There are no proven long term benefits of weight loss. In addition, weight loss is almost always unsustainable, which means those who attempt weight loss are likely to regain it within a few years (Mann, 2007).
There are a number of medical conditions that are associated with being Higher Weight. These are often referred to as “ob*sity related conditions”. Due to fatphobia within the medical field, doctors falsely assume that weight loss will prevent these conditions. That is because they fail to acknowledge the numerous reasons why being higher weight increases a person’s risk of illness (including inequalities in healthcare, weight stigma, weight cycling, and social determinants of health). In the case of type 2 diabetes, for example, there is no evidence that losing weight will reduce the risk of long term complications such as a heart attack or a stroke. And yet almost all diabetes specialists and educators recommend weight loss (Look AHEAD Research Group, 2013).
There is no question that thinner people are treated better in all areas of their lives. It therefore makes sense that Higher Weight individuals feel better after they lose weight. However, there is no evidence that this improves health outcomes beyond the short term. For example, one study shows that people with osteoarthritis of the knee who were forced to lose weight prior to their joint replacement surgery were no better off after a year, let alone after seven years (Torres-Claramunt, 2016)
There are numerous risks including the physiological consequences of semi-starvation (fatigue, metabolic disturbances, hormone disturbances, malnutrition etc.), and the psychological consequences of semi-starvation (mood changes, anxiety, reduced memory and cognition, low self worth etc). The Minnesota Semi Starvation Experiment gives us q good deal of insight into what happens when a group of volunteers reduce their calorie intake to 1600kcal/day (Baker 2013).
Since weight loss is unsustainable (see above) and the majority of higher weight individuals have been encouraged to make multiple attempts to lose weight over their lifetime, they become weight cyclers (sometimes known as yo-yo dieters). It is safer to maintain a stable weight (regardless of what that weight is) than to weight cycle and the metabolic consequences of weight cycling outweigh any known benefits (Li, 2023).
Intentional weight loss is a risk factor for eating disorders (Polivy, 1996). Higher weight individuals are more likely to go undiagnosed, and if they do receive a diagnosis, they are less likely to qualify for treatment. Restrictive eating disorders are common in Higher Weight individuals but these patients are often ignored or misdiagnosed by their doctors. Finally, intentional weight loss should never be recommended to a person with a history of an eating disorder, and yet this is routine practice.
A doctor is duty-bound to ensure that you are fully informed before you are able to consent to treatment. They must explain all of the risks, benefits, long term consequences and alternative options (including the option of no treatment). So whilst a doctor can recommend weight loss, they must ensure that you are fully counselled otherwise they are in breech of their duty of care.
This is a challenging question to answer because it has become commonplace in many areas of medicine, and there are number of well established excuses that are hard to challenge. One could argue that since there is no safe and effective way to shrink our bodies in the long term, forcing us to lose weight in order to access medical treatment is illegal. However, such a case has not yet been tried in court.
All of us hold negative beliefs, assumptions, and judgements about Higher Weight individuals. This is because we have been conditioned to think this way by society from a very early age. As a result, higher Weight individuals are excluded from many areas of society including employment, healthcare, housing, travel, community etc. This results in a loss of financial, social and political capital, which in turn leads to poorer health outcomes. Medical weight stigma refers to the consequences of the anti-fat systems, structures, and beliefs of individual practitioners.