Ep 77. Can You Be Fat and Healthy?

In this solo episode of The Body Grievers Club, Bri gets real about the question she hears constantly: “Can I be fat and healthy?” She unpacks why “health” is not a moral scorecard, why definitions matter, and how fear and shame sneak into our health journeys. Drawing from her clinical background and lived experience, Bri reframes health as amoral, explores correlation vs. causation in weight research, and offers practical ways to pursue care without handing your humanity to a BMI chart.
 

TIME STAMPS:

02:10 Why your personal definition of health matters

06:00 How medical fatphobia shows up and why health ≠ morality

13:20 What the research really says

16:00 Why food/movement is only 30% of the picture

20:45 Why “doing everything right” doesn’t guarantee health

27:10 Practical tips for navigating doctors

29:40 Exploring what it means to choose health behaviors (or not) without shame

RESOURCES:

• ⁠Health Without Weight Loss (with Mackenzie Woolwich)⁠
• ⁠Medical Fatphobia (with Ragen Chastain)⁠
• ⁠Diagnosed With Diabetes: Coaching Through Shame⁠
• ⁠Healing the Medical Narrative⁠
• ⁠Advocating For Yourself at the Doctor⁠

• Concepts: Social Determinants of Health, Patient Bill of Rights, Stacey Bias’s “Fat Archetypes”
• ⁠Bri's 7 Steps from Body Grief to Body Acceptance⁠

Want more of Bri?

• Instagram: @bodyimagewithbri
• Website: ⁠https://bodyimagewithbri.com/ ⁠
• Join the Body Grievers VAULT: ⁠https://www.bodyimagewithbri.com/the-vault⁠
• Use the coupon code BODYGRIEVERSCLUB for $50 off your purchase.

TRANSCRIPT:

Health is amoral. You are not a good or better person because you eat vegetables. You are not a good or better person because you exercise. You are not a bad or worse person because you don’t. And if there’s a part of you that wants to believe that, but a larger part of you that doesn’t feel safe to believe that, that, my friends, is the crux of this. It’s not actually about the behaviors, it’s about the belief that your humanity is at stake if you do not have or hold certain health behaviors.

Hi, and welcome back to another episode of The Body Grievers Club.

We’re going to jump right into today’s episode. We’re talking about fatness and health. Can I be fat and healthy? Can I exist in a larger body and also maintain health? This is a trick question in and of itself. And here’s why: I don’t know what your definition of health is. How do you define health? What is your working and active definition of health?

This question was the very thing that unearthed my eating disorder behaviors. It was the last straw that got pulled, and everything unraveled after this. I had a therapist I once told, “I’m working out and eating this certain diet plan because I just want to be healthy.” And she said, “Okay, cool. What does health look like for you?”

I said, “Well, I need to eat fruits and vegetables. I need to exercise. And I need to not feel out of control with food.” Now, quick aside: if you are someone who feels out of control with food, it’s very likely coming from a place of restriction. Not allowing yourself to eat foods creates a dynamic and cycle of feeling out of control around them. But I wasn’t there yet.

My therapist said, “By the definition you just gave me, then you’re healthy.” And I said, “Well, no, I’m not healthy because I exist in this size body.” She said, “Help me out here, because the definition you just provided didn’t include body size. So what size do you need to get to in order to be healthy?”

I said, “I don’t care about my body size. I just know that I can’t exist in this body size and be healthy.” I remember getting angry. Nobody had ever challenged me before when I said I couldn’t be fat and healthy. She wouldn’t let me off the hook. She said, “I see a dissonance. You’re saying you want health, you’re describing health, but then you’re also saying you need to exist in a smaller body. Let’s just say it is important. If you don’t have your health, if you don’t exist in a smaller body, why is that so bad? What is the scariest part about that? What story are you telling yourself?”

I remember crying and thinking, if I am doomed to live in this body, a body not accepted by society, no one will ever love me. I will spend the rest of my life alone. Every time I go to the doctor, no matter how hard I work, I will never be given credit. I won’t even be listened to when I say something is wrong.

If you’ve never had the experience of going to the doctor and not being believed when you say something’s wrong, it is shameful. It is dehumanizing. And it is trauma. So many of us in larger bodies dread going to the doctor because we know we’ll have to advocate for ourselves, defend ourselves. And it’s really hard to defend yourself when someone has the degree and the white coat. How is little old me supposed to challenge or navigate that conversation with the doctor?

Two questions I want you to ask yourself: What is my definition of health? And if I do not have my health, why is that so scary? What story am I telling myself?

I asked this on my Instagram stories: if you were working on some sort of health-promoting behavior—eating out less, working out more, eating more nutrient-dense foods—and I told you, “Okay, let’s say you do those things for a year, and your body size stays the same or even grows. Will that be okay for you?” Many of you said yes. If that’s true, go for it. Do it.

But my follow-up question was: Will you still feel like you did something wrong? Will you feel frustrated? This is about intention. What is your intention for this health journey?

Health is amoral. There is a moralization in our culture that says physical health is the most important thing. But as a mental health counselor, I can tell you: in my smallest, in my fittest, in my strongest, I was also the most anxious, the most disordered, and the most mentally unhealthy I’ve ever been.

And now, in my largest body, I am the most free, the most peaceful, the most aligned with my values. I no longer outsource my belonging to others. I don’t let anyone else tell me who I am. Does it still hurt? Of course. But I know my humanity isn’t at stake just because I don’t have a formal movement practice or because I get out of breath on the stairs.

If you are approaching food or movement with fear or shame, that is a red flag. Fear and shame are powerful motivators, but they do not produce long-lasting, healthy fruit. You will never shame yourself into health. You will never fear yourself into health. The fear is telling you a story, and your job is to listen to it.

One of the things I do with body image work is ask my clients: what is my body image story? How did I get here? What rules and stories have I learned along the way? I encourage you to do this with your health too. What’s your health story? Why is health important to you? Where did you learn you “have to” be healthy?

If you’re familiar with Stacey Bias’s archetypes of a fat person, you’ll know what I mean. There are nine archetypes—it’s like, you can be fat but you have to also be strong, or fat but also healthy. Wanting health without actually desiring health is really a longing for safety. It’s the longing to not experience trauma in the body you live in. And I am angry that that is your reality. That enrages me. You deserve unbiased medical care, no matter your body size.

People often say, “But I’m concerned for my health.” And they ask me specific questions about cholesterol, diabetes, A1C. I am not a healthcare provider. I can’t tell you how to manage those numbers. What I can tell you is that you can manage them without shame. There is no moral failing. If you believe there is, that’s where I come in. Where did you learn that the absence of health makes you less worthy? Where did this narrative come from that you are a “bad fat person” if you’re not healthy?

Research is often cited to argue that fat bodies are unhealthy. But does the research show causation or correlation? Those are not the same thing. Many of the same ailments correlated with higher-weight folks are also correlated with weight discrimination itself. So is it the body size, or is it the discrimination and lack of treatment?

If you’ve never looked into the social determinants of health, I encourage you to. They include socioeconomic status, genetics, access to quality care. According to research, only about 30% of health outcomes are influenced by food and movement. That’s significant, but it also means health is not fully within our control. Control is a construct. You can do everything “right” and still get sick.

So yes, I eat more vegetables now. But my motivation isn’t to be “good.” It’s because more fiber makes for a better bowel movement. If I don’t get enough, I don’t shame myself. It’s just information. I adjust and move on.

A lot of people say, “I’m afraid if I don’t take care of my health, I’ll die young.” But there’s no research that shows BMI shortens lifespan. In fact, we’re fatter than ever and living longer than ever. Longevity has increased.

There’s a Harvard study called “Genes are good, but joy is better,” showing the strongest predictor of long life is not genes or fitness but social connection. And how do we maintain joy and connection if we’re consumed with food policing and shame?

Sometimes, simply sitting with the grief of not being in a smaller body is the work. That’s body grief. It’s uncomfortable, but if you avoid it, it just keeps resurfacing.

I am in the fattest body of my life, with the least mobility, no formal exercise routine, and I don’t eat fruits and vegetables every day. And arguably, I am the healthiest I’ve ever been. My blood work is improving because I’m on the right medications. I see my doctor regularly now. I no longer have a trauma response at the doctor’s office.

I don’t feel shame when I step on a scale. I can hold that information without it undoing me. That’s evidence of healing. Because I faced it.

At the end of the day, no matter what body you live in, you will experience sickness. That has nothing to do with your humanity. It can feel hard and scary, but it doesn’t have to be shameful.

Two questions I’ll leave you with: What is my definition of health? And why is it important to me? Do I have to do it perfectly? I always say, we’re not going for gold. We’re going for “good enough healing.” What’s good enough health for you?

Maybe you want to exercise more to play with your grandkids. Can you do that now, even if it’s not comfortable? Can you sit with the discomfort instead of postponing joy?

At the end of the day, you have body autonomy. You can listen to this and say, “Hard pass.” That’s your right. I couldn’t get off the merry-go-round of doctor shame, dieting, and weight loss attempts until I risked unbelonging. Until I chose to stop shaming myself.

I ask myself: how would I show up for a client? How would I show up for my goddaughter? And why not show up that way for myself too?

If you need more, I have other episodes you can check out: Health Without Weight Loss with Mackenzie Woolwich, Medical Fatphobia with Ragen Chastain, Diagnosed With Diabetes, Healing the Medical Narrative, and Advocating for Yourself at the Doctor. These will give you both the research and practical strategies to support you.

Remember: grief needs to be witnessed to be healed. Sometimes just naming that you’re grieving helps. You deserve unbiased care, joyful connection, and a life worth living—in the body you’re in right now.