Note: This article discusses topics related to body weight, body size, and body image, along with societal stereotypes and behaviours such as fat shaming, that can be triggering and upsetting for some readers. The content is presented from an educational perspective with the goal of promoting understanding, empathy, and respect toward all body types.

Discussions about Fat Shaming (also known as Body Shaming) tend to evoke discomfort and controversy. It is a pervasive issue, deeply rooted in personal perceptions of body image and societal standards.

In this article, I present the drivers of fat shaming, describe the psychological impacts it has on its sufferers, and share strategies to overcome both the temptation to shame someone and the experience of feeling shamed.

I will also explore the advances in medical research that shed new light on assumptions made about weight and health. To that end, I’d like to thank Dr. Sarah Tedjasukmana for her valuable contributions to this article.

How Do We Define Fat Shaming and Fat Shame?

Here is my working definition of these concepts:

  • Shame is the intense emotional experience of feeling fundamentally defective or inadequate in comparison with others and therefore being outcast or struggling to belong.
  • Fat Shaming refers to behaviours that cause shame and other painful emotions in people whose body weight or size exceeds current societal standards of beauty and health.
  • Fat Shame (also known as Body Shame) refers to shame and other painful emotions that a person might experience when comparing their body weight or size to current societal standards of beauty and health, or when they become the target of fat shaming.

What Is the Primary Driver of Fat Shaming?

Fat shaming can be directed toward others (externalised) or directed toward oneself (internalised). In this article, I am focusing on externalised fat shaming, although the insights may apply to both.

In my experience as a psychotherapist, the drivers of fat shaming are the primary emotions of Fear, Sadness, and Shame. Primary emotions are the instinctive body signals that form in our bodies before any other emotion or thought.

This means that individuals who fat shame others experience these primary emotions as soon as they encounter a person who appears overweight or obese.

The reason for this instinctive response usually stems from painful influences during childhood and early adolescence.

During our formative years, many of us witnessed regular physical or verbal attacks against our loved ones with larger bodies. We might have also been the target of regular fat-shaming ourselves.

These incidents almost certainly produced significant bouts of fear, sadness, or shame in us. These moments were so intense that we are now anchored; that is, we experience those childhood-based primary emotions whenever we see a person who is overweight or obese.

This sounds like valuable knowledge to have, but there is a problem: primary emotions are very painful experiences.

Most people have never learned how to identify their primary emotions, so the physical experience can be overwhelming. Even when people recognise what they are feeling, they usually lack the skills to work through them.

Most people therefore seek to avoid primary emotions at all costs.

What Is the Secondary Driver of Fat Shaming?

One of the fastest ways to avoid primary emotions is to activate deeply-rooted beliefs that help us validate our avoidance. These beliefs are ironclad, having been shaped by our family culture and long-term exposure to mass media messages.

In the case of fat shaming, some of the beliefs about overweight individuals that help us validate our avoidance of primary emotions are:

  • “They are lazy”
  • “They lack self-discipline”
  • “They are incompetent”
  • “They are sloppy”
  • “They inconvenience others”
  • “They will die early”

When the individual who fat shames others activates one of these beliefs to avoid the painful primary emotion, they produce a Secondary Emotion – the secondary driver of fat shaming.

Secondary emotions help us avoid the pain of our primary emotions and experience a feeling of control over our environment. Secondaries produce lots of energy in us, and are helpful when we’re trying to stand up for ourselves, overcome life barriers, or correct historical injustices.

Unfortunately, however, secondary emotions are mostly harmful, and in some cases, destructive. They blind us to our primary emotions, produce dysfunctional behaviours, and are highly corrosive to other people.

In my experience, the key secondary emotions of fat shaming are Anxiety, Anger, and Contempt. These emotions play out in different ways. Here are two examples:

  • Fat-Based Rescuing. The individual engaging in fat shaming is feeling anxiety about the other person’s future prospects, including career, long-term intimacy potential, or health. Their fat shaming behaviour is intended to rescue the other from misery and pain. This rescuing approach is often seen between family members, friends, or in healthcare settings.
  • Fat-Based Punishment. The individual engaging in fat shaming wants to distance or protect themselves (or their tribe) from the impact of the larger person’s unseemly body parts and perceived behaviours. They feel anger or contempt at the other’s apparent disregard for societal standards, and use fat shaming as a punishing tool to nullify the “threat”.

In both cases, the individual engaging in fat shaming experienced a primary emotion initially, but successfully avoided it using the secondary emotion pathway.

What Are the Impacts of Fat Shame?

Fat shame is often associated with psychological distress, including symptoms of depression, anxiety, and low self-esteem. Research has shown a strong link between weight stigma and negative mental health, including the development of eating disorders (Puhl & Heuer, 2009; Levinson et al., 2024).

When a person suffers from fat shame, they are likely to experience a number of impacts on their lives, ranging from mild to severe. These include:

  • Inner Critic. Those experiencing fat shame are often attacked by a persistent internal voice that criticises their appearance, weight, or food choices. This internal voice can be punitive and contribute to feelings of shame and low self-esteem (Puhl & Brownell, 2006).
  • Disordered Eating. Fat shame may contribute to the development of disordered eating patterns, such as anorexia, bulimia, or binge eating, as individuals attempt to cope with negative feelings about their body (Stice & Shaw, 2002).
  • Social Withdrawal. People experiencing fat shame are likely to have a hard time trusting others and sharing personal information with them. Due to this social avoidance, they are more likely to experience loneliness compared to those who have a more socially acceptable body weight (Rotenberg et al., 2017).
  • Healthcare Withdrawal. Studies show that overweight people are likely to avoid seeking medical care due to fear of judgement by healthcare professionals. Although hard to believe, many health professionals demonstrate varying degrees of anti-fat bias to their larger patients, attributing negative stereotypes to them, including “lazy”, “sloppy”, and “stupid” (Chakravorty, 2021; Pull & Heuer, 2009; Tylka et al., 2014).

Brief Therapy Strategies for Overcoming Fat Shame

I am sharing 4 strategies that I regularly use in my psychotherapy practice to support clients who experience fat shame, or engaging in fat shaming but want to stop.

Strategy #1: Psychoeducation

One of my key psychotherapy strategies is psychoeducation. This involves sharing with my clients the latest research and insights that exist on a topic that affects them. This approach dispels myths, builds hope, and grows their skill set.

On the topic of Fat Shame, there are 3 core myths that I want to challenge:

  • Myth: Obese people are unhealthy and die earlier.
  • Fact: According to Cheung and Li (2020), individuals can be obese and enjoy metabolic and cardiovascular health. Other studies have shown that obese individuals who adhere to healthy habits do not experience earlier mortality compared to normal weight individuals. In other words, adherence to healthy lifestyle habits decreases the risk of premature mortality regardless of Body Mass Index (Bacon & Aphramor, 2011; Matheson et al., 2012).
  • Myth: Dieting and exercise are the solution to obesity.
  • Fact: There is no strong evidence for the effectiveness of diets in leading to long-term weight loss. And while combining diet and exercise can promote weight loss in the short term, behavioural programs that focus on improving diet and activity generally do not result in more than 3-5% sustainable weight loss in the long-term. Maintenance of even this modest weight loss requires continuous effort that would not be realistic for most individuals (Mann, 2007; Ramos Salas, 2014).
  • Myth: Obese people lack willpower and self-control.
  • Fact: According to Ramos Salas (2014), studies that compare the willpower and self-control between overweight and normal weight individuals show no significant difference. Furthermore, given the high failure rates of weight loss programs, it makes sense that overweight individuals (and most individuals for that matter) would lack the motivation to re-engage in these behavioural interventions.

Strategy #2: Identify the Unconscious Holds of Fat Shaming

I talked earlier about the Primary & Secondary Drivers of Fat Shaming. If you realise you engage in fat shaming behaviours, try to identify the unconscious influences of your childhood or early adolescence. Awareness of one’s unconscious habits is a key strategy to breaking their hold.

Questions to ask yourself:

  • Was I fat shamed as a child, or did I witness my loved ones getting fat shamed? If yes, what emotions do I experience now when I recall those moments?
  • What beliefs do I have regarding people with large bodies? Who “installed” those beliefs in me? Have I reflected on how valid these beliefs are?
  • When I am fat shaming someone, how exactly do I express my thoughts and emotions to the other person? What am I trying to achieve? Have I thought about the potential impacts on the other person?

Strategy #3: Identify Core Values

Unfortunately, fat shaming and fat-based discrimination might be with us for many more years. If that is true, then how do we cope with the “system” and thrive in spite of it?

One of the answers lies in identifying and sharpening Core Values.

Core values represent deeply meaningful ways of how we want to “be” in this world: how we want to think, feel, and behave. They help us move forward in spite of any obstacles or pain we might be experiencing, including fat shaming or fat-based discrimination.

When you have identified qualities you would be willing to always struggle for (or die for), then you have identified your core values. Some examples include:

  • Fairness and Justice for everyone
  • Unconditional love, for both my friends and enemies
  • Endless curiosity and learning
  • Showing kindness to myself and others

The Core Values strategy is often curative for my clients. I outline two ways to develop your core values in this article.

Strategy #4: Chairwork

One of my most highly valued psychotherapy interventions is Chairwork.

In its simplest form, Chairwork involves setting up two chairs, one facing the other. My client sits in one chair, and they face the empty chair.

Let’s assume that my client is experiencing fat shame.

I might ask my client to sit in one chair and visualise the fat shamer (“FS”) in the empty chair. I will then invite my client to tell FS about the impact they have had on them. I will guide my client throughout, first speaking from the secondary emotion of anger and then speaking from their primary emotions (fear, sadness, or shame).

There is also a twist: I might invite my client to switch chairs and be FS. I will then invite FS to respond to my client from their perspective. This process is called Role Reversal, and it deepens the client’s perspective even further. (Note: role reversal is used only when it is appropriate that my client gain the other person’s perspective.)

Chairwork is awareness-raising and liberating for my clients. Primary emotions that they have suppressed (or were not aware of) now come to the surface. The expression of anger helps my clients correct any injustice they perceive and gain a sense of self-mastery over their environment. They also experience relief and a sense of peace.

Chairwork can be emotionally confronting, so I always recommend working through this intervention with a psychotherapist trained in the approach. You can read more about the process here.

Next Steps

The insights I have shared are for educational and information purposes, and should be used only as a starting point for exploring fat shaming, fat shame, and weight stigma.

If you find any of these insights relevant to yourself or others close to you, your safest option is to speak to a psychotherapist skilled in these complex behaviours.

I hope you found this helpful.


  • Bacon, L., & Aphramor, L. (2011). Weight science: evaluating the evidence for a paradigm shift. Nutrition Journal, 10, 9.
  • Chakravorty, T. (2021). Fat shaming is stopping doctors from helping overweight patients – here’s what medical students can do about it. BMJ (Clinical Research Ed.), 375, n2830.
  • Cheung, B., & Li, H. L. (2020). Healthy obesity: reality or myth? Postgraduate Medical Journal, 96(1141), 649.
  • Levinson, J. A., Kinkel-Ram, S., Myers, B., & Hunger, J. M. (2024). A systematic review of weight stigma and disordered eating cognitions and behaviors. Body Image, 48.
  • Mann, T., Tomiyama, A. J., Westling, E., Lew, A. M., Samuels, B., & Chatman, J. (2007). Medicare’s search for effective obesity treatments: diets are not the answer. American Psychologist, 62(3), 220.
  • Matheson, E. M., King, D. E., & Everett, C. J. (2012). Healthy lifestyle habits and mortality in overweight and obese individuals. The Journal of the American Board of Family Medicine, 25(1), 9-15.
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  • Puhl, R. M., & Brownell, K. D. (2006). Confronting and Coping with Weight Stigma: An Investigation of Overweight and Obese Adults. Obesity, 14(10), 1802–1815.
  • Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: a review and update. Obesity (Silver Spring, Md.), 17(5), 941–964.
  • Ramos Salas, X., Forhan, M., & Sharma, A. M. (2014). Diffusing obesity myths. Clinical Obesity, 4(3), 189–196.
  • Tylka, T. L., Annunziato, R. A., Burgard, D., Daníelsdóttir, S., Shuman, E., Davis, C., & Calogero, R. M. (2014). The weight-inclusive versus weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight loss. Journal of obesity, 2014.

Tom Skotidas is a Psychotherapist and the director of Intermind. He helps individuals, couples, and families overcome their mental health and relationship challenges. Tom is also a Workplace Psychotherapist and Mental Health Educator.

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