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I’m delighted to gain this protection against COVID-19, but given my history of weight-based discrimination within the medical establishment, I can’t help worrying about the potential scrutiny I’m subjecting my body to. I don’t take my ability to get vaccinated for granted, especially given how long many restaurant workers, delivery workers, and other essential workers have been waiting for the same right; if I’m vaccinated, I’ll be able to know that I’m at less risk of spreading the disease to someone worse positioned to recover from it, and that’s reason enough for me. But even as I made my appointment, I felt a little funny that my BMI, a label I’d always brushed off as arbitrary—or, more accurately, expressly fatphobic—was what was allowing me to get my slot.

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BMI-based vaccine eligibility could represent a pivotal moment for the fat-acceptance movement, but it’s also a difficult one for many fat people. After all, most of us are so used to having doctors judge and shame us for our weight that the concept of it entitling me to something beneficial feels entirely unfamiliar. For years, I’ve been delaying annual physicals for fear of weight-related judgment and having my weight brought up in totally inappropriate contexts, as when a gynecologist paused my routine pelvic exam to extoll the virtues of a brisk daily walk. (I take one every day, and I’m still fat, but thanks, Doctor! Can we get back to my cervical health now?)

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