Suzanne Koven

Suzanne Koven M.D.

Cases and Stories

My Mother, My Weight

Mother and daughter communicated in the language of fat.

Posted Apr 13, 2009

My patient--I'll call her Amy--was heavy. Her mother, Sybil, also my patient, was thin. At Amy's visits to my office we always discussed her weight. At Sybil's visits Amy's weight also came up frequently.


"Doctor, can't you make her lose?" Sybil would plead. "I don't care how she looks. I only worry about her health."


Amy's version differed. "It's not about my health," Amy insisted. "She's obsessed with appearance. Mom can't stand for people to see that she has a fat daughter. She listens to you," Amy added. "Tell her to stop nagging me about it."


And so it went, for years; mother and daughter each tried to recruit me to join her camp in their private war over Amy's excess weight. Bound by my Hippocratic Oath (and ever stricter medical privacy laws) to maintain patient confidentiality I did a lot of nodding and muttering of noncommittal banalities including the all-purpose "Yes, I can certainly understand why you feel that way."


But I found myself thinking, whenever I saw Amy or Sybil, about the weight of weight in mother-daughter relationships. There has been lots of research on the genetics of obesity, the likelihood of having a weight problem if one or both of your parents did. Much less has been written about the role of weight in the emotional life of families. Particularly between mothers and daughters, weight is a kind of secret code, an inscrutable shorthand for concern, control, and rebellion. Most women I know-even many who are not heavy-tell me that when they see their mothers they are greeted with a quick but unmistakable up and down look. I believe Has she gained weight? is the mother's reflexive check of Is my baby doing okay? And, in turn, the daughter searches her mother's weight-scanning eyes to learn, Does she love me? Does she approve of me no matter what? Mothers and daughters, even when they don't speak, communicate fluently in the language of fat.


Amy and Sybil finally arrived at a truce of sorts. Amy moved out of state and Sybil, unable to monitor Amy's weight by phone (this was before Skyping) toned down the nagging. Not coincidentally, Amy started losing weight. When she was in town recently she visited me and she looked healthier and happier than I'd ever seen her. "So," I asked, "How did you finally do it?" Amy told me briefly about her conventional diet and exercise routine and added "Plus, I got over my mother issues." "Really?" I asked. "How did you do that?" "A little separation," Amy answered, "And a lot of therapy. Plus, something happened that made me realize I needed to give up this hopeless battle with her once and for all: I came home after I'd been gone a few months and when my Mom saw how much weight I'd lost she said, "Oh! You look so wonderful, dear! Now couldn't you do something about your hair??"

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