Sonalee Rashatwar hadn’t planned on being a therapist growing up. Her career path, she explained while sitting in the waiting room of Radical Therapy Center, the practice she co-owns in West Philadelphia, just kind of happened.

Rashatwar, now 31, endured an abusive relationship in her early 20s. After college, she started volunteering for a domestic-violence response team, an experience that showed her that she enjoyed working with other people who had lived through traumas.

“All of my work is to better understand what I’ve experienced,” said Rashatwar, who graduated from Temple University in 2011. “It’s almost like I’m healing younger versions of myself by trying to find language to describe what happened.”

As the fat-positivity movement has gained momentum, so, too, have debates around how fat folks should lead healthy lives. Rashatwar, though, considers how sizeism is affected by racism, misogyny, classism, homophobia, transphobia, and ableism, and she counsels people against intentional weight loss.

She pointed to the work of the artist-activist Ashleigh Shackelford, who has written that wearing clothes from the boys’ section growing up, when many items for girls didn’t fit, altered how Shackelford experienced gender. Rashatwar, who noted that people may perceive feminine bodies as more masculine if they’re fat, feels similarly about her upbringing. Being big and being the eldest child, she said, made her feel less like a girl growing up.

Her perspective, one of a fat South Asian nonbinary person, has gained enhanced notoriety through Instagram, where she often posts telegram-like advice to the account @thefatsextherapist. Last July, she celebrated 4,000 followers. Today, her follower count approaches 20 times that.

She posts her advice in colorful blocks of text (“your body is an heirloom," “do you consume porn with bodies that look like yours?”) and then expands on those concepts in the captions.

Rashatwar traces contemporary fatphobia to colonial brutality and how enslaved people were treated. Citing researcher-advocate Caleb Luna, Rashatwar said curing anti-fatness would mean dismantling society’s foundation: “I love to talk about undoing Western civilization because it’s just so romantic to me.”

We asked Rashatwar, a proud South Jersey native, about Instagram therapy, controversy over some of her comments, and how fatness affects sexuality.

This interview has been edited and condensed for length and clarity.

On the effects of fat trauma

"What some folks think is trauma is like the event itself that happened, like the car accident that I got into is the trauma. But that’s the event. What trauma is, is what gets stuck in my body. And the way that I react when I’m in a car in the future and it stops really quickly. That’s a trauma response.

“And so when we internalize fatphobia and we really, like, personalize a fat, traumatic experience, it can impact our sexuality by making it uncomfortable to receive a hug because we feel like, ‘The person hugging me is probably so repulsed by touching my body. Let’s just get the hug over with quickly.’

"Even though sometimes we’re starved for skin touch. Some of the fat clients that I work with, the only time when people touch their bodies is when they pay for a massage or when they’re paying for Reiki or some other kind of somatic body work. And that can feel devastating when that’s the only time that someone’s affectionately, lovingly, caringly touching your body.”

How self-worth can influence sexual interactions

"When we teach someone to experience shame based on your body, whether it’s about race, body size, disability, and we internalize that shame, we internalize this sense of our body having less self-worth than other bodies.

“When we internalize a low self-worth and our body having less value, we might be less likely to experience pleasure within a sexual relationship or to ask for the type of touch we want and don’t want within a romantic relationship. Or to be able to even stop a sexual encounter when we want it to stop.”

When body-image abuse comes from a significant other

“If we haven’t received comprehensive sex education, we don’t know what our sexual rights are and what our rights to pleasure are, the kind of treatment we deserve. And oftentimes we, we tolerate body-image abuse from partners. I work with clients who are recovering from an experience with sexual assault and a partner will say, like: ‘I get you’re depressed, but like, it’s been a week since you’ve been in the gym. And if your body changes because of this, I’m not in this. I’m no longer going to be attracted to you. I’m going to dump you. I’m going to leave this relationship.’ It’s pressure to maintain a body size in order to maintain a relationship.”

Being an ‘Instagram therapist’

"It’s super-overwhelming sometimes because with so many followers on Instagram, it feels like there’s a pressure to produce content all the time. And I feel like I need to be putting out something new and super profound. Like no one’s ever heard of this concept, every day. But I don’t do that because that’s so overwhelming. A lot of folks will reach out into my DMs and ask really personal questions.

“It’s also really gratifying. So when I post really, really political and radical content where I’m talking about like being anti-cop, anti-U.S. government, anti-military folks are like, ‘Whoa, I’ve never heard these ideas before.’ ”

Her comments on the Christchurch shooter

“The language that I used in that talk that I gave was actually that I was not surprised that the person who shot up the mosque in Christchurch, New Zealand, was also a fitness instructor. I was not surprised by that because people who are Nazis, people who are white supremacists, people who are trying to think of the perfect race are also super fatphobic. … Oftentimes it’s very eugenic.”

On pushing for better health access

"[An] almost universal collective fat traumatic experience is like going to the doctor, and how BMI and the body mass index scale is used universally to categorize and pathologize bodies based on fatness. One really important macro way that we would have to undo fatphobia would be to finally get rid of BMI, to not use it for insurance purposes. Because people who are of my BMI category and up are denied insurance coverage, are denied lifesaving procedures and medication, are denied gender affirmation surgery, are denied all kinds of things that we deserve access to — fertility treatments and IVF.

“That’s one really big macro way that I could think of. Because BMI has already been debunked.

The ‘fat’ word

“I always respect the language that people want to use. Even when I’m working with a client, I’ll ask. I’ll say, ‘I’m comfortable with using the word fat, but if there’s another word that you’d like to use, I’d be more than happy to use that.' And so sometimes, I have clients willing to use a word like fluffy, or curvy, or even plus-size. And that’s fine. I’m happy to use different language, but I will challenge and I will ask, What is it? Where are, like, the genetic memories attached to the charge of this word? Because the word itself doesn’t have to be emotionally charged. But there’s stuff there that we should explore together.”