A few weeks ago, a wanted-to-be scientist name Rachel Fox, bravely shared the fat-shaming she’s endured during her years as an undergraduate science major at a prestigious university. The overt and covert discrimination by the scientific community has led her to make the decision to say goodbye to the field altogether.
Her story should make us angry. Not only on her behalf for another human to have to endure insensitivity and harassment based on size, but also for ourselves. We’ve just lost a potential brilliant scientist because our society is so bigoted that we can’t see talent beyond a jean size. She could have been the next scientist to cure a terminal illness or discover a new planet. What if Jonas Salk or Stephen Hawking were told to avoid milkshakes and made to feel less than?
Fox’s op-ed piece left me reflecting on where else larger people are missing. I started to look around at my own field and wondered… how many aspiring therapists have changed course because they didn’t feel welcomed by the community?
In the field of eating disorders, I’d anecdotally suggest that there is a disproportionate number of clinicians with smaller bodies, as compared to the general population. I can take educated guesses as to why this might be. One reason might be that of fields in psychology, those with histories of their own eating disorders are perhaps drawn to working with this population. And while the vast majority of clinicians with their own histories of eating disorders are fully recovered, they may continue to be more aware of their own body size and possibly engage in some weight-control practices. More optimistically, it could be argued that these clinicians may be disproportionately smaller because they tend to be more mindful about their eating, practicing what they preach and not using food in unhealthy ways.
But the cynic in me wonders if there is not something more disheartening going on. Are we losing therapists of larger body sizes because they are not feeling welcomed into this field?
There is some research to suggest that this may have some validity. For starters, patients with eating disorders are often considered to be much more highly attuned to others’ weight and shape, including those of their therapists. While some with eating disorders claim that they “judge” only their own bodies, many others acknowledge feeling hyperaware of others’ bodies and even making assumptions about their therapists based on body size. A recent study (Rance, Clarke, & Moller, 2014) examined patients’ perceptions of therapists bodies and found that some patients assessed a fat therapist as less trust-worthy and more likely to lose control. This study asked patients to report on their experiences, but often the beliefs, assumptions, and feelings are less overt and conscious. It’s not difficult to imagine how a patients’ weight bias, particularly in the midst of an eating disorder in which weight and shape’s importance often gets elevated, can create a seemingly hostile environment for a therapist.
I wonder, though, if more of that hostility and distrust doesn’t actually come from within our own ranks, however. A study by Puhl, Latner, King, and Luedicke (2013) reveled weight bias among eating disorder professionals. In fact, 56% of us reported having observed our colleagues express negative comments about obese individuals. If more than half (and I’d suggest it’s actually much more than half) of us observe these behaviors occurring — and are we addressing them? — it’s easy to imagine how uncomfortable a fat therapist might feel in that setting.
Just as in the STEM field, the eating disorder realm is full of assumptions about what professionals should be doing with food. Insiders and outsides, explicitly and implicitly, seem to assume that someone who treats eating disorders should be of a middle-of-the-road weight, or even thin. If someone deviates from this, the assumption becomes that they must not really know how to manage a relationship with food. Thus, how in the world could they teach or inspire someone else to do the same?
Obviously — or, apparently, maybe not so obviously, these assumptions are unfounded. But they permeate our experience in this field and it’s easy to see why we don’t observe as much diversity in body shape and size among therapists.
Perhaps the best thing that we can do to avoid losing talent and diversity is to become ever more aware of own stereotypes and biases. Once we can acknowledge these, we can take more conscious steps to not allow them to guide our decision making and treatment of others in our field.
Do you think people of larger sizes are underrepresented in the eating disorder field? Why or why not?
**Please note that I don’t believe that there are not fat eating disorder therapists. I personally know many. I do believe that there aren’t as many as one might expect and that there are reasons for this…
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