I was really disappointed with your response to the woman who wrote to you complaining that her partner was overweight, and therefore, undesirable (June 29). I wonder if there are issues on the side of the writer too?  Maybe she has some things to think about in regard to her attitude towards fat, health and body image as well, particularly because of her own "health conscious" background (which may also have been biased in regards to body size, shape and fitness). As a clinical psychologist working with eating disorders, I am concerned about blaming, and shaming, "fat" people.

Writing within the constraints of a word limit it is not always possible to cover all  angles on a topic. This letter from Dr Annette Ostermeyer (annette.ostermeyer@bigpond.com) raises important points.

“Bodies change all the time, due to weight gain (or loss), but also due to ageing, pregnancy, disability or illness," says Dr Ostermeyer. "Why is the onus always put on the overweight person – that they must change – rather than the other person also thinking about why they are so easily repulsed by body changes?  Desire is not just about physicality – it has so many layers and the body is one of them.  So it's OK to reject someone who is fat, but not OK to reject someone who is chronically ill or disabled?  Will it be OK if he tells her he no longer finds her desirable when she is pregnant, or has a 'baby belly' after having one or more children?  Will she be happy with him leaving her for a 20-year-old in a few years, because her ageing body is no longer 'desirable'?”

An eating disorder is often the symptom of other, deeper psychological problems. Dr Ostermeyer continues, “Maybe this relationship has issues in other areas and this is where her dissatisfaction is being played out?  Maybe he resents his wife buying a couples' gym membership that he didn't ask for – and maybe these behaviours occur on other levels and with other issues.  Maybe he has some deep insecurities that he hasn't spoken about, because he's male and men struggle to talk about these issues in the way women minutely dissect them.”

At the time that I was writing the original column, I discussed the issue with Melbourne fitness coach, Wendy Ritchie (writchie@bigpond.net.au). She, in turn, talked about it to a group of her male colleagues. She was surprised by their unanimous response that sex was the most effective motivator for their male clients. The idea that they might no longer be able to have sex was far more compelling than thoughts of illness and death. However, Dr Ostermeyer observes, “that sex can be a very strong motivator for men, for physical reasons, but also because I feel that men experience connectedness and intimacy through sex”.

All of us tend to go through life judging the people we encounter. Sometimes, we realise that the thing we dislike in someone else is a thing we dislike about ourselves. Sometimes, we are ruled by the ego, seeing ourselves as right and others as wrong. These tendencies can become entrenched in long-term relationships.  If something about your partner is really bothering you, look inside to your own flaws, weaknesses, failures and insecurities before you roll up your sleeves and set about "fixing" them.

Tackling a situation that is affecting your relationship is best done as a team. Couples counseling can be useful in enabling both partners to understand all sides of an issue, and what role their personal traits play in creating stress and unhappiness.

Finally, we all need to challenge our societies' fetishising of the "perfect body". Where there is love, goodwill, trust and authenticity there can be desire. Where there is intimacy, unconditional acceptance, playfulness and connection, partners can feel safe and supported, and this is what ultimately gives each person the courage to love themselves, and to care for their own wellbeing.

Please send your questions to abtlastnight@gmail.com