Doctors Say Weight Loss Might Be Hurting More Than Helping

What if losing weight isn’t the key to getting healthy — and might even make things worse?

A growing number of doctors say the traditional focus on weight loss overlooks what really matters: habits, well-being, and compassionate care. Most people struggle to keep the weight off long-term, and the pressure to shrink can lead to stigma, stress, and even disordered eating. Instead, experts are urging a shift toward evidence-based, person-centered care that prioritizes health — not the number on the scale.

Rethinking Weight-Loss Goals

Focusing only on weight loss might be doing more harm than good, according to a group of experts writing in The BMJ. They argue that while shedding pounds is often seen as the key to better health, that view may be too narrow—and even misleading.

Dr. Juan Franco and his team explain that most people with higher body weight are unlikely to maintain significant weight loss through lifestyle changes alone. At the same time, weight loss efforts may carry risks, including the potential to reinforce harmful weight stigma.

The researchers emphasize that healthy habits, like eating well and staying active, absolutely matter. But they also point out that body weight alone isn’t a reliable snapshot of someone’s overall health. They urge doctors to focus on evidence-based care that respects individual needs, goals, and well-being, no matter a person’s size.

Lifestyle Limits Exposed

For decades, the go-to strategy for treating obesity has been to cut calories and increase exercise. But recent studies show these lifestyle prescriptions rarely lead to lasting weight loss. Even more importantly, they haven’t proven effective in reducing heart attacks, strokes, or early death.

That doesn’t mean healthy living isn’t worth it—it absolutely is. But by shifting away from weight as the main goal and instead focusing on personalized, compassionate care, doctors may be able to offer better support, improve long-term health, and reduce the stigma many patients face.

Weight Bias & New Paradigms

Focusing on weight loss might also contribute to societal weight bias, negative attitudes, assumptions, and judgments about people based on their weight, which may not only have adverse effects on mental health but may also be associated with disordered eating, the adoption of unhealthy habits, and weight gain, they add.

They point out that recent clinical guidelines reflect the growing recognition that weight is an inadequate measure of health, and alternative approaches, such as Health at Every Size (HAES), acknowledge that good health can be achieved regardless of weight loss and have shown promising results in improving eating behaviors.

While these approaches should be evaluated in large clinical trials, doctors can learn from them to provide better and more compassionate care for patients with larger bodies, they suggest.

Toward Compassionate Care

“Doctors should be prepared to inform individuals seeking weight loss about the potential benefits and harms of interventions and minimize the risk of developing eating disorders and long-term impacts on metabolism,” they write. “Such a patient-centered approach is likely to provide better care by aligning with patient preferences and circumstances while also reducing weight bias.”

They conclude: “Doctors’ advice about healthy eating and physical activity is still relevant as it may result in better health. The main goal is to offer good care irrespective of weight, which means not caring less but rather discussing benefits, harms, and what is important to the patient.”

Reference: “Beyond body mass index: rethinking doctors’ advice for weight loss” by Juan Victor Ariel Franco, Emma Grundtvig Gram, Lene Meyer, Diego Grandi, Benjamin Cruzat, Lene Bull Christiansen and Rasmus Køster-Rasmussen, 25 June 2025, BMJ.
DOI: 10.1136/bmj-2025-084654

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