Fat Friend Syndrome

before and after

During my many years as a doctor, I have seen a disturbing rise in cases of Forced Adipose Transference syndrome (F.A.T.S), a.k.a. Fat Friend Syndrome.

First, some facts.

Body Mass Index – The Body Mass Index (BMI) gives a rough and ready guide to a person’s weight in relation to their height. It is calculated by dividing weight in kg by the square of the height in metres.

For example, my weight is 76 kg and my height is 1.7 metres.

1.7 x 1.7 is 2.89. 76 divided by 2.89 gives a BMI of 26.3.

If maths is not your bag, then click on Count Duckula —-> duckula

A healthy BMI is between 18.5 and 25. Between 25 and 30 is overweight.

Over 30 is obese. Superman

Over 35 is severely obese

Over 40 is morbidly obese

Over 45 is Super Obese

Click on Superman to read about obesity on theguardian.com

What is Transference?


Transference happens all the time, and not just in the way described above. Humans are social creatures, and other people’s emotions do rub off on us. As part of my training, I was taught that if speaking to somebody gives you feelings of anger or resentment, that is how the other person is likely to be feeling; a useful insight when dealing with difficult or challenging customers.

In F.A.T.S, the affected individual is the victim, not of their own distorted body image, but that of a “concerned” friend or relative, who is transferring their insecurites and negative feelings onto the victim.

Let’s do some role playing. These are our three characters.

The castThe conversation proceeds thusly.

Dr Evil is sat at his desk, plotting evil deeds and signing prescriptions when there is a clap of thunder and Shrek enters stage left, Cinderella in tow.

Dr Evil: What can I do for you today?

Shrek: It’s Cinderella, Doc. She’s too skinny. You can see her muscle definition, her clothes look good on her, and she doesn’t need three attempts to get out of a chair.

Dr Evil (turning his attention to the fair Cinderella): Tell me Cinderella. Are you feeling well?

Cinderella: Yes, doctor.

Dr Evil: Are you losing weight?

Cinderella: No, Doctor. I have always been slim.

Dr Evil: Are you eating well?

Shrek: She eats like a pig, but she’s still like a skeleton with tits.

Dr Evil: I see. Do you do any sports or exercise?

Cinderella: Oh, yes. Last night I danced for hours at the ball, then I went home with three handsome princes and we played hide the salami until dawn. After that I had to clean the house and make breakfast and lunch for my ugly sisters.

Dr Evil: Let’s pop you on the scales then. You’re about 5-3 aren’t you. Your weight is 50kg. Your BMI is 19; perfectly healthy. Off you pop.

Shrek: She is NOT healthy. She is too skinny.

Dr Evil: She looks fine to me, and her BMI is normal. Would you like to hop on the scales?

Shrek: Not bloody likely.

Exit Shrek and Cinderella stage left, leaving Dr Evil wishing that he had studied law instead.

Defining Fat Friend Syndrome.

In order to be diagnosed as suffering with F.A.T.S, the following criteria have to be satisfied.

– The victim or transferee (usually a young woman in her teens or early twenties) has a normal, or slightly low BMI and has NO history of recent or unexplained weight loss.

– The victim has no concerns about her own weight or body image, except those concerns voiced by others (transferrer). There are no features of eating disorder.

– The victim must look and feel well, with no loss of appetite, lethargy, low mood, or features of diabetes. Physical examination is normal.

– The instigator or transferrer is often obese, and if prompted will admit to “needing to lose a stone,” but rarely more.”

– The transferrer will REFUSE to be weighed. Weighing scales are Kryptonite to an instigator.

– The medical consultation will have been arranged at the insistence of the instigator.

– The instigator is ALWAYS female. Men, even obese ones, have no problem with slim women.

So what is going on?

Two thirds of adults in the UK are overweight or obese. This means that those of normal weight (ie BMI of 18.5 to 25) are now a minority. It could simply be that most people have become so unaccustomed to seeing somebody who is slim, that they think there must be something wrong with them.

However in my opinion there is more to it than that, and as I have been a doctor for 20 years, my opinion on these matters is dope.

Nobody WANTS to be obese. It’s uncomfortable in the heat, it makes you breathless, your joints ache, it causes low mood and low self-esteem, and there is still social stigma and prejudice.

It’s tough being overweight, and losing weight is way harder than giving up smoking; it’s far easier to pretend that the problem lays elsewhere and that others are too thin. It’s easier to give others a hard time than it is to bite the bullet, and whether consciously or subconsciously, that is what is happening. Being overweight is frustrating (I’m no shrinking violet myself) but to transfer insecurities about body image onto others is not the answer.


All this, “Real men like curves, only dogs like bones?” is shite. Some men prefer curvy women, but ‘fat’ is not ‘curvy’. Curvy women have wide pelvises and large breasts, and a woman is either that shape, or she is not. No amount of fat will make a slender woman curvy, in the same way as no amount of cream cakes will make me look like The Rock. Believe me, I’ve tried.

We can’t all be top models. I’m short, with short legs, receding hair and a big nose. Tough break. But when I sit and watch The Avengers with Mrs Harker, and she is cooing over that Thor bloke, I don’t say, “ha. He’s too tall and muscular. Real women like short, dumpy blokes like me.

Dr  Harker’s Conclusion.

Life is tough. Biscuits will always taste better than apples. Sitting in front of the TV will always be more fun than jogging in the rain. Lifting a Big Mac will always taste better than lifting a dumbell, and people will do what they want to do. This is why people of a normal, healthy weight are now in the minority, but they ARE normal. Being overweight is common, but it is not normal.

If the majority of people smoked, would it then be reasonable to pester non-smokers for not having yellow fingers and airway disease? Perhaps take them to the doctors and ask the doctor to prescribe twenty Benson’s?

It’s as Moses said, “leave my people the fuck alone.”

Or something like that.

Peace out.

Disclaimer: F.A.T.S is not a formal diagnosis, but who knows? Maybe soon…..

About Dr Rupert Harker

I am the author of the Urban-Smith mysteries. Book 2, The Werewolf of Worttenham Wood is due out in June.
This entry was posted in Harker health, The Meme'ing of Life, Twogging and bleating and tagged , , , , , , , , , , , . Bookmark the permalink.

15 Responses to Fat Friend Syndrome

  1. martafelipe says:



  2. Reblogged this on HarsH ReaLiTy and commented:
    Now that was an interesting read. -OM
    Note: Comments disabled here, please visit their post.

    Liked by 1 person

  3. Sinderella says:

    Curves are great, circles are not.


  4. jdawgswords says:

    I certainly hope i’m not the fat friend…well, anyway…last time I checked I was morbidly obese…yeah, whatever


  5. Ellen Hawley says:

    Good post. And I love the new translation of Moses. Far closer to the original, I’m sure.

    Liked by 1 person

  6. This was interesting, but how can you say anything about it if it’s not a formal diagnosis?


    • I invented it based on my personal experience as a GP. I should have called it Harker’s syndrome, but I love acronyms, so I went for F.A.T.S.
      I have published an article on how to invent your own disease on my blog. Very helpful if writing medical thrillers.

      Liked by 2 people

  7. I’m just curious when you state that larger individuals are transferring their insecurities on to others perceived to be “too skinny” can you state the same about slimmer individuals that discuss health issues toward others they perceive to be “too fat”?


    • I suppose it depends on what constitutes a discussion. If someone has a genuine concern or interest in someone else, then it should be possible to discuss most issues in an honest way. I suspect that is not what you are getting at.
      Regarding transference specifically, I have not personally experienced someone who is clearly underweight transferring their own anxieties onto someone of normal or slightly raised BMI.
      Those with eating disorders tend to focus on their own body image, rather than that of others.


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