Fat Women’s Experiences in Therapy: “You Can’t See Beyond…Unless I Share It with You”

Abstract

This article reports the results of a qualitative exploration of fat women’s experiences with weight-related microaggressions in psychotherapy. We conducted semi-structured interviews with 15 women about their weight-related experiences as therapy clients and asked for their advice to therapists who work with fat women. We used a general inductive approach to code the data into themes and found that common microaggressions included therapists who overly focused on weight, therapists who appeared to be less interested in clients because of their weight, and dissatisfaction with waiting room seating options. Participants advised therapists to allow their clients to initiate conversations about weight. Results suggest the need for increased awareness of: (a) how clients’ weight may impact therapists’ attitudes and choice of interventions and (b) how weight might influence fat clients’ in-session presentations.

Keywords:

• Advice to therapists
• fat women
• microaggressions
• therapy experiences

Notes

1 Two participants reported BMIs below the study cutoff (33.51 and 33.93). They were included in the study because: (a) they had previously attended therapy at a BMI of 35 or higher and (b) their BMIs were in the “mildly overweight” range at the time of study participation.

2 In response to this question, two participants also described interactions with their therapists that we coded as microaggressions; we included these incidents in the section below that outlines participants’ descriptions of weight-related microaggressions in therapy.