what it feels like: 'the wounds are still open' living with obesity, judgment and self-doubt
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one of the biggest lessons matt larsen has learned from living with obesity, addiction and mental health issues is the importance of accepting and loving yourself.
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matt larsen, a well-educated and compassionate researcher in toronto, has been through a lot. he’s rebounded from addiction, depression and homelessness, coming out the other side to make things better for others. he says that starts with creating awareness and understanding so that people can be kinder. yes, kinder.
he wants to know why there is so much shame surrounding homelessness and health disorders, as if people are solely to blame for their struggles?
“there are all kinds of systemic factors that shape our lives,” he says of the multiple determinants of health that people—including healthcare professionals—need to recognize instead of passing judgment.
now in his early 40s, matt is enrolled in a master’s program in health services research at the university of calgary where his thesis focuses on the experience of shame felt by people with homelessness and diabetes (he also has type 2 diabetes), and how these individuals cope. he’s a “big guy” at 6’4” and about 300 lbs., so he’s also made it a point to speak out about his obesity and participate in advocacy groups like obesity canada and obesity matters to share his story.
“i’ve talked about my homelessness and mental health and addiction endlessly as if it’s very matter of fact. i used to go to marijuana anonymous for years and i’m pretty open about talking about this. the obesity stuff, though, is a little different. i find myself slowing down because it’s like the wounds are still open,” he says candidly. he grew up as a larger kid in weight and height getting teased at school, but only so far since his size could be intimidating. problems in childhood and adolescence have a lasting effect, however.
feeling unattractive is painful to talk about
“it’s more than just being teased. it’s being made to feel unattractive. this is the stuff that’s painful to talk about. there’s so much shame with the condition.” matt has experienced a number of health issues linked to obesity. he was diagnosed with type 2 diabetes in his early 30s, then high blood pressure and high cholesterol. all are managed with medication, along with a breathing device to address his sleep apnea.
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his diagnosis of obesity came in stages, with his family doctor first saying he had a “jelly belly” that he should try to shrink and then later another doctor confirming that he was morbidly obese. “i’ve experienced, like, a lot of weight-based stigma over the years. people take it as a character flaw, like you’ve done this to yourself, you’re weak, you’re all these things. and it’s this massive stigma of shame.”
how did he go from a young adult who taught english in japan for a year, then graduated from teachers’ college and started supply teaching to being homeless and taking refuge in local shelters? as most people would agree, things don’t always go the way you expect.
he shared a place in brampton, ontario with his girlfriend at the time and felt pressured to find a full-time teaching position. the supply teaching was challenging because he’d get a wakeup call at 5:30 a.m. to head to a school for a day or two where he didn’t have regular colleagues to connect with or students to get to know. “you’re just in a random school and gone the next day, so that was affecting my mental health,” he says, adding he started smoking a lot of marijuana with his girlfriend.
“people might say marijuana is not addictive. but i think really anything can be addictive. after a while, we were just doing it on all occasions, like when you feel bad and when you feel good. that sounds like addiction to me.” he felt weighed down by depression and bouts of sleeplessness. he reached out for help and was diagnosed with depression and bipolar disorder, which explained his mood swings and increasing manic episodes “that were quite scary.”
the downward spiral of mental health disorders
then his relationship fell apart, he wasn’t able to support himself and he ended up on the street in 2018. “i was homeless for a little over a year, moving around to a bunch of different shelters. they’re all terrible.” he doesn’t talk about the shelters as being unsanitary, but the mental strain of living where there’s no place for privacy and closed doors.
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by the end of that year, he decided to get clean of marijuana and go to a rehab facility in toronto.
“i was there for four months and i was around people who are fentanyl users, crack users, severe issues. and here’s me, this big, fat doughy weak dude who can’t even handle marijuana. i felt like a fake around these people. and i’m the fattest one there, so i’m an outsider in that regard too. i couldn’t have felt more of a failure at that time.”
his honesty about his feelings is telling, although sad to hear. and he’s still having a hard time silencing his inner critic and acknowledging the courage it must have taken to go through rehab and change his life.
“i don’t know how i’m ever going to be the same again. i don’t know how i’m ever going to get over the shame of failing at being a teacher and academic and fallen so low.”
another turning point was meeting a university of calgary health researcher who helped matt move into subsidized housing where he went on disability for a few years and could afford basic necessities. it gave him a base for stability, like regular meetings with a psychiatrist, and making time for journalling, yoga and meditation.
he has used his lived experience as the foundation for his work as a peer researcher in community projects with the university of calgary where he’s currently pursuing a master’s degree. “my studies are on shame specifically experienced by people who’ve lived experience of homelessness and diabetes, which i clearly know a lot about,” he says, exposing his own vulnerability. “i’m really interested in this concept of shame. it’s basically this feeling that we’re flawed, like there’s something inherently wrong with us. guilt is the feeling that you’ve done something bad where shame is the feeling that you are bad. i want to figure this out. i don’t want to feel like this.”
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while his research doesn’t look at obesity, he talks about the same feelings of shame that keep chipping away at his self-esteem. his work has also been an exploration about society’s perception on what is a good and happy way to live. he interviewed seven people experiencing homelessness, including a woman who is also engaged in drug use and prostitution. she is well spoken and very intelligent, he says.
“i remember thinking, she could do so much better. she told me that was she was comfortable in her life. i was like, ‘that’s not good. i wish i could like wake her up’ kind of thing. eventually, though, i changed my mind on that, thinking ‘who am i to say how she should live her life and what choices are best for her?’ if she has found acceptance for herself, why would i question that?”
there’s freedom in accepting who you are
one of the biggest lessons he’s learned is the importance of accepting and loving yourself, and the freedom that could bring you to be who you are. lose the guilt and the shame.
“we have to find a way to radically accept ourselves wherever we are in our journey. this is the only time we have. it doesn’t make sense for me to only love myself when i’ve lost like 100 lbs. i’ve got to love myself in the meantime, too.”
when it comes to living with obesity, his own experiences have shown that everyone needs to address their own internalized bias—patients, healthcare professionals, policymakers and so on, who are surrounded by society messaging that equates a slim body with vitality, health and success.
“and we need to address more of the psychological stuff. there’s so many factors that hold people back i think from change,” he says. “i’m not dieting. i’m not focused on my weight although i know i should be. i’m interested in knowing what is holding me back.”
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