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"When you're willing to play the clown, I think it lets people off the hook. But when you start talking about weight, it gets a little bit too real for people."
When you've been a fat kid, a little bit of that fat kid stays with you, no matter if you stay fat or not. But how to cope with that? Well, that's exactly what comedian Ian Karmel and his sister, Alisa Karmel, PsyD, aim to tackle in their poignant memoir T-Shirt Swim Club: Stories From Being Fat in a World of Thin People (June 11). "I've seen so often that people's representation with fat was either as a punchline or as an object of pity. And I hated that we were either Cartman [from South Park] or the whale," Ian says. The two write about growing up fat and not addressing it. Eventually Ian's weight would reach 420 pounds when he decided to lose the weight, but not his humor. "I had two goals in writing my part of this book, which was to be as honest and as vulnerable as possible and even harsh on myself. And be clear about my opinions and my feelings and what I went through. I was like, if I'm gonna get my story out here, and help my sister get her story out there and her professional opinions too, I'm gonna have to do it through being funny."
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Editor's Note: This conversation has been edited and condensed for publication.
As a former fat kid, I've always thought, once you're a fat kid, you're always a fat kid, don't you think?
Ian Karmel: Alisa and I, one of the things we thought about naming it was Fat is Forever. And that's something we did touch on in the book as well, because if you're a fat kid, if you're fat ever, you get a sense of how the world treats fat people, both benignly and malignantly. You never lose that. And especially if you're a fat kid, that's a foundational part of your upbringing that stays with you forever. When I was at my lightest, I got down to 220 or whatever, still my brain was locked in fat mode all the time. It will shape the rest of our lives. That's why it has to stay a constant relationship.
Alisa Karmel: A lot of people that I work with, they go through all the dietary steps, fitness steps, the stress management steps, you name it, to try and improve their health. And they do, but then they come and work with me and they're like, I still haven't addressed my mindset. Like, I've made all these changes, I've lost all this weight, my body fat percentage is reduced, but I still have this—we call it dissonance in psychology—that I'm still a fat kid in my head, even though I'm a 56-year-old person and my weight significantly reduced. And I personally experienced that too. It's a really hard part of it.
Ian Karmel: The second you think you're not a fat kid, when you're a fat kid... Like, if I'm ever in a room that has a box of doughnuts in it, my relationship is to that box of donuts first. If I'm eating it, my relationship is to it. And if I'm not eating the donuts, that's also the dominant thing going on in my head. 'Not eating these donuts. I'm not eating these donuts. I'm not eating these donuts.'
I can remember when I lost a lot of weight and I was doing stand-up and I'd be telling jokes about being fat, but they wouldn't connect because it's not how people saw me. Ian, do you experience that at all?
Ian Karmel: Yeah. It was jarring. The first time I got up on stage after I'd gotten to a much slimmer weight was crazy. Because you realize you've been shaping your stand-up comedy career based on how the audience perceives you. But deeper than that, you've been shaping your entire life based on how everyone perceives your personality. The way you can find that you fit into social groups or social structures is all predicated on I am different. And I am different because I am fat. How do I make everyone else comfortable with that? And then make myself comfortable with that. But it was wild. I tried to tell jokes about losing weight, and even those didn't hit.
I noticed that too. People don't want that. It makes them uncomfortable. And, as a fat person, you can see it in their faces. When I get on a plane, I know people are thinking, 'I hope he doesn't sit next to me.' Fatness is scary for people, even if it's just a joke about losing weight, it's too real. It's almost like you're talking about death, it just stops the room.
Ian Karmel: It is. You are kind of talking about death, right? And when you're willing to play the clown, I think it lets people off the hook. But when you start talking about weight and the motivation behind losing it, it gets a little bit too real for people. I was doing [a show] here in LA., and I had tried to tell some jokes about losing weight. They didn't really work super great. And once jokes aren't going well, you rely on your old Get Out of Jail Free card jokes. I'm sure you have the same experience, when you try to use those and they land wrong, the audience isn't looking at you and thinking, 'Hey, there's a person who weighed 420 pounds their entire life.' They're looking at someone who's like, 'Hey, you look like somebody who enjoys jogging. Why are you making fun of fat people?' And a woman came up to me and very nicely, but still verbally, was like, 'Hey, I don't think you should tell those jokes anymore. They're not landing the way you want them to.' And it was nice. It was someone putting into words [something] that I had been suspecting in my head for a while.
Alisa, why is this book important for the people to get inside the thinking of what it's like to live in a larger body? And how we can exist in that way and communicate about it?
Alisa Karmel: I mean, you're not alone. And I think something that we really tried to drive home with this book is that it is so isolating to be the fat person or to have a fat past. Our weight fluctuates as we grow. I just had a baby; I'm dealing with another fluctuation. I'm like, 'Oh, my God, what is this body?' It just constantly evolves and it's so easy to hate your body. It's like weight is just another thing to hate. I see so many people have such self-deprecating thoughts and have depression and have anxiety and all these mental health diagnoses, that the core of it is the way they feel about their body and how much they hate it. And so, I think the importance for me with this book is to increase your awareness and see how we can change your relationship with your body and maybe work on those health behaviors, because I think a lot of people are guilty of not really taking care of their bodies. So how can we find a way to love and accept your body, which takes a lot of effort, and then also take care of it. And I think those can happen at the same time. It doesn't have to be one or the other. And I think that's a mistake people make. Like, I can accept it. Okay, so does that mean you don't have to improve it? I think improving it and accepting it is a hard job to do. But I think both are necessary to live a happy life and a healthy life.
And when you can pinpoint that moment, especially for people who suffer from overeating or binge eating, when you can pinpoint that moment when the shame started. I have a moment where I remember I was eating Frosted Flakes and my brother commented on the second bowl that I was eating. I can viscerally remember the shame from that moment to this day.
Alisa Karmel: I think it's about acknowledging it first and having some compassion about it, because I think a lot of people are like, 'Dammit, I failed.' A lot of it happens during adolescence, and then we just kind of stuff it down. And every time an emotion comes that's provoked from a memory about that, we just eat and eat and eat and then maybe have a compensatory behavior, throwing up or exercising a lot or fasting or just being mean to yourself. It happens over and over and over until you call attention to it.
Ian Karmel: You're 100 percent right. Moving on from it is a good thing to try to do. I also think you should be prepared for a world where you never move on from it. You have to sort of learn to deal with those impulses forever. I have found when I'm at my healthiest and when I'm addressing my anxiety, I do feel those impulses less. I feel them every now and then. And this is so, like I am rolling my own eyes at what I'm about to say, but one thing I discovered in meditation, which is a thing I started getting into to address my anxiety, is how to deal with intrusive thoughts. Not try to just stuff them into a trash can or stuff them deep down and get rid of them, it is to acknowledge their presence. 'Hey, I see that you want to eat an entire tray of lasagna right now. I acknowledge you wanting to go into the kitchen and do that over the sink. We've done that before. I acknowledge that thought. We're not going to do that right now. I'm gonna go get a sparkling water or we're gonna have an apple or we're gonna go for a walk or whatever.' I think learning to live with them as much as put them in the past has been helpful for me at times.
One of the things that I've found is that for many of my straight male friends, talking about weight and body image issues is almost impossible. Have you found that?
Ian Karmel: We are behind on a lot of stuff, and one of those is acknowledging that we have those feelings. Gay men and women tend to have those conversations more openly and more often. And they can turn toxic. Absolutely. But at least they're having those conversations. And at least they're also having nontoxic versions of those conversations. What I have found, and again, speaking in generalities here, straight men don't really ever acknowledge those feelings existing. They don't have conversations about them, certainly with their friends, which is crazy, because we definitely feel them, and we definitely think them, and we definitely feel less than. You're watching Jason Momoa as Aquaman or whatever and I'm thinking, 'Well, I should have gone to a different movie.' Or maybe you're thinking, 'Hey, this is awesome.' Whatever you're thinking, there is a part of you in the back of your head being like, 'Man, I don't look like that with my shirt off. What did he do with his body here? How come his abs look like that? He looks strong.' You're going through all these things in your head, and you don't really talk about them. We're getting there, men are getting their toxic body moment. And I think the way it's manifesting itself is through hyper diet control, weighing grams of protein per day, versus like amount of carbs. And they come from it in that you have to eat them this close to the workout. So, it's trying to claw our way into that body conversation as masculinely as possible. Where it's like, Jason Bateman only eats this much food and that's why he looks like this at 50. Or we analyze Travis Kelce. It's like, how to prepare your body for a kind of war.
With that said, Alisa, how do you address it with men medically? Because they're not watching Oprah or reading the magazines about it.
Alisa Karmel: Men are the protectors. That's an identity that they really relate to, and you can't protect others if you're not protecting yourself. So, most of the men that I'm working with, they have families and they're the breadwinner, or one of the breadwinners that are there taking care of them. And they're like, I just don't have time, I need to dedicate all of it to making money. And it's like, 'Well, how are you going to make money if you're on a hospital bed? We got to really zoom in. I know that sounds a little bit obvious, but for a lot of men, it's really hard to pause and be like, 'Okay, what do I need to do to protect myself?' And I feel like once we get in that way, they might be a little bit more willing to have the conversations that are really difficult.
How do you find the balance between having the real conversation about taking active steps to not only have a good mental health outlook, but also a good physical outlook, while also keeping It funny?
Ian Karmel: I just wanted to avoid things that I'd seen in the past and no shade on the people who have attempted to communicate being fat, losing weight, health, all that stuff. They're very complicated. They're very emotionally loaded. But I've seen so often that people's representation with fat was either as a punch line or as an object of pity. And I hated that we were either Cartman or the whale. I hated that. Either you are Kevin James, or you were My 600 Pound Life. I could keep going. I didn't want [the book] to be maudlin or overly serious, because I think people tune out when that happens, because I've tuned out. I've had doctors try to have serious conversations with me, or when I've watched a documentary that's like, 'you're gonna die if you keep doing this kind of thing.' And it gets too dark, and you glaze over. We're still humans, we crave entertainment, and we crave more than empathy and people relating to us. So, I thought the only way I know how to relate to people is through humor. So, I had two goals in writing my part of this book, which was to be as honest and as vulnerable as possible and even harsh on myself. And be clear and about my opinions and my feelings and the thing and what I went through. Every time I've talked about these stories, I have tried to approach them to find the humor in them. Because oftentimes when you're on-stage doing stand-up, I'm sure you've seen this, you can get laughs from surprise. You can also get laughs from relation because people like relating to things, they like to bring up a feeling that people didn't know they had. And there's this relief and delight that comes from that. So, I tried to find those through trying to get as specific as possible and as honest as possible, try to find those moments that people could relate to, and try to think of them in metaphors that would maybe make them easier to digest or to make these feelings more relatable to people who hadn't been through them. And at the end of the day, it's just the only way I really know how to write I don't like those maudlin views. I don't think I could write one. Certainly not a successful one. So, I was like, if I'm gonna get my story out here, and help my sister get her story out there and her professional opinions too, I'm gonna have to do it through being funny.
Yeah, the scare tactic never works. That whole egg in the frying pan, 'this is your brain on drugs' tactic, it doesn't work.
Ian Karmel: The egg in the pot thing is such a great point. Anyone who's been fat, you've had people trying to terrify you from the second you became aware that you were fat. And I did stop going to the doctor, I stopped putting myself in positions to hear from those people who would try to scare you. Rather than saying, 'Boy, I better address these issues.' I was like, 'Boy, they sound pretty serious. Better not put myself in a place where I'm gonna have to hear from them ever again.'
I can so relate to that. I gained weight during the pandemic and was terrified to go back to the doctor once it was safe. Alisa, you must experience that all the time with patients?
Alisa Karmel: All the time, all the time. And even when folks don't go in for weight related things, as soon as that scale gets read and the doctor looks at the number or the blood pressure cuff, as a fat person, you know I'm about to get yelled at, I'm about to get ambushed with all sorts of advice and I'm just gonna shut down. And then it becomes the chief complaint even though that's not at all what the patient went in for. It happens all the time. And I've only recently started saying like, 'Hey, can we not talk about my weight?' And they don't know what to do with me.
Another big part of this conversation needs to be about some of the new medicines available for weight loss, like Ozempic or Mounjaro. Full disclose, I'm on Wegovy, a form of Ozempic, and it's been a huge help for me to get my weight under control. How do you initiate conversations around these new drugs?
Alisa Karmel: I don't think that they should be scolded. I don't think that anything is off the table when it comes to being healthier and I think it's worth exploring different approaches, whether for somebody that's shifting their diets, shifting their exercise, pursuing weight loss surgery, trying a medication, these are all options. And I feel like there's so much research going on about them, you just need to know what you're getting into. I think that a lot of folks who get into these options don't really fully know what they're getting into, and then that's where the issues arise. But when you do the research, which as a fat person who's hopeless, you're gonna do the damn research, you're gonna look it up, you're gonna know the ins and outs of what you're doing. That's what bothers me, folks come to me, they're like, 'Is it bad I'm on Wegovy? Is it bad that I'm pursuing surgery?' No. Let's talk about what that's going to mean for you and how you're gonna be able to stay committed to that to live a life of values that you want. That's where that's my stance on it, and I know that's not a popular stance, but that's just what I believe.
And people not wanting to talk about using Ozempic, it's the opposite for me. As a comic all I want to do is talk about it.
Ian Karmel: What are you talking about at dinner parties as you're pushing a chicken breast around or whatever. It's so interesting, as we've been out talking about this book a little bit, a few different people have tried to bait me with that because I lost the bulk of the 200-pound chunk of weight to get myself to a healthy position where I could then fluctuate, and people are like, 'Are you mad at the people who now use the drug? Because you didn't do it? Because you did it the hard way?' And I'm like, 'Hey, it's all the hard way.' There's not an easy way. You can't really understand that until you have been 350 or 300, or 400, or that weight where you're like, 'Boy, I am pretty far.' I don't need to lose 10 pounds, I don't need to lose 20 pounds, to be healthy, to have my blood pressure at a point where it should be, that my heart is in a place where it should be. It is medically advisable that I lose more than 100 pounds. And that seems insane. That number is saying, 'Hey, I need to lose 100 pounds.' And then you think about how hard it is to lose two pounds. That it's like, 'Well, you know what? I'm gonna get Panda Express for dinner.'
Alisa Karmel: And that's the part that I think is important. If somebody's using a medication and getting Panda Express for dinner, like that's a conversation we need to have. Because obviously, there's a disconnect there that the medication isn't just a free ride, nor is the surgery. And you can probably speak to that. You don't get to just keep eating whatever you want and use this medication.
Exactly. And also, if someone is turning to medicine or surgery, trust and believe this isn't the first time they've thought of losing weight. It's not like they heard about the shot and were like, 'Well finally, I guess I can start losing weight now.'
Ian Karmel: They don't put down a doughnut and pick up Ozempic. The amount of time between those two things is a lifetime.
Alisa Karmel: And likely the medication or the surgery is actually going to be more affordable than dieting because most diets aren't covered by insurance and some medications, and some surgeries are. Some folks are in positions where they can't even afford to have a healthier lifestyle. So, this is a lifesaver for them.
Ian Karmel: I think the ultimate goal for anyone whose weight is at a place that is unhealthy, and I keep saying that, because I think you can be a little fat and still be healthy, right? I'm speaking to the point where how fat you are is affecting the quality of your life and the duration of your life perhaps. Whatever gets you to that point where you're around longer for the people who you love and who love you, that's beautiful. And I guess what would be my hesitation about Ozempic, Wegovy, any of those drugs is the same hesitation that I have about any diet, including the one that I did to lose the 200 pounds—which was to have food delivered to my house every morning, I was doing intermittent fasting, and it was protein, vegetable fruit, right? Okay, so let's say you go off even the food delivery thing for a couple of weeks. Now, all of a sudden, whether it's the food delivery, or Wegovy, or the all juice diet, or whatever it is you did, now you're out in the wilderness? Do you know how to build a healthy life for yourself outside of these harsh restrictions that perhaps you needed to place on yourself? Because you weren't great at making decisions. So then how are you setting yourself up to succeed? Have you learned to have a relationship [with food]? Do you have the tools? No matter what the fix is, that's the thing that's going to make it stick.
Ultimately, what do you hope people take from the book?
Ian Karmel: There are all these things that society does to fat people that are terrible in pop culture and that we do to ourselves and that we do in relationships, but you're the person at the end of the day, if you want to make a change, you have to be that person who makes that change. And it sucks what society does to us. But you can't die because society sucks. You can't hurt because society sucks. You can and you will. But at the end of the day, I think get yourself to the doctor and just know it's gonna suck. But know that that sucks a whole lot less than having a stroke.
Alisa Karmel: The doctors are working on it. Also, after going through so much education, near the end of my education, I started noticing a little bit more awareness of, 'Hey, this is how to talk to somebody if they're fat.' What a concept. And it's new. So hopefully, doctors will have a little bit more comfort talking to somebody who's fat. And then once that happens, we'll actually have some helpful strategies to talk and to hear and to just create a more supportive environment, which I feel like is the issue. I think my biggest goal with this was to instill hope. I didn't have hope for most of my life, I just thought, 'I'm fat, I'm doomed. It doesn't matter if I get smarter, it doesn't matter if I do anything else that's successful because I'm fat. Everything won't matter.' And then all of a sudden, I went and achieved a doctorate while I was fat, and I met my husband and I had a baby, like, you can do things and be fat. I identify as a fat healthy person. And it's possible. I didn't think it was and I wish I had heard something that instilled hope in me when I was younger, and it never happened. So, I'm hoping I can be that voice to some parents, to some adolescents, to some teachers, to some doctors, to all those different populations. There is hope.
