Weight Loss Prescribed Without Context

The first time a doctor told me to lose weight, I was an underweight teenage athlete.

I was recovering from multiple ACL surgeries complicated by a severe post-operative infection that landed me in the ICU. I had lost a significant amount of muscle mass in a short period of time. This was not intentional weight loss, and it certainly was not healthy weight loss. It was the result of illness, immobility, medication, and months of physical stress on a body that had previously been strong.

At a routine orthopedic follow-up, new measurements were taken for my chart. I weighed less than I had in years, even accounting for some recovery since hospitalization. A physician I had never met reviewed my chart without looking at me and explained that my osteoarthritis was severe. Then came the recommendation.

If I continued gaining weight, I was told, I would wear out my knee and need a replacement decades earlier than my peers. The solution offered was simple: use my body less. Avoid impact. Avoid loading. Avoid movement. Keep my weight down.

What struck me wasn’t just what was said. It was what wasn’t.

There was no discussion of body composition. No acknowledgment of muscle loss or skeletal muscle mass. No distinction between fat and lean tissue. No conversation about nutrition, recovery, or how strength could support a compromised joint. No plan. Just a number on a chart and a warning attached to it.

The implicit message was clear: smaller is safer.

At the time, I didn’t yet have the language to name what felt wrong. I only knew that the advice was deeply demoralizing. I was not being treated as a whole person. I was a data point. A BMI calculation. A knee attached to a number that needed to go down.

Years later, I understand the broader issue.

Physicians are trained to diagnose and treat disease. Most are not trained in nutrition science, body composition assessment, strength and conditioning, or the psychological risks associated with weight-focused advice. When weight loss is prescribed without context, without tools, and without a plan, it can do real harm.

Telling someone to “lose weight” is not a treatment strategy. It is not actionable guidance. And when delivered without nuance, it can reinforce disordered eating, undermine recovery, and reduce long-term health outcomes rather than improve them.

Weight alone does not explain joint health. It does not capture muscle mass, load tolerance, metabolic health, or functional capacity. Advising someone to eat less and move less in the name of preservation often does the opposite. It slows metabolism, accelerates deconditioning, and increases fragility over time.

This is not an indictment of medicine. I am firmly pro-doctor and pro–Western healthcare. It is a reminder of scope. Expertise matters. Nutrition is nuanced. Strength is protective. And health is not defined by having less gravitational pull on the planet.

If you have ever experienced the sinking feeling of being told to lose weight without being given the tools to do so safely, sustainably, or intelligently, you are not alone. Your body deserves more than a directive. It deserves a plan.

Body composition is complex. Nutrition is contextual. Health should be viewed holistically, not reduced to a single number on a chart.