(Content notes: disordered eating, medical/psychological testing and gatekeeping, late capitalist hellscape. Feel free to skip if you’re not feeling up to that.)
I’m strangely fond of doing multiple choice psych tests. I think it dates back to all those Scantron tests they gave me when I was a kid. I always did rather well at them, so they have good associations.
Today I’m filling in an EDE-Q, the diagnostic tool used to decide whether I can get an Eating Disorder Plan from my GP. This would give me forty Medicare-subsidised psychologist and ten dietician sessions over the next year for my disordered eating. If I “fail,” I’ll have to fall back on a Mental Health Treatment Plan, which would get me twenty psych sessions, or maybe ten if they don’t renew the pandemic-era increase by the end of this year.
One of the questions on the EDE-Q asks:
Over the last 28 days, how many of them have you felt fat?
What does that even mean? Lots of fat activists have written about the term “feeling fat”, but of course I can’t find any of their posts to link to now, because the search results are spammed to hell and back with SEO content content for every vaguely health-and-wellness-related website. Ah well.
What most of those health and wellness sites mean when they say, “Fat is not a feeling,” is that “fat” is not an emotion per se. When we “feel fat” we should dig deeper and figure out whether we feel angry, sad, ashamed, or whatever. (Or for that matter whether we feel sexy, content, or resilient. If fat is an emotion it doesn’t have to be only a negative one.)
What I recall various fat activists saying (and to be fair, I was mostly reading their stuff back in the first big wave of blogging, pre-2010, so I am paraphrasing from memory) was: Fat is not a feeling, it’s a physical part of your body. You can’t just will it away by thinking positive. It’s a part of you that you carry through the world, and that the world and its systems interact with in various ways. (This is largely the difference between body positivity, which seeks to change your feelings, and fat activism/fat justice/fat liberation, which seek to change the systems of oppression that make life shit for fat people.)
Anyway, I’m a fat justice person, and also firmly an NT on the (notoriously bullshit) Myers-Briggs personality type index, which means I’m into “thinking” rather than “feeling” (I hear every therp I’ve ever had groaning with recognition at that.) So, when I see a question like “Do you feel fat?” I parse it as, “Do you feel (believe, think, know) that your body has a large proportion of fatty tissue?”
Yes, yes I do. That’s a fact. I’m not putting myself down, and if I’m having any particular emotion about it’s because our culture has taught me to do so, through systemic prejudice and outright rudeness and bullying. The fact of the matter is that my body is somewhere in the upper deciles of the population when it comes to percentage of fat content.
So I ticked “every day.” It would be delusional to think otherwise.
Sidebar: most of these EDE-Q questions emerge from the diagnosis and treatment of anorexia nervosa, which was the first identified eating disorder. Until recently, you had to have a BMI of 18 or lower (severely underweight) to be diagnosed with anorexia. As you might imagine, this led to a really warped view of who has it and what their traits are. It also led to questions like “do you feel fat?” which would indicate, in a person of low body weight, that they have a misapprehension about their actual size.
Then there’s the EDE-Q question that asks your sex assigned at birth (at least an improvement on the old version, which just said “If female…”) and then asks how many periods you’ve missed lately, if you’re not on the pill. I’ve missed three in the last 3-4 months, because as a trans person I’m on testosterone, which stops them. Even if I wasn’t, I’m reaching the age where I might be dealing with peri-menopause. But that question is clearly aimed at young cis women who have very low body weights: the stereotypical presentation of anorexia.
Luckily, the truthful answers I’ve given work in my favour, in this instance. But they don’t always.
If you’re interested in more on the topic of “atypical anorexia” (i.e. anorexia nervosa in people with larger bodies, older people, people who aren’t cisgender girls/women, etc.) the Maintenance Phase episode on Eating Disorders (transcript available in a tab on that page) with Dr. Erin Harrop is great listening.
All of this reminded me of a questionnaire I took last week for my psychologist (it’s an end of year thing, we’re doing lots of paperwork to figure out what we’re doing next.) The question was:
How often do you feel like a disaster (physical/criminal/medical/financial) could strike at any time?
I was filling in this questionnaire on the day that the Maribyrnong river flooded in a once-a-century event, pushing hundreds of Melbourne’s inner suburban residents out of their homes. I’ve only just stopped living in a caravan myself, after being pushed out of my own long-term home subsequent to the housing crisis brought on by (let me check my notes) a global pandemic that’s infected almost half the country and killed 15,000 of them.
How often do I feel like disaster could strike at any time? Well, constantly, of course.
Then there’s the DASS, the screener used to test for depression/anxiety/stress and usually used by your GP to get you on one of those Mental Health Treatment Plans. Or the shorter K10 screener used by Beyond Blue and many social services. They ask questions like,
How often do you feel like the future is hopeless?
Look, climate grief is real. Workers are hating their jobs more. More people than ever are living in tents. People can’t afford healthcare, or can’t find it in their area or in a timely fashion. Marginalised people are over-policed and disproportionately incarcerated. There’s a lot of shit going on.
As they say in the classics, “Just because you’re paranoid doesn’t meant they’re not out to get you.” Or to put it in a more 2022 way, “Just because you’re anxioused and depressed doesn’t mean there’s not plenty to be anxious and depressed about.” That, I admit, sounds pessimistic. So let me end on a small high note: if you find yourself in that situation, don’t blame yourself, and don’t try to fix yourself. Recognise that things are a bit shit, and then work, within your abilities, to fix them.
- Make sure your enrolment is up to date for the upcoming Victorian state election.
- Drop an email to your state or federal MP or local councillor to tell them what matters to you and what you want them to do about it. You can just dash off an email, and it counts, I promise!
- Help someone: you could formally volunteer with some organisation, or just directly help out someone in your community with something they need (this is called mutual aid.)
- Next time someone recommends self care to fix what’s ailing you, feel free to point out that “self care” has been co-opted by capitalism to push responsibility for fucked systems onto the individual. Or just say it inside your head, remind yourself that your feelings are hella legit, then go take a bath anyway.
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