The Inner World of the Fat Child
Challenge for a Child Abuse Counselor
By Eliana Gil, Ph.D
From Radiance Fall 1987
Alissa is eight years old.
She is painfully shy. She does not converse easily. She will not make
eye contact and she does not like to be touched. She walks with her head down, afraid to
look around her, suspecting all eyes that are on her. She wears oversized sweaters and
baggy pants, and her bangs cover half her face. She smiles infrequently. Her brother
teases her incessantly about how large she is, and how much she eats. He tells her that
she smells bad, and he calls her Petunia Pig.
At school Alissa skips lunch because shes afraid other children
will see her eating. She is mortified to go to P.E. class. She never raises her hand in
her classes because she does not want to be called on. Alissa does all right in school,
earning Bs, but her parents disapprove of her grades because they cannot tolerate someone
who doesnt work to potential.
Alissa does not have a favorite teacher, and no one at school seems to
pay attention to her. She has one best friend, another outcast, who is tall and gangly.
They are referred to as Mutt and Jeff. They are always seen together, huddled, sneaking
looks at the outside world. Mostly, Alissa is an invisible child, although she is
convinced that her presence takes up a great deal of space.
Family life is far from ideal. Alissa gets home and withstands her
brothers verbal taunting for two hours. Her parents arrive home together.
Alissas mother is fit and wears tailored clothes. Her father is successful and a
workaholic. Alissa has already eaten the food she has stored in a secret place in her
closet. Sometimes, her brother uncovers her latest stash, and shes constantly afraid
this will become a topic for conversation at dinner.
Alissas mother cooks dinner, and dinner takes place without
enthusiasm from anyone. During the meal, most of the remarks directed at Alissa are
negative. Her brother, for example, reports the jokes that were played on Sis at school.
Everyones behavior at the dinner table indicates that two sets of rules exist for
each child, the "good" child and the "bad" child. What makes Alissa
bad is that she is fat. What makes her brother good is that he looks physically good.
Alissa is scrutinized by her mother every day. They discuss what she
will wear. "Are you wearing the same old clothes again? My God . . . dont you
have any self-respect at all? Im telling you now, unless you wear some of the
clothes Ive been buying you, Im just gonna stop buying you clothes altogether
. . . Its clear you dont care how you look anyway . . . Your father wanted to
invite his friends to dinner but he was ashamed to let anyone see the tub of lard we call
our daughter . . . Im going to take you to a shrink to see if they can figure out
how to get you to stop eating us out of house and home . . . I just cant believe
youre my flesh and blood."
"But Mom," Alissa thinks to herself, "Im sorry. I
dont know whats wrong with me. People dont like me. Nothing I wear looks
good. Im ashamed too. But mostly Im sorry for you and Dad, because I know how
gross I look. I wish I were dead. I wish you had adopted me and could give me back. I wish
I could get a really bad disease and get skinny from it. I wish you could trade me in. I
wish I could trade me in. I hate to go to school. I hate people looking at me. I can see
them laughing. I know how I look. I look awful. Theres nothing good about me. Why
couldnt I look like my brother? I cant even exercise. I cant bend down.
When its time to swim, my body and face get hot inside, and I could just die when I
have to go into the pool. When I went in with my towel wrapped around me, I could have
died. And I hate to try on clothes. I know nothing fits. And I can see the disgust in your
face when I try things on that dont fit. I cant stand to have you look at me.
I cant stand to look at myself. I wish I were invisible. I hate myself."
Alissas mother asked me to see her daughter. Alissas
father did not come in for the initial session, and has displayed consistent disregard for
The mother described her child as inadequate, dowdy, and obese. When I
asked if there were any positive qualities she saw in her child, she stated that Alissa
was able to entertain herself alone in her room, and that she did "keep out of the
way." She said that the child was causing marital problems, since her husband felt
that she should be able to get the child to lose weight.
When I asked for a history, it was clear to me that Alissa had been born
as a result of an unplanned pregnancy. The parents were Christian, did not believe in
abortion, but felt that the child was a mistake they would have to "live with."
The pregnancy was difficult, and resulted in a weight gain that the mother found
intolerable. She angrily told me that it had taken her four years to achieve her normal
weight. She claimed that the infant was "no picnic." Feedings were perceived as
contradictory because even though the child cried for food, she spit up half of what she
was given. The mothers explanation for this was that the child couldnt wait to
stuff herself and made herself sick as a result.
The mother says the child embarrasses her, and she wants some assistance
to help Alissa lose weight. When I offered to assess Alissas situation, her mother
firmly stated, "Her only problem is she cant control her appetite, and she
looks like hell . . . of course, no one wants to be around her." When I asked how she
had helped her daughter in the past, she replied that she had tried a thousand different
diets and punishments for the past year, and then simply "gave up." When I asked
how Alissa and her brother got along, she said "He does the best he can, given that
they go to the same school. He has to bear the burden of his relation to her."
When I finally met Alissa, I found a severely depressed child with an
extremely negative self-image. She felt unacceptable, unloved and unworthy. She was
helpless and hopeless. She desperately wanted her familys approval, but none was
forthcoming. Her drawings, her play, her comments all suggested a child whose spirit was
broken, and who assumed a tremendous responsibility for the problems in her family.
Her parents were unwilling to meet with me unless I was ready to suggest
a weight-reduction program. I insisted that the issues were deeper, and that I was
concerned about the childs depression and self-deprecation. They acquiesced to
twice-weekly visits for a specified period so that I could determine the best
"weight-reduction program" for her.
The work was compelling. I allowed the child to be herself, free from
judgments. She looked forward to our sessions, since I was the only nurturing resource in
her life. Slowly, we explored her sense of being defective. Slowly, we looked at her
strengths. She developed trust, and began to see herself through my eyes. She began to
develop confidence in certain abilitiesshe was one of the most artistic children I
had ever seen. I encouraged her, and was by her side when she began to validate her
She was afraid to take her work home. One day she was able to, and her
father responded positively. Her fathers validation, slight as it was, meant the
world to her, and gave her hope. Her mother still ignored her talent, asking, as she
always did, if I were discussing her weight.
I helped Alissa love herself. My premise was that she should love
herself as she was, and learn to appreciate her cognitive, emotional, creative and
spiritual aspects, so that she could accept her physical being later. I tried to achieve
the same goal with her family.
The child was a scapegoat in this family. She was held responsible for
her fathers slow succession up the career ladder; for her brothers disruptive
behavior; and for her mothers unhappiness with her own career. The mother held her
responsible for damaging her body, and for restricting her education (she had quit school
when Alissa was born). Her father was unfortunately passive and disconnected. His energies
were focused on his job, which resulted in his wifes feelings of rejection and
neglect, feelings that she inflicted upon her daughter.
Alissa was lucky. Through therapy she had a "corrective
experience," in the sense that I allowed her to be herself. I repeated key phrases to
her; "you are special just the way you are," "you are a pretty girl,"
"you are smart and I like being with you because youre fun, too." I
remember her silence and look of disbelief when I first made these remarks. But I was able
to convey the sincerity of my words, and slowly she allowed the thoughts to enter her
I took Alissa on outings to the park. I encouraged this reluctant child
to experience the pleasure of physical activity. She was so constricted by her negative
self-image that she had learned to hold still, in an effort to remain unnoticed and free
I traced her body on a large piece of paper once, and together we
colored in a wonderful outfit. I would comment that this body was strong and healthy. She
took great pride in picking out the colors to dress her doll. When it was finished she was
proud of her art-work, and the task had been fun and not layered with the shame and
anxiety I had come to expect.
My work with Alissa was positive for her. Her parents, however, treated
the therapy with the same disregard as they did almost anything Alissa liked. They
constantly asked me when they would see results. I kept telling them that the results were
happening under their very eyes. They did say that Alissa was taking better care of
herself (combing her hair, "matching" her clothes, etc.) but the enormity of
such events escaped them. Alissa was developing a positive identity.
I met with her parents for a number of sessions. They listened
attentively as I talked about their daughter. Their quizzical looks usually meant that
they thought I was describing another child. I told them I believed that if they ignored
the weight issue, and restrained themselves from making comments that pressured Alissa,
her weight might begin to decrease. My goal was not to have Alissa lose weight, but to get
her parents to stop badgering their child. They were willing to try anything, and
acquiesced to my request.
Alissa noticed the change right away, and responded initially by eating
more food, and then by eating as she always did. She no longer needed to horde food. She
began to believe her parents might actually like her.
Alissa developed an interest in volleyball, and played the sport well. I
instructed her parents to make family outings, and after postponing six times, the outing
occurred. Alissas parents were surprised at her agility, and refrained from making
anything but positive statements.
While her parents changed minimally, Alissa thrived. I see her or hear
from her at least once every six months. She is now fourteen, and feels more optimistic
about herself, her talents, and the future. ©
ELIANA GIL, Ph.D., is an author and has worked in child abuse
treatment and training.
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