Rejecting Anti-Fatness: Reclaiming Our Bodies from a System That Was Never Meant to Hold Us

By Christine D. Fazio, LMHC
Psychotherapist | Relational, Psychodynamic

I often sit across from people who’ve spent a lifetime at war with their bodies. Clients whisper confessions about “losing control,” “letting themselves go,” or living in fear of becoming large. These aren’t just personal insecurities, they’re echoes of a culture obsessed with thinness, control, and perfection. A culture that assigns worth to a number on a scale. A culture that devalues fat bodies and makes invisible people living in them.

If you carry shame and fear about your body, you are not alone. And you are not the problem.

Anti-Fatness Is a System, Not a Personal Failing

Let’s name what we’re up against: anti-fatness is systemic. It’s built into our medical systems, workplaces, media, and relationships. It shows up in how chairs are designed, in who gets hired or taken seriously, and in who receives compassionate healthcare. And for many people, especially Black, brown, disabled, trans, and queer folks—body size becomes yet another axis on which their humanity is questioned.

From a psychodynamic lens, the messages we receive about our bodies sink deep. They shape our inner worlds. Children who internalize fatphobia often carry unconscious beliefs that their worth is conditional. That love must be earned through control, smallness, or self-denial.

How Internalized Fatphobia Hurts Us

Internalized fatphobia can sound like:

·       “I feel gross, and I don’t want my partner to touch me”

·       “No one will want me unless I change my body.”

·       “I’m failing at taking care of myself.”

These beliefs do more than cause distress, they fracture the self. They create internal dynamics of shame, punishment, and perfectionism that mimic early wounds or relational traumas. They keep us alienated from our own bodies, seeing them as enemies rather than companions.

The Inner Conflict of Modern Body Positivity and Inner Dialogues

Fatphobia is a social illness that runs deep into our body and psyche. In more recent times, we’ve working to externally combat some of the fatphobic narratives. This means that it’s not “cool” to diet, restrict or to even “care” about our physical shape. But the fails to address the deep-rooted experience of on internalized fatphobia. Instead, it pushes our self-loathing or diet culture narratives into isolation and in the recess of our private minds, where is thrives in the darkness. Just because our intellectual, adult selves truly believe in the body liberation/neutrality, this does not address the deep wounds of body oppressions routinely applied by the social and private spheres. The conflicts often present for my patients like this:

·       “I can’t tell whether I am working out to be thin or because it’s healthy”

·       “It’s like I totally reject diet culture, but I don’t want to be fat and feel so guilty I feel this way”

·       “If I really release my self-loathing, I will just lose control and be fat”

And in therapy, we work to shift our patterns, give language and normalize the conflict and build a bridge between how want to experience our bodies and how we actually do.

A Relational Path Toward Body Liberation

Healing from internalized fatphobia isn’t about replacing self-loathing with forced affirmations. It’s about rebuilding a relationship—with your body, with your self, and with others who can truly see you.

In relational therapy, we explore:

·       Where did these body beliefs come from?

·       How have power, trauma, and oppression shaped your experience of your body?

·       What would it feel like to live without the constant pressure to shrink?

We make space for grief—for the years lost to dieting, the pain of being unseen, the longing to take up space without apology.

And slowly, we create new patterns. Not just cognitive shifts, but embodied ones. Moments where you choose nourishment over restriction. Rest over punishment. Pleasure over penance.

Toward a World Where All Bodies Are Safe

Body liberation is not a personal project—it’s a collective movement. As therapists, we must be accountable to how fatphobia, ableism, and white supremacy shape our work and our spaces. We must challenge clinical norms that pathologize fatness and equate thinness with health.

To those reading this who live in marginalized bodies: you don’t have to earn your right to be seen, heard, or loved. Your body is not a problem to be solved. You don’t need to be fixed—you need space, safety, and connection.

You are already whole.

If you're interested in working with a therapist who understands these dynamics—who sees your body as sacred, political, and worthy—I welcome you to reach out.

Let’s unlearn, together.