Focusing too heavily on weight loss for individuals with a high body mass index (BMI) may do more harm than good, according to experts writing in The BMJ. Dr. Juan Franco and colleagues argue that traditional lifestyle interventions based on calorie restriction and increased physical activity are often ineffective in the long term and may unintentionally reinforce weight stigma, leading to negative health outcomes.The review highlights that, on average, individuals with higher body weight are unlikely to sustain meaningful weight loss over time through lifestyle changes alone. Moreover, evidence shows these interventions have little impact on reducing cardiovascular events or improving survival.鈥淒octors 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,鈥 the authors write. They stress that while healthy habits are beneficial, weight alone does not accurately reflect a person’s overall health.The article also warns that focusing on weight can worsen societal weight bias, affecting mental health and promoting disordered eating. Instead, the authors support more holistic, patient-centered approaches like Health at Every Size (HAES), which emphasizes health and well-being without focusing on weight loss.They conclude that quality care should be tailored to individual needs, regardless of weight. 鈥淭he 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.鈥漅eference: Franco J V A, Grundtvig Gram E , Meyer L, Grandi D, Cruzat B, Christiansen L B et al. Beyond body mass index: rethinking doctors鈥 advice for weight loss BMJ 2025; 389 :e084654 doi:10.1136/bmj-2025-084654