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For Carmen, it's her body issues that are standing in the way. Weighing close to 300 pounds, she says her body feels like a "fat suit" that she can't get out of. Calling her bedroom her "little cave," Carmen says she stays in bed as long as she can so she doesn't have to deal with the outside world.

When she first meets with Dr. Berman, she tells her she'd like to be in a relationship, but she can't accept that anyone would want to be with her. Recently, she says there was a man who seemed interested, but she blew him off because she got scared.

Dr. Berman: What's the worst thing that can happen?

Carmen: The worst thing that can happen is that we get to the point where we're, you know...

Dr. Berman: Where you're what?

Carmen: We're about to have sex basically.

Dr. Berman: Okay.

Carmen: And I'll have to be naked and ... it would just turn him off. Like he would scream, "Oh my God, that's disgusting." Then just kind of leave.

Dr. Berman: Would you feel any worse than you feel now?

Carmen: I think I would. Worst case, yeah, if I grew the nerve to actually get to that point and then someone were to just reject me.

Dr. Berman: So your fear—both of those fears—end up in the same place. Where you're alone.

Carmen: Yeah.

Dr. Berman: And that seems really scary and sad to you. ... What are you feeling?

Carmen: I just feel hopeless—like it doesn't matter. Like sometimes I think, "Why bother?"

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