Watch any episode of My 600lb Life and you will see that there is a direct, and oft-repeated, correlation between childhood sexual abuse and obesity. This is something that the book's author, Roxanne Gay, also experienced and speaks to very early on in her narrative. Gay gained most of her weight shortly after her abuse; at the time she realized that she was comforting and emotionally medicating herself with food, and she later came to realize that she was subconsciously insulating herself from the outside world as well, and protecting herself from unwanted attention. Eventually, she became obese, and then morbidly obese, finally receiving a diagnosis of super-morbidly obese as she strove to become physically repulsive to men and to keep them away from her all together.
Having a dysfunctional relationship with food also leads to a dysfunction in every other relationship as well, and if not dysfunctional, each relationship is governed by the way in which others view excessive weight. Her relationship with her parents, for example, becomes difficult, and she finds that it is increasingly difficult for her to deal with their perception of her. until this becomes another emotional issue that she uses food to hide from.
Gay's feelings about other people who judge her weight are not positive; sometimes people just stare, and don't say anything, but sometimes they are more vocal, and comment about her size. People are sometimes angry with her for letting herself get to be this size. Walking down a street can result in negative words from complete strangers, which she resents because she does not feel it is for others to have an opinion about her obesity.
As well as talking about the reaction of others to her size, Gay also tells the reader of her own reaction to how big she has allowed herself to become. Sometimes, when reacting to the criticism of others, she is defiant and convinced that she wants to be left alone to be fat but on other occasions, she has moments of introspection, and feels self-loathing and looks at her body with the same hyper-critical eye that she looks at other people.
The book ends with a number of questions and observations that can be quite controversial; Gay lambasts the clothing industry for their failure to make clothes big enough for the super-morbidly obese woman. She is equally scathing about transportation companies, city planners and other agencies that she deals with who similarly do not make accommodations for the super-sized. This is, in her opinion, damaging to self-esteem and makes it seem unacceptable for a person as large as she was to be out and about in society.
