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“I’m Fat. I Have ADHD. And I Won’t Be Ashamed Anymore.”

“If you are fat with ADHD, the mirror that society holds up to you reinforces all of your worst suspicions about yourself. Self-perceptions of being ‘lazy’ or ‘careless’ collide with emotional hypersensitivity when you are fat shamed. Then, of course, there is the rejection sensitive dysphoria that delivers a double dose of shame and self-loathing.”

An illustration of a body positive woman smiling and jumping

A lifetime as a fat woman — and, yes, I say fat for reasons I’ll soon explain — has primed me to expect rejection on all fronts. Though I’ve cultivated the stereotypical mask and armor of the “jolly fat person,” nothing could fully shield me from the shame, humiliation, and rage that usually follows a real or perceived injury. For as long as I can remember, I’ve lived with a profound sense of having “missed the mark” and failed to achieve my potential — despite the help of several therapists, two weight-loss surgeries, and countless eating plans.

Recently, after concluding that I was beyond help, I decided to abandon it all – therapy, weight-loss plans, and everything that goes with them. But I knew I owed it to myself to investigate one stone not yet unturned: ADHD.

With a proper diagnosis and treatment, I was finally able to get a handle on “typical” ADHD problems (organization, time management, etc.) that I’d always assumed were personal defects. But the most important revelation came when my therapist introduced me to the concept of Rejection Sensitive Dysphoria (RSD) — an extreme emotional sensitivity to real or perceived shame, rejection, or criticism commonly experienced by people with ADHD.

RSD explained why I’ve been called irrationally oversensitive and reclusive since childhood. It explained why criticism made me feel not just utterly mortified, but like I wanted to die. Being fat, and experiencing judgement because of it, of course, offered such fertile ground for my RSD to fester.

But discovering RSD also meant I could finally learn to manage these intense emotions. It meant that I could take the word that had caused me so much pain and hurt – fat – and reclaim it, so as to reclaim my life.

[Click to Read: 3 Defining Features of ADHD That Everyone Overlooks]

Promise… and Humiliation

I remember the agony I felt as I threw myself into my mother’s arms, crying inconsolably because I was sure none of the other First Graders liked me. As a fat girl, it was a good day if someone didn’t call me “fatso” or “tub of lard,” or make oinking sounds as I passed by.

I was an easy target for bullies, and the very adults trusted to protect children also joined in the mockery. To survive, I developed a kind of radar calibrated to respond with fight, flight, freeze, or fawn.

Still, my young self was driven by an exuberant joy of discovery. From astronomer to ballerina to archaeologist, my ambitions changed almost daily. As with many children with undiagnosed ADHD, my teachers predicted a bright future for me. As I got older, difficulties with focus and with executive function began to surface, and my puzzled teachers reflected my broken promise and worthlessness back to me. Gradually, the brilliant future they had foretold fizzled out, as did my self-esteem.

[Read: “I Could Have Been Myself for So Much Longer.”]

I began college as a pre-med major, and was determined to turn over a new leaf. Though I loved school, I despaired when I turned out to be as “lazy” as ever. I barely passed my courses. Then, during my second year of college, my mother, the beating heart of our family, died. My life fell apart without her — I became down and drifted, barely managing to graduate three years late.

Eventually, I managed to pick up the pieces of my life and decided to give medical school a try. I applied to a prestigious program specifically to help students with poor academic records but high potential get into medical school, and was elated when I was invited for an interview. But barely five minutes into our conversation, the admissions officer, nodding her head with pity and condescension, said, “My dear, you are what we refer to as the ‘classic underachiever.’” Humiliated, I slinked off in resignation.

Much later, my college academic advisor, who had given me a favorable reference, revealed that the admissions officer had contacted her and admitted to rejecting my application because I was fat. Evidently, the school found academic failure less problematic than being fat.

My personal life was similarly nullified. I had so thoroughly internalized the messages about being fat that I felt cancelled out as a woman. The rare compliment I received fell into that special category reserved for fat girls such as “You have such a pretty face – if only you’d lose the weight” or “You’re not bad looking for a fat girl” (implying that you might possibly, with some effort, be salvageable). I learned to dress strictly for utility, because wearing makeup and jewelry and nice clothes were tantamount to inviting the Male Gaze – presumptuous and preposterous.

I assumed that romantic relationships were beyond the realm of possibility. I was convinced that no man could ever find me attractive. Even when, to my astonishment, I did get asked out for the rare date, RSD lay in wait like an IED prepared to detonate at any word or gesture that hinted even slightly of shame or judgment.

I remember, for example, spending a lovely evening with someone whom I had allowed myself to believe might be seriously interested in me. As we watched TV, I was moved to stroke his cheek until he said, with great kindness, “Please forgive me, but in my family, we were never physically demonstrative – it’ll take me a little time to get used to this.” I instantly withdrew my hand, silently swearing to myself, “You will NEVER have to worry about me touching you again!” But, of course, I never breathed a word of this to him. The relationship soon cooled.

Fat Phobia – The Last Acceptable Prejudice

There is no doubt that fat shaming is an acceptable form of bigotry in our culture. We have defined fat as one of the very worst qualities – physically, medically, aesthetically, morally, and beyond. Perfect strangers feel entitled to make negative judgments about and even show hostility toward fat people.

If you are fat with ADHD, the mirror that society holds up to you reinforces all of your worst suspicions about yourself. Self-perceptions of being ‘lazy’ or ‘careless’ collide with emotional hypersensitivity when you are fat shamed. Then, of course, there is the rejection sensitive dysphoria that delivers a double dose of shame and self-loathing.

Once I learned about RSD, the seemingly irrational emotional dysregulation that ruled my life began to make sense. Understanding that brain chemistry played an important role in my reactivity helped lighten the burden of guilt I’d borne for being defective and feeling like a failure. I also discovered there were tools I could use and skills I could learn to help manage my emotions and how they impacted my life.

Treating RSD alone, however, was only half of the equation. If I expected to be able to exist in this society, I needed to learn to deal with my outer as well as my inner environment – in other words, I needed to address my own internalized fat phobia.

Conquering Fat Shaming and RSD

Fortunately, fat phobia is being challenged more and more. Public figures like Lizzo are turning norms on their heads by promoting the power and beauty of fat people. Literature that supports fat acceptance is increasing — from serious works of social criticism to popular romances that normalize the notion of fat people falling in love and having happy sex lives. Fat activists are also working to combat discrimination and dismantle the untold ways that fat phobia is built into our institutions. There is also a rich and vital online community of people of all shapes and sizes who are actively promoting fat acceptance. Their slogan: “Fat joy is an act of rebellion!”

That is why I have reclaimed the word “fat” – a word that was so hurtful that even hearing it made me cringe.

Although it was hard at first, learning to repeat “fat” without flinching felt like a real triumph over a word that so many times had made me want to die. Now, fat is just a neutral noun or adjective with no power to hurt me.

Overcoming fat-shaming, though, is an ongoing journey. As I walk this path, I am learning to accept and cultivate love for my body. The more I understand about fat shaming, the better equipped I am to protect myself from its unhealthy effects. Every new insight presents me with an opportunity to disarm the hair trigger that has always linked society’s negative messages to my RSD. Tools such as mindful meditation have helped me learn to recognize RSD in real time, and to calm the immediate distress of shame.

Separating myself from the RSD story has given me the space to become who I really am. For the first time in my life, I’m truly allowing myself to “take up space” and to live large — starting with this article. I’m no longer going to allow fat phobia, RSD, or ADHD to prevent me from living the life I want and deserve.

Fat Shaming and ADHD: Next Steps

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