"Feeling fat"

"I feel fat."
"You are trying to make me fat."
"You keep telling me I'm fine but I know the truth."

Sound familiar?

It sounds like vanity. But what if those feelings are as real to them as the shoes on your feet, the distance to the end of your fingers, your sense that there is a back to your head - even though you can't see it?

Not metaphor: physically real.

Eating disorder sufferers often have distorted senses of their "body schema" - which we conveniently confuse with vanity or an over-valuing of skinny media images. But what writes the map in our heads, and what distorts that image?

I believe these sensations and cognitions are as real as anything we feel. They cause the same suffering as it would if you or I woke up of a morning to discover our nose was ten times its original size and everyone denied that obvious truth.

A parent on the Maudsley Parents Forum recently reported of her daughter: "she won`t go out and she sits with her hands over her face constantly" because she was sure there was something wrong with her "perfectly normal" nose.

Among the interesting work on this body image mapping is the amazing book, "The Broken Mirror" and online information at BDDCentral.

The New York Times recently ran a piece "When the Brain Says, 'Don't Get Too Close'" with this interesting observation: "For example, when a person is threatened or anxious, body space expands in an effort to keep others away." and notes: " there is recent evidence that anorexia is partly a disorder of the body schema"

We call it "lack of insight" when we see a sufferer holding on to what seem to us to be false beliefs, and we try in vain to talk them out of it.

But perhaps the true lack of insight is ours: of how hard they are trying, of how heroic their work to recover really is.


  1. Hear, hear, Laura.

    And I'd like to add the fact that, contrary to popular belief, anorexia nervosa is not caused by the desire to be thin. Some people seem to fall into it during the dieting process. But the "feeling fat" that is a hallmark of anorexia is a consequence of starvation, not the cause of it. An important distinction, both for treatment purposes and for looking at causality.

  2. I like Jessica Weiner's (Do I Look Fat in This?) approach: "Fat is not a feeling!" Surprise, happiness, anger, sadness, disgust, and fear. No fat. ; )

  3. Hmm, I always hear that "fat is not a feeling" but I think it is. The feeling is so deep and real, like you said. Fat is a physical feeling and, for me, is very much a psychological one as well.


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