Fatorexia and the Rejected Self

What makes some people believe they're thinner than they really are? What dangers does this distortion carry? Today, we want to talk about fatorexia.
Fatorexia and the Rejected Self
Valeria Sabater

Written and verified by the psychologist Valeria Sabater.

Last update: 21 December, 2022

In her book, Sara J. Bird explained her unique experience with fatorexia. During one of her medical check-ups, the doctor asked her to get on the scales. When she did, she was shocked to see that she weighed over 17 stones. She couldn’t believe it. Furthermore, her excess weight – the evidence she couldn’t see – was seriously affecting her health.

She still couldn’t take in what the doctor was telling her. In fact, for a moment she thought that a much larger person had entered the room and, at one point, had gotten on the scales in her place. There could be no other explanation. So she went home, embarrassed and outraged. She took off her clothes and looked at herself in a full-length mirror.

However, she was unable to recognize herself. There was something in her mind that was preventing her from identifying with the woman in the mirror. She was a stranger, an unknown version of herself, a completely altered image. What was happening? Why couldn’t she perceive the reflection of her own body as her own?

There are people who perceive themselves as being at a healthy weight, despite developing diabetes and cardiovascular diseases associated with being overweight.

Fatorexia: definition, characteristics, and causes

Fatorexia is an eating disorder (ED). Just as there are people who are extremely thin and perceive their reflection in the mirror as overweight, this condition has the opposite phenomenon. Obviously, the health risks are also high.

It’s hard to believe that there are those who aren’t aware of their excess weight. Indeed, in a society that associates beauty with thinness, it’s quite surprising that there are men and women who buy their clothes without even realizing that their size doesn’t coincide with the ‘supposed’, albeit dangerous, canon of the ‘normal body’. However, it happens, and the incidence is more common after the age of 45 years.

Fatorexia is a type of dysmorphophobia, and there’s nothing as complicated as the distorted perception of our own bodies. Being unable to see our own obesity, and perceiving ourselves as slim is an extremely delicate psychological phenomenon that’s well worth looking at in more depth.

Fatorexia is more evident after 45 years of age. At that time, serious health problems have already appeared, such as cardiovascular diseases, hypertension, etc.

What kind of psychological condition is it?

Fatorexia doesn’t currently appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Despite this, we can define it as a distorted perception of one’s own body, in which the sufferer believes they look slim and healthy. When, in reality, this isn’t the case.

There are a number of diseases associated with an unhealthy diet and being overweight. This condition would fall within the classification of eating disorders (ED) and, in many cases, can be as serious as anorexia. The health risks are as follows:

Sara Bird, the British woman we mentioned earlier, in her book entitled, Fatorexia: What Do You See When You Look in the Mirror? explained that, for 20 years, she was unable to see her love handles and the accumulated fat on her body.

The symptoms of fatorexia

Fatorexia is a recently recognized condition that hasn’t yet been precisely clinically defined. However, doctors and patients describe the disease as follows:

  • A person suffering from fatorexia avoids looking at their body in the mirror. Therefore, they only pay attention to their face and look in small mirrors.
  • They’re unaware of how much they weigh.
  • They always wear loose clothing which they claim is to make them feel more comfortable.
  • They deny that they’re overweight. If someone makes a comment about the fact that they’re overweight, they either brush it off or completely deny it.
  • They usually claim that they’re ‘big-boned’, not overweight.
  • The most dangerous thing is that they eat compulsively. Indeed, they eat in an unhealthy way, resorting to caloric foods, rich in fats and sugars. It’s a way of relieving their anxiety, stress, and worries…

The cause of fatorexia

In 2021, the Italian Auxological Institute (IRCCS) conducted research on fatorexia. They mentioned the theory of allocentric blockade. This means that patients employ a strong defense mechanism because they can’t tolerate the image of their physical self.

Often, these are people who, five, ten, or 20 years ago were the correct weight. However, due to work, stress, or anxiety, their eating habits changed. This resulted in a drastic change in their body image, an alteration that they didn’t want to accept and that they proceeded to deny and underestimate.

woman suffering from fatorexia
People with fatorexia need emotional support.

The treatment

As a rule, behind the fatorexia sufferer is someone who began to feel bad a long time ago. Work or lack of work, family, a breakup, or even life dissatisfaction, caused their eating habits to deteriorate. For this reason, experts recommend that friends and loved ones don’t keep telling them they’re overweight. 

It’s best to ask them how they are and if we can help them in any way. As a matter of fact, in disorders such as fatorexia, the therapeutic goal isn’t to lose weight. It’s to address the reason why the sufferer’s eating habits have changed.

Therefore, it’s essential that the sufferer attends psychological therapy. Only when the emotional triggers that led to their poor nutrition are addressed, will they be able to take the next step. That of seeing a nutritionist and starting a healthier life.

Finally, if you have a friend or family member who seems to have an inappropriate relationship with their food, make sure you don’t ignore the fact.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Granese, Valentina & Pietrabissa, Giada & Manzoni, Gian Mauro. (2018). Do subjects with obesity understimate their body size? A Narrative review of estimation methods and explaining theories. Psychology, Society, & Education. 10. 265-273. 10.25115/psye.v10i1.2150.
  • Robinson, Eric & Hogenkamp, Pleunie. (2015). Visual perceptions of male obesity: A cross-cultural study examining male and female lay perceptions of obesity in Caucasian males. BMC public health. 15. 492. 10.1186/s12889-015-1821-3.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.