Creating Safe, Affirming Spaces for People of All Sizes

Kristine Weilert

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?


Recommended Reading & Resources:


“Everything You Know About Obesity is Wrong” by Michael Hobbes

“You Have the Right to Remain Fat” by Virgie Tovar

“Hunger” by Roxane Gay

“20 Ways to Be Fat Positive” by Virgie Tovar

The Association for Size Diversity & Health:

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Headshot Sarah Landolfi

Sarah Landolfi

CCIH is proud to partner with Sarah Landolfi, a psychotherapist specializing in trauma informed, fat-positive therapy for LGBTQIA+ folks. As an educator and consultant, she partners with therapists and other healthcare providers… Read More