a heap of ideas and a heap of woes

Just the fact that so many people talk about "feeling fat" and "looking fat" despite not actually being fat, betrays that it's fucking not all about health. People fear even this perceived proximity to fatness. "I feel fat today" means "I feel ugly and therefore some kind of unworthy". "I look fat in that picture" means "I appear uglier than I consider myself to officially be". Neither of them means "I feel compelled to check my cholesterol" or whatever