Weight-loss focus may harm obesity patients, experts warn
Focusing only on weight loss in people with obesity could cause more harm than good, medical experts have said.
Standard advice to eat less and exercise more often fails to deliver sustained weight loss and may reinforce harmful weight stigma.
Although widely promoted, these strategies have shown limited long-term benefits for reducing events such as heart attacks or strokes.
The BMJ commentary, published by Dr Juan Franco and colleagues, argues that body weight alone is a poor measure of health.
Instead, they call for care tailored to individual needs and based on the best available evidence, regardless of a person’s size.
For decades, people with a high body mass index (BMI) — a calculation of weight in relation to height — have been advised to cut calories and increase physical activity.
But studies show these efforts rarely lead to lasting weight change.
The authors also warn that a strong focus on weight can fuel bias — negative attitudes and assumptions based on body size — which has been linked to poorer mental health, disordered eating, and even weight gain.
They highlight growing interest in alternative approaches such as Health at Every Size (HAES), which focus on improving health behaviours without aiming for weight loss.
These models have shown encouraging results in changing eating patterns and supporting wellbeing.
The authors wrote: “Doctors should be prepared to inform individuals seeking weight loss about the potential benefits and harms of interventions and minimise the risk of developing eating disorders and long term impacts on metabolism.
“Such a patient centred approach is likely to provide better care by aligning with patient preferences and circumstances while also reducing weight bias.”
While more large-scale studies are needed, the authors suggest these models offer useful lessons for clinicians aiming to provide respectful, personalised care.
They concluded: “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.”
