Fat in the Psych Ward
Image Description: A hospital food tray containing pasta with red sauce, sliced pears, red juice, a glass of water, and silverware is carried by a Black person wearing dark blue scrubs. A hospital bed and curtain can be seen in the background. Image Credit: Curated Lifestyle via Unsplash+.
Content Warnings: Discussion of hospitalization, mental illness, suicide ideation, disordered eating
Would you like a snack? the nurse asked as he got me set up in my room at the far end of the psych ward. He was tall and fat. This must be a fat person looking out for other fat people kind of thing, I thought. But I only wanted water because I assumed you’re not supposed to enjoy anything after attempting to drown in Lake Michigan, after agreeing to be in the psych ward.
However, I had misunderstood the purpose of being there. My hunger shouted over my depression for the first time in weeks, so I changed my mind. He smiled as I told him that I did want a snack. He brought back two small bags of chips and a large plastic cup of ice water.
The crunch, the salt—the chip tasted delicious. A small reminder of my ability to enjoy something.
The granola bars and other snacks were more than a welcome to the psych ward gift. Having an appetite was a sign of healing. Eating was an indication that I wanted to be alive.
I love food. I love being fat. To my surprise, the psych ward—well, this one—was a fat-affirming space. I had the privilege of being in a private facility on the border of Chicago’s Boystown where I stayed for five days in September 2023. I acknowledge that not all psych wards are like this. It was also very queer-friendly. Staff wore various pride stickers on their badges that showed their gender and/or queer identities. Ours were affirmed too, if we wanted to be open about them. While at first, I kept being a gainer to myself, I felt comfortable being open about being nonbinary and asexual.
Psych wards are in-between spaces where we’re inside and outside of the world simultaneously. Time is expanded, meaning days feel longer than 24 hours. This allows for friendships to form very fast, as they did with me and three other patients. We called ourselves The Breakfast Club, after the ‘80s movie. We ate all of our meals together.
The size of the portions shocked me. I didn’t expect so much food and for it to be presented so nicely, plated on large trays, the plastic fork and spoon wrapped in a napkin. Eventually, I told The Breakfast Club about being a gainer and they simply said, “That’s cool.”
In daily life, doctors had told me to restrict not only the kinds of foods I ate but also the amount of food I consumed. But there in that in-between space of the psych ward, food was viewed as an essential component of our recovery. Personal dietary concerns were taken into account as my diabetes and high blood pressure were noted on my meal receipts, but the amount of food was not restricted.
An article from McLean Hospital states, “Adequate calorie consumption, derived from various sources such as carbohydrates and fats, ensures the brain receives the energy it needs to function efficiently.”
This seems like common sense, but think of all the messaging we absorb from diet culture. My mother and grandmother were always on diets, drinking SlimFast instead of eating solid foods. As a fat kid, my weight often came up as a problem to fix. My enjoyment of simply eating confused my parents. Born into a football-loving family, my parents tried to entice me into playing the game by saying I could eat all I wanted if I played football. I went to one practice. I froze anytime one of the other boys ran at me. So we went back to the diets.
In high school, I started running and lifting weights—not to be like the football players, but to be more like Madonna. First came praise until I got to what my parents deemed “too thin.” My mother told me I needed to gain muscle, but not too much because she worried my neck would overly thicken like my father’s. How I wanted to look wasn’t a consideration.
The paradox: Someone who enjoys being fat feels an equal pull to conform to societal body standards. One is considered “healthy” and one is not.
None of this came up in the psych ward. Not by patients. Not by the staff. Are you hungry? Here’s some string cheese and a snack pack of pretzels. When you’re eating meals, focus on your food and be mindful of it instead of being distracted by watching TV. According to an article in The National Institutes of Health’s June 2021 newsletter, “Mindfulness-based treatments have been shown to reduce anxiety and depression. There's also evidence that mindfulness can lower blood pressure and improve sleep. It may even help people cope with pain.” Italian ice, my favorite evening psych ward snack, did, in fact, help me cope.
Is this how much I should be eating? I wondered aloud to one of the med techs as she took my vitals. I wanted verification from a professional. Another paradox: a gainer marveling at the amount of food they were given at the hospital.
“More or less,” she said. She cited the connection between our bodies being nourished and being able to heal. Other benefits reaped during my stay: my blood sugar and my mood improved because I ate consistently. My trip to the psych ward made it clear that I had to make changes in my life and how I viewed myself, my body, so I started to think how I could bring this view of eating and fatness home.
Dialectic Behavioral Therapy (DBT) is the treatment for Borderline Personality Disorder, which I received as a diagnosis while in the psych ward. When my psychiatrist explained her reasons for my diagnosis, I noticed how Borderline had haunted my entire life, including my eating habits. One symptom of Borderline is all-or-nothing thinking.
I’d go through cycles of wanting to be as fat as possible, devouring a ton of calories to get bigger faster and then one day it would switch and I’d go in the complete opposite direction. All or nothing. I should be thin. DBT cautions against “should statements” because they imply punishment. And make no mistake: I was punishing myself for wanting to be fat.
Image Description: August Owens Grimm, a fat, white person with a salt-and-pepper beard, sits shirtless and looks at the camera. This photo was taken a few weeks after returning home from the hospital. Credit to the author.
However, the psych ward’s attitude towards food and bodies represented the middle path: food for nourishment and enjoyment rather than reward or punishment. The main tenant of DBT is building a life worth living. This can mean a lot of things to different people.
For me, it is accepting that I enjoy living as a fat person. Eating is a comfort for me. When my co-editors and I were formulating the type of stories we wanted to include in Fat and Queer, the three of us agreed we wanted work that found joy in being fat and being queer. The pieces had to present the intersection of joy, fatness, and queerness. Being in the psych ward brought the concept of those intersections back into my life.
We are not one thing. Being fat is not good or bad. It just is, and you can have a fat life worth living.
