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An article about attitude.

The Stages of Fat Self-Acceptance: A Conversation With Carol Normadi

Diabetes Health Staff

Nov 4, 2011

Fat people can go through several stages before reaching self-acceptance.

Carol Normadi is a licensed marriage and family therapist in Northern

California who is co-founder of Beyond Hunger, Inc., a group dedicated to

helping people overcome obsessive concerns with food. She has co-authored

two books on the topic of food obsessions: " It's Not About Food: Ending Your

Obsession With Food and Weight " (Putnam, 1998) and " Over It: A Teen's Guide

to Getting Beyond Food and Weight " (New World Library 2001).

Normadi and Diabetes <http://www.diabeteshealth.com/> Health publisher

Nadia Al-Samarrie live near each other, which led to a recent conversation

between them about the stages that fat people go through in accepting and

dealing with their weight. In some ways, those stages-denial, anger,

bargaining, and acceptance-are much like those that grieving people

experience.

Nadia: What do you think is the source of hostility toward people who are

fat?

Carol: I think maybe it's suppression of the feminine, because fat is

perceived as feminine. Yet fat, happily, is what gives us the ability to

have a baby. You can't get pregnant

<http://www.diabeteshealth.com/browse/pregnancy/> if you don't have the

energy reserves-fat-to support a developing child. When we as a culture went

towards oppressing the feminine, we wanted to take off all those rounded

places. That's one piece of it.

The other piece is that we as a culture try to define things in terms of

good or bad, so religion, ethnicity, skin color, and fat are the areas where

we place shame and judgment. I can't tell you how much hate mail people in

the fat acceptance movement get when they put themselves on Twitter or a

blog. They get tons of hate mail-really abusive stuff. We live in a world

that is fat-phobic and prejudiced against fat. So, if you're dealing with a

body that is " overweight, " you're going to have some shame about it because

that's what you've been taught.

Nadia: Let me play devil's advocate. If you have diabetes and are

" overweight, " you have to worry about certain complications. There are

consequences that affect not only your own quality of life, but also

society. If you're not taking care of your diabetes, someone else has to pay

the bill for your neglect. This is where I think the topic gets really

complicated. It's not just about your image and whether people like or

dislike fat people. It also involves taking on the responsibility we all

have for our own health.

Carol: Yes, everybody has responsibility for their health, and everybody has

a responsibility to do the best to take care of their health, whether they

are thin, or have a normal body size, or are fat. The difference is that

because of society's prejudices, fat people carry around a layer of shame,

and that shame gets in the way of taking good care of themselves. It's not

that people who have larger bodies don't need to take care of their health

just as much as people with smaller bodies do. It's that their shame often

leads to self-destructive behavior. So, to get people like that to really

show up and take care of their bodies, you have to first take care of the

internalized shame.

Nadia: Could you say that not taking care of your body is acting out and is

a form of anger?

Carol: Absolutely.

Nadia: Can anger be an extension of denial? In other words, denial is where

you don't see any need to cope with weight issues. But anger comes when you

know you have to cope but don't want to?

Carol: Well, anger is a healthy response to being hurt or frustrated because

you know you're expected to give up things you love. You know all the things

you're supposed to do, and you resent them.

Nadia: Such as new considerations for your diet.

Carol: Exactly.

Nadia: And the social rituals you participate in.

Carol: Yes. Anger's a normal process. The thing is to have a relationship

with your anger so that you can hear it and have other people hear it. But

you have to learn how to express it without being self-destructive.

Nadia: Are there stages to working through denial and anger?

Carol: Yes. I think part of it is a matter of time. There's definitely a

stage where you have to integrate your anger and get used to it and how you

feel about it. I think that support is really important. If you see other

people who are in the same situation who hear and understand you, and say,

" Yes, this is really hard. I've been here, " I think that's significant. That

kind of support and information allows you to shift your thinking and focus

on learning how to handle your anger and make a transition out of it. You

may have a big burst of anger in the beginning, and it will continue as you

hit walls along the way. But each wall you hit is part of the process of

coming to terms with your anger, being able to acknowledge and express it,

and finding people who can really hear you and empathize with you.

Nadia: Once people hear you and empathize with you, do you start bargaining?

Is that the right term? Do you bargain with yourself?

Carol: Well, you bargain with God.

Nadia: What if you don't believe in God?

Carol: What I mean is that you are saying to yourself, " Okay, if I do this,

I want the universe, or God, or my body to stop what's happening to me so I

can get rid of this diagnosis. " So it's your mind's way of trying to control

what's happening to you. Remember, too, that all of the stages you go

through may be linear, but you may not go through them in a linear way. You

may move into denial, and then into anger, and then to bargaining, and then

all the way back to denial in one day. So you can move in and out of the

stages.

Nadia: Then bargaining is an attempt to control the outcome?

Carol: Right. You're trying to control the outcome, but can't. You can't

control the diagnosis. The only thing you can do is things that support your

body to be healthier. So, as you're trying to wrap your mind around having

to do things differently-perhaps radically differently-you go into the

bargaining stage. While you're there, you eventually come to terms with the

challenge facing you. You understand that what you wanted to be under your

control cannot be. But you also understand there are other things that can

be under your control. That's when bargaining moves into acceptance.

Nadia: When you move into acceptance, is it permanent?

Carol: Not always. Bargaining is the place from where you can move forward

into acceptance or backward into anger. You might go back to anger because

when you bargain, you're trying to control the situation by offering a sort

of bribe: " Hey, if I pray every night, or if I'm good to my mother, or if I

run every morning, the diagnosis will change. " But when that doesn't work

and your body doesn't cooperate by accepting the bargain, you get angry at

it and at the fact that you're going to have to give up certain behaviors.

Nadia: It seems that you can be shifting between all of these stages all the

time. It's not like you have to complete one stage before moving on to

another, or that you get a certificate for completing each stage.

Carol: Yes! Monday you're in denial, and Tuesday you're angry, and by Friday

you're in acceptance, but by Saturday you're having second thoughts. It just

takes time and an awareness of what you'll be going through.

(Editor's Note: This is the first in a series of interviews that Nadia

Al-Samarrie will be conducting with Carol Normadi on the topic of people's

attitudes toward food and weight and how they can think about them in more

positive ways.)

_____

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- Nov 4, 2011

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