I hear the familiar hesitation in your voice when we speak. The sharp intake of breath, and the disappointing sigh of an unposed question, like the hiss of an emptying balloon. With coaxing and reassuring, you come out with a familiar question.

But what about your health? Am I not even supposed to care?

And with that, you step into a long and living history. It stings and disappoints, as it always does. As a fat person, someone is always telling me about their concern for my health, and hearing it from such a dear friend smarts. I need you to know about your companions — the friends, family, colleagues and strangers who have expressed those same concerns for as long as I have been fat.

I was eighteen years old the first time someone told me I was going to die.

I had just gotten the first job that I’d been truly passionate about, working with poets and novelists whose writing I so admired, and had relied on in my adolescence. Luminaries whose work reached its warm hands into my ribcage, cradling everything vital and tender there, at a time that felt so isolating. A favorite poet was holding a reading, and I was in charge of it.

I’d spent months planning that first event and I couldn’t have been prouder. Dozens of people showed up, and everything was going according to plan. I stationed myself behind the food, dishing up plates for attendees and welcoming them as they made their way through the line. An older man, well dressed, smiled as he accepted the plate I handed him.

“When did you put on all that weight, sweetie?” he asked me. “Was it when your dad left?” I felt my face flush, and held my mouth stubbornly, clumsily shut. “You don’t have to die just to spite him. And you are going to die.”

My coworker stood next to me, her face a wrench of horror, shock, paralysis. Neither of us could muster any response, just slack faces and eyes welling with angry tears. We talked about it for hours afterward. Did he just decide today was his day to be the grim reaper? Who goes around telling strangers they’re going to die? She couldn’t shake it. Neither could I.

For her, that stranger was a grim and gruesome anomaly. But for me, he was more rule than exception. His remark, while sensational, was a familiar interruption, an abrupt reminder of just how insurmountable my fat body was for those around me. Family, friends, classmates and colleagues had long since cast me as a specter, frequently reminding me of my death, always couched in concern.

This was not the first time I’d been shaken by someone else’s perception of my body. In high school, I’d lived the life of so many fat kids before me, eventually coming to the hard-fought conclusion that the only solution was to retreat, weather the storm, and wait for high school to end. My passion had been theater, but while I auditioned for school plays, I was rarely cast. The role was for a fiancé, explained the lead in the school play. No offense, but who’s going to fall for a big girl? Guys want someone who’s healthy. At my next audition, the hot stage lights on my skin felt redundant — my body always seemed to be floodlit anyway. I felt like my own shadow, larger than life, unwieldy, the distorted silhouette of a real person.

Teachers expressed concern. One day, I’d brought a salad for lunch. In the cafeteria, one teacher suggested that I scrape the croutons off to the side. “The carbs can’t be helping,” she said, her voice high pitched and apologetic, her face a familiar mask of studied, sympathetic pain. I felt the salad turn slimy and sad in my mouth, limp greens coating my tongue. I dropped the remainder in the trash, and forwent lunch for the next several days.

So I got a part-time job, using the money to hire a personal trainer. He was fantastic: the kind of musclebound man I had learned to fear, but with an openness and kindness that consistently caught me off guard. When I first visited him, he asked me what my goals were. I said I wanted to stop being unhealthy. “What do you do that’s unhealthy?” he asked. “I’m big,” I said. He furrowed his brow, then reframed: “your goals could be that you want to be able to go hiking with a friend, or you want to run a half-marathon, or you want to be strong enough to pick up your little sister. It doesn’t have to be about your weight.”

I wanted to cry. He had seemed so nice, but he didn’t understand. He hadn’t been to the fat camp I’d been sent to as a child. He hadn’t seen the sidelong glances as I walked through the city, and the echoes of laughter I could never be sure weren’t about me. It did have to be about my weight.

I relented, remembering the work and savings that had gotten me there. My goal was to build endurance, so that I could run the mile at school without coming in last. And, over months’ worth of work, I achieved that goal, and I set another. And another. And another. I kept meeting goals, kept getting stronger and healthier. I lost a little bit of weight, but I was still fat. Andbecause I was still fat, anyone at any time could decide to express concern, a reminder of just how clearly I was failing to meet my deepest need: having a different body.

I launched a new strategy — one that I used for years, well into college. I illustrated all the ways I was trying to lose weight: writing blog posts about all the meals I was cooking and how healthy they were. Opening each conversation with some anecdote that had happened at the gym that week.

Invariably, someone would chime in with a diet suggestion. Have you tried orDid you know or It worked for my sister or Oprah says. It didn’t matter what I said or did. There always seemed to be someone ready to offer unsolicited advice. It was a crashing, atonal symphony, discordant notes all insistent on their own direction. I kept searching for a melody that never came. When I would ask, once in a great while, for a moment of silence, I’d see that mask again — the grimace that everyone learns to use with fat people — I’m just concerned for your health.

I had played a game I couldn’t win — as long as I was fat, I would always be seen as unhealthy. All of the trying, all of the successes, all of the little affirmations and crushing defeats — the only part of me that could be seen was the failure. In a fat body, I would always be worthy of blame.

And so, again, I withdrew. I stopped going shopping with friends to save myself from the countless sidelong glances from salespeople in a straight size store. I stopped going out. I stopped dating, or even talking about crushes.

All of these things, I learned, were for the thin. Dating, travel, love, sex, achievement and happiness weren’t for me. They were, the world insisted, rewards for the willpower I had, but which my body stubbornly refused to manifest. I kept exercising, kept trying new approaches to eating — tallying calories and carbs and points. None of them delivered the promised body, the beauty standard that was supposed to be so readily won with some effort. My life could only begin when I obtained the body that wouldn’t come.

All the while, family, friends, colleagues, classmates and perfect strangers returned to that furrowed brow and sing-song voice of concern, giving gift certificates for gyms, ordering for me at restaurants, sharing before & after pictures of bariatric surgeries. I just want you to be healthy.

The metrics of my health were strong — blood pressure fine, cholesterol normal, blood tests clean — but no one ever asked about that. The one measure that could be trusted — the shape of my skin — answered those unposed questions, and any claims I might make to the contrary were suspect at best. My friends and family metamorphosed when we talked about my fat body. All of their trust and love transformed into irritation, anger, and patronizing concern. Our rapport fell away. I could be trusted with their highs and lows, their professional successes and their relationship problems, but not, it seemed, with my experience of my own body.

There was no illustration of effort, no gesture sufficient, no health record convincing enough to stop the constant remarks and suggestions. Because most of us learn a script to recite when we see bodies like mine. I just want you to be happy. I’m concerned about your health. It’s probably sugar. It’s probably carbs. It’s probably your workout. It’s probably you.

Over time, I’ve come to understand why. Nearly every conversation about fatness is a conversation about weight loss — one that considers all of us part of the same precarious circumstance. According to those anxiety-soaked conversations, we’re all perpetually teetering on the edge of becoming fat.Keeping fat at bay is like a foreign threat that’s turned internal, a Red Scare in our own bodies. One false move, one indulgent meal, one day without vigilant terror could lead any one of us to become fat.

And fat means more than just the size or shape of your body. In those panic-driven conversations, fat means you’re not trying. It means you’re not loved, because fat isn’t lovable. Fat means you’re not strong, not moral, not smart enough to stay alert to the threat of fat. Fat means you’ve failed.

When others see my body, it reminds them of all of that. I’m a manifestation of that cultural nightmare, the worst case scenario for their bodies to become. If you see something, say something. And when others see me, they do. Because if they’re explaining diet advice and mortality rates to a fat person, no one could mistake them for one.

People will say things to fat people that are heartless, thoughtless. They would not say them to anyone else, and they are not saying them to anyone else. Every warning shot we fire about fatness is aimed at ourselves. It is always a flagellation, a punishment for perceived failings, past or future, real or feared.

In that way, concern hurts all of us. For those who aren’t fat, it continues to feed that anxiety around becoming fat, the unthinkable possibility that always surrounds them. And it hurts our relationships. All of a sudden, all of our familiarity, friendliness and warmth fell away, replaced by prescriptive, cold and sometimes condescending exchanges.

It hurts me as a fat person because of the message it sends. Well-intentioned advice, day after day, week after week, year after year, shows me that I am seen first — and sometimes only — as a fat person. It is a tidal wave of reminders that I am, despite everything else, failing the one measure that matters. No matter how hard I try, how much money I spend or how many calories I ration, no matter how strong my mettle, it doesn’t matter. It can’t be seen. I don’t have the luxury of an uninterrupted day. Every day someone finds a way to show judgment, disdain or concern for the maligned vessel that carries me through the world.

Fat people learn quickly and deeply that our bodies are not our own. They are public property, to be commented on, judged, prodded, rejected. Others are always entitled to our bodies, and they are never our own.

As an adult, I have eked out practices to reclaim my body, just for a moment. I call myself fat. I make jokes about the way I’m perceived. I wear bright colors and fitted clothing. I have found my own peace of mind; set aside that long line of comments to right an eternally haunted relationship to dieting and food; exercised because it makes me happy and makes me feel good. All of that amongst those grimacing masks of concern, a Greek chorus foretelling my tragic death. Was it when your dad left? You are going to die.

You asked if you should care about my health. Of course you should. I would want you to care if I fell ill, or if I were struggling with a health condition. But I’m not. And looking at me won’t tell you how strong I’ve become, the contents of my doctor’s files, the oceans of blood that my sturdy heart pumps through me. My dress size isn’t my medical chart. My body — all of our bodies — are too complex and wonderful to be reduced to that.

I am still fat. I live in the body that I have. I take care of it, and it reciprocates. I take small measures to tend to my own health and take the reins of my own happiness. The Greek chorus is still there, repeating glorifying obesity and glamorizing an unhealthy lifestyle.

What I need from you, dear friend, is to buck that trend. In my life as a fat girl, now a fat woman, I have heard every form of concern, prescriptive, tough love and lecture. I have become an reluctant expert in weight loss techniques, some learned in desperation, others learned by force. I promise, I know.

What I need from you is your friendship. I know what that looks like; what it feels like. It is not pitying, not lecturing, not repeating refrains or insisting on approaches that I have asked you to abandon. Your friendship is a warm and glowing thing, living and responsive, reciprocal and heartfelt. It is not sing-song concern, not a stale script with a wooden delivery.

What I need from you is a respite from that relentless chorus. Take off your mask, put down your script. Sit with me, friend to friend, eye to eye. Let’s talk.

Like this piece? There are more like it, including A request from your fat friend: what I need when we talk about bodies and What it’s like to be that fat person sitting next to you on the plane.