Creating Safe, Affirming Spaces for People of All Sizes

There are few experiences as disheartening as going to a new place – a doctor’s office, a restaurant, a hair salon – and finding that it was not designed with my body in mind. (Don’t even get me started on airplanes). As a fat woman navigating a world made for people with thin bodies, I often feel alienated, embarrassed, and just plain too big for the spaces I want or need to occupy. And if I want my experience to be pleasant, or just want to avoid unpleasantness, I often have to advocate for myself in ways that people with thin privilege do not even have to think about.

“Could you please seat me at a table rather than a booth?”

“Would you mind moving your chair? I can’t get through.”

“Could I have a seat belt extender?”

“Please use a larger blood pressure cuff.”

These are phrases I am accustomed to uttering – and I feel far less shame around taking care of myself and asking for my needs to be met in these ways than I used to feel. Confronting fatphobia as I encounter it sometimes feels like a chore, but at other times it feels downright invigorating. The more I believe that I deserve to take up space like anyone else, the more I feel empowered by actually taking it.

My experiences living in a fat body have informed the way I work as a therapist in myriad ways. I work hard to create a client experience that reflects my values of weight inclusion and fat positivity; I draw on my own negative experiences with healthcare providers and try to do for my clients what I would have liked providers to do for me.

Here are some questions to ask yourself about your psychotherapy practice:

-Do I use language like “good” or “bad,” “healthy” or “unhealthy” to describe foods, body weights or sizes?

-Is the space in which I practice size-inclusive? Could a fat person comfortably sit in the chairs in my lobby or office?

-Do I attempt to practice beyond my scope, giving psychotherapy clients diet, exercise or nutrition advice?

-Do I make assumptions about people’s health, values, morality, work ethic or intelligence based on their physical appearance?

-Do I assume that certain people want/need to lose weight based on their body size?

-If someone has explicitly stated that they want to lose weight, do I contextualize their desire to do so within the larger frame of fatphobia and diet culture?

-Do I have a problem with certain body shapes and sizes? Do I view certain bodies as “good” and others as “bad” or as needing to change?

-Do I acknowledge my own thin privilege, if applicable?

-Do I understand fatphobia and how it fits into multiple and interlocking systems of oppression?

-Am I doing my own work around food, weight and body image?

-Do I believe in people’s right to self-determination as it relates to their food choices, their body size, and their weight? Or do I have an agenda for them?