She ate less and less, and spent longer hours working out.

But when she looked in the mirror, “even though there was less of me, I was still out of place,” she says.

Over time, it dawned on her that this wasn’t going to make her happy. In fact, it was hurting her. Her blood-pressure levels had begun to yo-yo. Her serum-iron levels had dropped. Through it all, the urge to fade away, to shrink, didn’t go away. It didn’t even lessen.

“I’ve learnt that rarely, if ever, does weight loss bring the sense of bliss and moral superiority that is promised,” says Thomas, an interdisciplinary artist and researcher from Canada who is currently assistant professor of comics, graphic novels and sequential arts at Teesside University, England.

How did we get here, she wondered. To the point where we would make ourselves ill, just to avoid being “ugly”, “lazy” and “sick”. Why is obesity the only condition it remains acceptable to target?

Thomas’s new graphic novel, Shrink, uses medical research, history and anthropology to address these questions. The semi-autobiographical work also details what it is like to inhabit a large body, in a world that views such bodies as a kind of affront.

***

So, what is it like? Thomas likes to lead with a powerful example.

She has a Master of Fine Art degree from University of Calgary. She has a PhD from Concordia University, Montreal. Yet, like the protagonist of her book, whenever something went wrong in her life or her work, her first thought wasn’t: Oh how awful. Or, I guess I must be really tired.

Her first thought was: “I’m too fat for this.”

In the book, Thomas describes childhood experiences that cemented this idea. She recalls being oinked at in school. Having her name on a debate team banner changed to “Plumps” (a nickname she acquired when she fell during a running race and lay splayed out on the school track).

She describes a secret high-school boyfriend who wouldn’t acknowledge her in public, and then moved on to someone else. “I was just PRACTICE,” she writes.

***

A large part of the book, underlaid by extensive research citations, deals with medical bias. Appointment times are shorter for people with large bodies. Patient histories are often skeletal, and medical advice focuses almost entirely on weight, weight gain and weight loss.

In her own experience, she recalls contracting strep throat at 16 and visiting a doctor for an antibiotic prescription. “You could stand to lose some weight,” he said, in passing.

How would that have helped with strep throat, she asks? Why was it okay to give a teenager such an experience, and such a memory?

***

In quick, raw, black-and-white sketches, Thomas recaps how we got here.

Among the hunter-gatherers, fat meant survival. Plumpness remained a marker of beauty, plenty and fertility, all the way to the Industrial Revolution. Then, economies opened up, food became more plentiful, and incomes boomed. Portliness was no longer a sign of unusual wealth or ruddy good health, Thomas notes.

By the 20th century, a turning point. As health insurance became more widespread, and more organised as a profit-seeking industry, weight began to be used as a marker of health again. But this time, skinnier was better.

In 1959, the Metropolitan Life Insurance Company published tables of “desirable weights” (relative to “frame” and height) that would go on to shape the idea of body mass index (BMI). A higher weight-to-height ratio became linked, in this school of thought, to a heightened risk of premature death. Those with a higher BMI began to be charged a higher premium.

Amid a wider cultural shift — led by consumptive writers and actresses; and the romanticisation of emaciated artists, going back to the tuberculosis-stricken poets of the Renaissance — those struggling with bulimia began to be celebrated as beauties, on screens and on ramps, on playgrounds, in classrooms, within the community and the family.

Larger body types, and larger people, became the beasts.

***

Thomas calls her storytelling format “graphic medicine”.

It’s a style of communicating medical information through art that she first experimented with while working alongside sociologist Genevieve Rail at Concordia University. Shrink, five years in the making, formed part of Thomas’s PhD research on the history of the medicalised body with a focus on women’s health. The book was her doctoral thesis.

“I had been wondering if all our findings could be made accessible to the women we had spoken to, and others like them,” Thomas says. “That’s how this storytelling approach evolved.”

The process has been cathartic, she adds, and the feedback to the book, heartening.

The most surprising responses have been from men. “Many reach out to say the book helped them understand how a wife, daughter, mother or sister might be feeling about their bodies. But many also say it tapped into their own struggles with their appearance and health. I wasn’t expecting that.”

Thomas has two more graphic-medicine novels in the works. One will delve into Alzheimer’s disease; the other into polycystic ovarian syndrome.

“Academic research, while integral to policy and real-world impact, ends up alienating the ones it is meant to really help: the layperson,” Thomas says. “I hope graphic novels like this one can help change that.”