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What Does “I Feel Fat!” Really Mean?

What Does “I Feel Fat!” Really Mean?

By Carolyn Coker Ross, MD, MPH, CEDS

In our fat-phobic, diet-obsessed culture, we have come to confuse being thin with being happy. We have been conditioned to believe we have to look a certain way in order to deserve the life we want. We have been taught by the media, our families, and society that if we are in a bigger body—or if we are different in any way from what society deems acceptable (young, thin, not gay, of a certain race or religion or political affiliation)—we cannot have what others have and, most important, what we desperately want.

It is not uncommon for individuals with binge eating disorder, emotional eating, or food addiction to report that they “feel fat.” But fat is not a feeling. So how can a person understand what it means to “feel fat”? Feeling fat describes a negative relationship with the body. How a person thinks, feels, and sees their body, and what behaviors result from this, is the definition of body image (National Eating Disorders Collaboration, 2021), and individuals with eating disorders often view their self-evaluation from the lens of how they think or feel about their bodies, which can lead to higher levels of emotional distress, a poorer quality of life, and depression (Ferreiro et al., 2014).

The formation of body image is complex and includes influences from parents, family, peers, and media images. Media images that promote the thin ideal play a direct role in body dissatisfaction (Hogan & Strasburger, 2008) and start very early in childhood and continue through adulthood. Girls and young women are more likely to be praised for their appearance than for their sports achievements or good grades.

Body Image and the Media

Images in the media of influencers, models, and other public figures are often computer enhanced, meaning that what a young girl sees is not the real version of the person, but an enhanced, perfected one. In other words, the media portrays images that are not attainable in the real world (Grabe et al., 2008).

The involvement of the media in promoting a specific body type dates back to the 1800s, when women were forced into painful corsets that accentuated their breasts and buttocks. A century later, a thin, boyish body type was in favor and women who had curvy figures were seen as indulgent and lacking in self-control.

The modern-day emphasis on the thin ideal has trained women to aspire to have Barbie-doll figures that are impossible to achieve, and that has led to 80 percent of U.S. women being dissatisfied with their bodies and children as young as 6 years old wanting to lose weight. The influence images in the media has continued to grow and has become more “real” than real life.

Black Women and Body Image

Since slavery, Black women’s bodies have been vilified and devalued and, when compared with white bodies, were considered to be hypersexualized, unattractive, and undesirable. In the past, studies on Black women’s body image showed more acceptance of larger body size and less internalization of the dominant culture’s body image ideals. A deeper examination of these studies shows that Black women are not immune to the dominant culture and are affected by European standards of beauty. Hip-hop videos and other media aimed at Black women used to promote being “thick,” or having a curvy body and big butt, as the ideal. However, newer trends promoting the thin ideal are showing up in hip-hop music. A recent analysis of body types in hip-hop music videos showed an overrepresentation of thin women. The smallest body sizes were associated with music themes of sex or materialism (Zhang et al., 2010).

Body image for Black women may also be tied to their hair. For many Black people, their conformance with dominant cultural norms and identity is wrapped up in the style and texture of their hair. Straighter hair or relaxed curls that mimic the dominant cultural ideal of straight hair have been prized in many Black women. Black women spend an inordinate amount of time and money to conform to European standards for hair, and if they choose to wear their hair natural, they not infrequently face discrimination at work and microaggressions in social settings.

Finally, colorism has long been a part of BIPOC cultures, in which lighter skin color is seen as more favorable to darker skin. This is an in- and out-group measure of value and attractiveness and status that is not easy to manipulate and may have a direct effect on Black women’s body image. More research is needed on the impact of hair and skin color, which are not usually included in studies on body image in Black women (Awad et al., 2015).

What Are the Causes of Negative Body Image?

Girls are more likely than boys to develop body dissatisfaction. Children of parents who diet frequently or have a negative body image are at higher risk for body dissatisfaction. Experiences of being bullied, being called names because of your size, being told that you fit in an “unhealthy weight category,” or seeing images on social media that make you feel bad about how you look can all cause negative body image. Research has repeatedly shown that exposure to social media images that depict and glorify the thin ideal affects body image concerns, particularly in women (Grabe et al., 2008).

Early childhood trauma is an often-overlooked cause of body dissatisfaction. Childhood sexual or physical abuse, which is interpersonal trauma, involves violations of physical boundaries and can have a far-reaching effect on an individual’s body image. The fact that these types of traumas often occur during the period of development when a child is in the process of distinguishing between their body and those of others (body ownership) makes them more likely to result in body image disturbances. Memories of childhood trauma involving the body may lead to an individual’s rejection or withdrawal/disconnection from the body. This is seen in many eating disorder patients with a history of trauma who feel cut off or alienated from their bodies. Lacking body awareness, they are unable to identify and, therefore, regulate emotional sensations felt in the body and often turn to food or food-related behaviors to regulate uncomfortable emotions.

Many trauma survivors with eating disorders also experience body shame and body hatred. They may report a lack of physical vitality and reduced physical well-being. Survivors of repeated physical or sexual trauma are also more likely to experience dissociation from their bodies as a survival or coping strategy from the time of their trauma, persisting into adulthood. Studies have shown that early childhood trauma affects multiple domains, including body satisfaction, body attitude, body awareness, and body acceptance (Scheffers et al., 2017).

Why Body Image Issues Are Not the Problem

Abuse or neglect or any other negative experiences in childhood can lead to what is called toxic stress. Toxic stress causes an overproduction of stress hormones: cortisol, adrenaline, and noradrenaline. This leads to physical changes in the brain. The brain of a traumatized child resets itself to be in fight-or-flight—regardless of whether there is a current threat to the individual’s safety or security.

Childhood trauma or adversity makes it seem as if everything in the world is dangerous and unsafe. Childhood adversity is associated with difficulties in school, depression, feelings of despair, and trouble developing healthy relationships with peers and teachers because of difficulty with trust. People who have had toxic stress in their lives often find solace in food, drugs, or alcohol; inappropriate sex; high-risk sports; or work, in an effort to cope with their feelings of depression, fear, and shame. That is why food and body image issues are not about food or about the body. Rather, a focus on body image, body dissatisfaction, or body hatred is the solution that can serve as a distraction from other issues, such as childhood trauma, that may not have been addressed.

Body image issues can also serve as a cover-up for underlying shame, low self-esteem, or feelings of unworthiness that stem from adversity in childhood. It is important to identify the root cause of body image issues. What is the true cause of body hatred or dissatisfaction? Body hatred may serve a specific purpose that is unconscious:

  1. Many people feel they can “hate themselves thin.” This is the belief that if you keep beating yourself up mentally about your body size or shape, it will motivate you to engage in behaviors that will help you attain the “thin ideal.”
  2. Another purpose that body dissatisfaction can serve is as a distraction that keeps you from thinking about other issues in your life or trauma from your past. If all your problems are related to hating your body, that’s where your focus goes when you have problems in your relationship or when you’re anxious about your job insecurity. You may think, “If I could just lose weight, this wouldn’t be happening.” Then you can focus on finding the perfect diet or joining a gym, which takes your mind off your divorce or other problems.

Identifying the root cause of body image issues requires taking the focus off the number on the scale, because the problem is not the size or shape of your body. The underlying driver of the thought “feeling fat” is emotions that have been pushed down and the behaviors you’ve used to keep yourself from actually dealing with those emotions and past traumas or current life problems.

Fixing your body won’t fix your life. Losing weight or fixing your body won’t fix the problems you have at work. It won’t help you change the core beliefs, such as “I’m worthless” or “I’m not lovable,” that came with you from previous experiences of childhood adversity. Having the “perfect body” won’t actually make an abusive spouse change their behavior, nor will it guarantee that no one will ever leave you.

What Does “I Feel Fat!” Really Mean?

The thought “I feel fat” points to unresolved issues—either from the past or from current life stressors. However, at the deepest level, this thought is an expression of the desire we all have: to belong and be accepted. In the current iteration of our society, people living in larger bodies are stigmatized, ridiculed, and bullied. They are made to feel like they don’t belong. Add to this the perpetuation of the “big lie” that if you are thin, you will fit in, be happy, and be healthy. We can only truly belong when we are being authentically ourselves. Part of being authentic is to have agency over your own body (body ownership). That means that your body is nobody else’s business.

Healing from trauma and childhood adversity is a journey that enables the development of the authentic self. This journey is not something that can be prescribed by anyone, as each individual’s path is different. However, there may be guides along the way that help an individual reintegrate the parts of themselves they have shunned, the image of their body that has been perverted by society, and the dreams and desires that may have been thrown to the wayside—waiting to become thin.

The thought of “I feel fat” can serve as a messenger to help an individual look beneath the surface and find what has been waiting to be discovered—who you truly are and who you were meant to be.

About the author:

Carolyn Coker Ross, MD, MPH, CEDS is an author, speaker, expert in using Integrative Medicine for the treatment of food and body image issues and addictions.  She is the CEO of The Anchor Program™, a non-diet online (telemedicine) program for individuals with binge eating disorder, emotional eating and food addiction.   Dr. Ross is a graduate of The University of Michigan Medical School.  She completed a residency in Preventive Medicine and a Master’s in Public Health (MPH) at Loma Linda University and a fellowship in Integrative Medicine with Dr. Andrew Weil’s Program in Integrative Medicine at The University of Arizona.  For the past 4 years, Dr. Ross has been an international speaker and consultant on issues of cultural competence, antiracism and diversity in mental health with a particular emphasis on the treatment of eating disorders in women of color. 

Dr. Ross presented a TEDxPleasantGrove talk on “Historical and Intergenerational Trauma in January 2020.  She is the co-chair of the AAEDP-BIPOC (African American Eating Disorder Professionals – Black Indigenous People of Color) subcommittee of International Eating Disorder Professionals (  She is the author of 3 books on eating disorders, the most recent is “The Food Addiction Recovery Workbook.”  She is a contributing author to the recently released book: “Treating Black Women with Eating Disorders: A Clinician’s Guide.”  She is co-founder of the Institute for Antiracism and Equity (– a consulting group that works with University counseling centers, treatment centers and other facilities offering mental health care – training staff and health care professionals – to make culturally competent mental health care more available and accessible to Black, indigenous and people of color. 


Awad, G. H., Norwood, C., Taylor, D. S., Martinez, M., McClain, S., Jones, B., Holman, A., & Chapman-Hilliard, C. (2015). Beauty and body image concerns among African American college women. The Journal of Black Psychology41(6), 540-564.

Ferreiro, F., Seoane, G., & Senra, C. (2014). Toward understanding the role of body dissatisfaction in the gender differences in depressive symptoms and disordered eating: A longitudinal study during adolescence. Journal of Adolescence, 37(1), 73-84.

Grabe, S., Ward, L. M., & Hyde, J. S. (2008). The role of the media in body image concerns among women: A meta-analysis of experimental and correlational studies. Psychological Bulletin, 134(3), 460-476.

Hogan, M. J., & Strasburger, V. C. (2008). Body image, eating disorders, and the media. Adolescent Medicine: State of the Art Reviews, 19(3), 521-546, x-xi.

National Eating Disorders Collaboration. (2021, March). Body image.

Scheffers, M., Hoek, M., Bosscher, R. J., van Duijn, M., Schoevers, R. A., & van Busschbach, J. T. (2017). Negative body experience in women with early childhood trauma: Associations with trauma severity and dissociation. European Journal of Psychotraumatology8(1), 1322892.

Zhang, Y., Dixon, T., & Conrad, K. (2010). Female body image as a function of themes in rap music videos. Sex Roles, 62(11), 787-797.


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