”. I would _love_ to fence. Unfortunately, I can’t because I’m out of shape. If I dropped 50 lbs, maybe I could, but that’s my problem. And I’m just sharing it for context, not for anything else.

The point is that I think that we do have a huge problem with obesity in our society and it would be better if more of our population was thinner. HAES, if I’m understanding the concept correctly, is about being able to do pleasurable physical things & eating normally. I guess I’m confused as to how is being unable to walk a block and eating two thousand calories for one meal is HAES.

Now, would I say anything about that to someone’s face? GOD NO! Shaming is never the answer. My concern was that in calling her out, Susan shamed the letter writer back.

I think we’re closer than we think. It’s a matter of approach.

Uhm, I realise this is an old thread, and I am wary, because the response to this article has been so overwhelmingly positive that I feel quite alone in my reading… I am counting on you to hear me out, though.

I cannot shake the feeling that you have inferred context that I could not find in the letter itself. The clear correlation to size is the comment about the extreme dinners and the sentence “there is clearly a correlation between her size and her happiness”

Nowhere in the letter, however, does the writer say that they want to approach her friend about shedding some kilos. I had a feeling that they wanted to approach the subject of her obvious unhappiness and the unhealthy weezing when walking. Yes, in their mind it is connected to the friend’s obesity (which is not necessarily true, as you rightly pointed out). But that is exactly why the author asked about how to approach the subject without fat-shaming, i.e. without going into the territory of approaching this solely from the angle of “you need to go on a diet and exercise because you need to lose weight”.  Because they realise her unhealthy habits are a symptom of underlying mental issues. How, though, did you conclude so clearly that they would advise her to just lose some weight and everything else will right itself?

Am I reading this letter completely wrong?

I would also suppose (tell me if I am wrong here) that someone in the throes of serious (mental) health issues is used to deflect well-meaning comments of “are you okay?” with a mumbled “nah, I’m fine”. I always thought that as a friend, I should be allowed to push a little harder, to express my concern and let her know that I am watching a decline, that I am not going to let slide while standing idly by and satisfying myself with a polite question now and then.

Actually, I would hope that some of my closest friends would take a stand and let me know in no uncertain terms that they see this, and they will watch me and call me out if they think whatever situation I am in is becoming unhealthy. I would NOT want them to comment on my size only when clearly depression and lung-wheezing (possibly lack of stamina) is my issue – but I would want them to express concern about my health and my unhappiness.

And I did not infer from this letter that the writer thinks the girl’s biggest or only problem is her size.

My first response to the letter was the same as what you said – but the more I thought about it, the more I changed my mind.  The phrase “she refuses to do anything about it” is what really got to me – because it is so laden with judgment and misguided beliefs.

Do you think that the issue that they are trying to get around is simply physical fitness?  If so, I do not understand why size has been brought into it at all – and once you bring size into it, it is also laden with judgment and misguided beliefs.

I think you are right that people have a right to push.  But I also think that it is completely absurd to imagine that the friend has zero understanding of her size and “obvious visible health problems.”  Telling somebody that they are fat while cloaking it in worry is 100% not helpful.  She knows she is fat.  She knows she wheezes.  There is no reason for anybody else to approach her and tell her all about it, or to try to gently nudge her into changing.  She gets that every day, from every media source and every person she comes into contact with.  A friend does not need to push, especially when being fat *does not cause* health problems.

And you asked how I concluded that they are hoping that she will lose weight and everything will right itself – if not that, what are they wanting to know?  What is the letter writer hoping to get in terms of advice?  How to approach her and tell her that she is unhealthy?  Do you need to approach somebody who has MS and tell them that they are unhealthy?

I really am curious.  I initially wrote an entirely different article, but the more I thought about it, the more certain phrases pounded in my head.  And really – if not “how do we get our friend to change her size,” what is this letter asking?

I think I am beginning to understand better where you are coming from.

I am from a family where half the women are in constant battle (or at an uneasy peace) with their size, and I know better than most of my friends that size has nothing to do with health, and on the other side, weight gain can be a sympton or result of health problems (think: uncrontrollable diabetes and ongoing cortisone treatment at the same time, for unrelated reasons). It hurts incredibly when you imagine all “outsiders” see just a fat person.

So yes, I would like to think I am aware of the fact that thinness and health get conflated in all the wrong ways and should not ever be used synonymously.

I think you were absolutely right in pointing out that the letter-writer should not fall into the trap of conflating health and thinness.

Maybe the feeling about the letter differs in nuances. I assumed they were conflating or correlating her health to her size. But at the same time I thought the author was looking for a way to approach the friend in order to avoid falling into the trap of making her feel that the size is her biggest issue, or the writer”s only concern.

I dunno, maybe I am too blue-eyed? Projecting my own  intentions on others?

 I would have thought the writer was looking for advice on how to gently push the issue more (in a healthy direction) without breaking the friend, or doing more harm than good.

Again, basing on my anectodal evidence. Some family members know they are not healthy (see above), but they also know they should push their body nonetheless, to counter some of the detrimental effects of disease (and treatment!). I do not need to remind that person every day that she is a) unhealthy and b) fat. But I need a positive approach to get her out more, to make her enjoy movement despite the aching body, to shield her from her own negative thoughts when she is, for example, too ashamed to wear a bathing suit but we both know swimming is much needed exercise.

How do you do this and avoid reminding the person of all the wrong things? I guess that is the question that I would have asked… 


I definitely, definitely see your point.  And as I said, my original intention in writing this article was to do just that – I had thoughts in mind of “invite her to do things with you because you enjoy her company, and if those things are active, all the better, but don’t invite her to do things just because they are active.”  But the more I thought about it, the more I thought that the pervasive “fat = unhealthy” attitude was showing through.  Because from what I can tell, the person isn’t asking about how to encourage all of her friends to live healthy, active lifestyles – instead, she is asking how to convince her fat friend to lose weight/be active for her own good.

And to be honest, it’s the “she refuses to do anything about it” sentence that just pushed me over the edge.  Once you are seeing a person in that light, I have trouble believing your good intentions.

Our opinions are not that far apart. :-)

I guess we will never know the full intentions of the writer without speaking to her (I am assuming “her”) – or getting a longer letter. Knowing the pervasive general attitude of many, it might just be that you are right in your assessment and I was too gullible.

Heee, thanks! Amicus is Latin and means friend, and diptus rhymes – and also vaguely reminds me of a Polish word often used as a character name in children’s stories. :-)

Concerning the article… I understand the need to point out that thinness does not equal health, but I did not expect the entire answer to be about this. If I put myself int the place of the letter-writer, I would have missed a few concrete pointers in: how do I broach the subject of my concern gently, but persistently?

I also think it is an extraordinarily (phew, spelling?) thin line we are walking with this. I do not equal size with health. Lord knows I was at my most fragile often when I was skinniest. But at the same time, there are situations where a ballooning size and weight gain is absolutely the result of bad health or medication or unhealthy habits.

I caution to not approach such a subject (with a friend)  from the angle of size, but to be supportive in finding out the underlying symptoms. We should not assume anything about what the size of a person infers about her health if we don’t have the facts, but sometimes we cannot completely discount weight as an issue, either.

And we should also keep in mind that being far away in size and numbers from the type of body a person is used to inhabit can be a traumatic experience in and of itself.

I also just want to reiterate that I am thankful for your feedback on this – I’m sure you aren’t alone in taking the letter that way (as I said, that was how I originally took it), and I would hate for this to be a place where people feel like they can’t voice their opinion because it is different.

Naw, I really did not expect a flame-war. :-) But I wanted to test the waters because I felt that all comments were basically agreeing with each other.

One last thing about the letter: I would actually try to assess if said friend has seen a doctor because, for all we know, it could be asthma and an absolutely out of control thyroid that could be causing all this trouble.

I am incredibly glad we had this chat – civil and reasoned, it’s like I am in internet heaven!

Hey there. You know, the letter writer did already get in her friend’s business a little by telling her she should walk, and this obviously wasn’t welcome advice. Because the letter-writer detailed her friend’s eating habits, I definitely read the letter as, “How can we fix her fatness?”

There really isn’t anything else the letter writer needs to do, beyond be an awesome friend and hang out with her friend a lot. If her friend wants any other help, she can ask for it. Unless her friend is a moron, and it doesn’t sound like she is, she is aware of the connection between eating, exercise, and obesity. What new thing could the friend say, really?

I love love love this.

I remember that, when I was thin because I wasn’t eating enough, people complimented me and said I “must be doing something right” even though I was at my unhealthiest of my life. Now I’m fatter and probably more out of shape, but this isn’t really related. Gaining back the weight has actually made me healthier! I’m not sick as much, and when I am sick, it’s less harsh on my body. I feel better. I just have to keep reminding myself that, despite what society says, I look better as healthy than I did as thin.

ETA: I just want to mention, I in no way wish to imply that thin people are unhealthy or unattractive; my body just wasn’t meant to be like that, so it was unhealthy for me.

Yes! Thank you for saying this. I got dysentry on a research trip for my thesis one summer and when I came back to school people were like “you look great!” When, in reality, I was super duper sick and was only skinny because my body hadn’t really been absorbing nutrients for quite awhile.

In my time (and my weight has fluctuated a fair bit in recent years- due to depression, grad school weight gain, and amoebic dysentry) I have been a really unhealthy skinny person, an unhealthy fat person, a healthy fat person, and now a healthy average person. Am I currently heavier than the ideal? Slightly, but I also exercise a lot, am strong enough to throw people much bigger than me (in martial arts), I eat food that sustains me,  and I don’t get colds or flus often. This feels right to me.

I really wish we could talk about women’s bodies societally the way men’s bodies are talked about. Size is less of a factor when you talk about the amazing things bodies can do (swim, run, walk, do martial arts, create other human beings) than how big or small they are.

I definitely feel you. I have to claw my way to self-love of my body as it is now. But when your body’s size is made to be your body’s main utility (because of course your body could only look good while it is thin, and of course that’s the only thing that matters for women’s bodies!), people automatically think “Thin women = better women.”

I hope you’ve been doing better medically now. That sounds like it just sucks.

Yes, absolutely.

Now if it’s a matter of fitness rather than weight, you know what is awesome (from personal fatty experience)? The Warm Pool at the YMCA. It helps with the knees, and lets you build stamina- which can be a huge barrier to finding your own fitness level. Fitness levels that are right for her might not have any effect on how much she weighs or looks like she weighs. But yes, warm pool can be great if you are someone like me who needs a little help around stamina building. :)

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