I was at a women's soccer game – I'm a huge women's soccer fan – with a friend of mine, and I was looking at their merchandise and was flipping through the racks. On the importance and impact of saying and hearing the word fat in a neutral way So when we talk about the health risks of fatness, we don't talk about very simple mechanical things like that, that might actually be giving us numbers that are not super reliable because we're using tools that are not designed to measure fat folks' health. Thin people can use those conical blood pressure cuffs without instance, but when fat people try and use the ones designed for thin people, it gives us artificially high blood pressure readings. There are also conical blood pressure cuffs that are designed to fit fatter arms. Most doctor's offices carry cylindrical blood pressure cuffs, which are designed for measuring thin people's blood pressure.

So we are building environments that are hostile, not only to some vanishingly small minority of people, but to most of us. It's worth reminding ourselves in these conversations that in the United States, the average is plus size.

On the myth of the 'average' body and the way it affects our environments, like blood pressure cuffs So this is really sort of a deeply, deeply imperfect tool that we are using, not for the thing that it was designed for, which was population level analysis. For fat people like me, what that means is that doctors offices will code most of our visits as 'obesity interventions,' and that we will, in some cases, be denied even routine surgical care because our BMIs exceed what doctors offices are expecting.

And it has become a major barrier to care, in particular for trans and non-binary folks seeking any kind of surgical care who will be told that they can come back for surgery when they've reached a certain, usually relatively arbitrary BMI level. It was also never designed, tested or adjusted for women. So what researchers have found is that it may actually actively be harming the health of people of color and black folks and indigenous folks for whom it was never designed and was never tested or meaningfully adjusted for. And its reliability goes down from there. doesn't distinguish between fat or muscle or any of that stuff. So we're talking about, exclusively, the bodies of white western European men from closer to 200 than 100 years ago, and we have continued to use that. It was developed by a mathematician, statistician and astronomer, and he was working exclusively with data from French and Scottish military conscripts in the 1800s. The BMI was not developed by a healthcare provider. On the myth of the Body Mass Index (BMI) as a reliable indicator of health

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