First and foremost - mswinter - I am deeply saddened that this essay has caused you so much pain.

Second, I am saddened to hear some of the responses to this post/essay...i have similar body issues that the rest of you have reflected and actually identify myself with the image that he portrays of Betty even though I am not the same size.

But I would ask who has read the whole essay? Not just the parts that were quoted or the partial essay online? I have the book so I've now read the entire essay.

In the end Betty admits that she too hates fat people and didnt want to go to overeaters anonymous or any other dates with obese people etc because she didnt want to be around other fat people. She was not oblivious to his disdain for fat people and confronts him with it at the end of the essay. Part of the reason that she stays with him was not because he was a "great psychiatrist" because she clearly doesnt feel he is great, but because he was interested in what she might say if she wasnt trying to entertain him all the time. He started to be interested in her once they had the agreement that he could interrupt her when she was being silly, entertaining, etc. The real work started then and prepared her for taking a more active role in her own health.

This psychiatrist worked through his and her issues. I am not defending his methods. And he stated that he had limited to no experience with obese clients.

Further, she was enrolled in an medical weight loss program at the same time that she was seeing Yalom. He had no involvement with the weight loss except as it came up or across in the therapy.

While I acknowledge that this is a difficult topic for many of us, different approaches help different people with this issue. Having just spent 10 weeks in an eating disorders program - I learned first that I have an eating disorder and I am not the eating disorder and second that it is never about the food -- the food is just a symptom and that comes out very strongly in this essay.

I like the comment from the therapist that they all have biases. I am sure other people out there have been shunned for reasons other than weight. I'm a diagnosed depressive, GAD, borderline with an ED - most therapists dont want to touch me with a 10 foot pole and have been thru 7 therapists and unfortunately may have to find number 8.

I know that there are nice looking people who are ugly because they are so dark inside and I know there are people who are not "10s" but are so incredibly beautiful because they are so beautiful inside.

I hope we all find our inner beauty.