I am the opposite polarity. I am a big guy. At my lightest I was 200 while going to the gym six days a week. I haven't been able to stay in that kind of shape for a while. It isn't easy but medically losing weight is the correct option. However the ammount of support that requires is more than most people can access under capitlaism. I am way below a doctor. However when I have been. Working with patients I do always try to get them to lose weight. The most that can be reasonably expected of a person is to make small lifestyle adjustments and hope they increase functional capacity. Just saying, " lose weight" is counterproductive per the literature I have seen. Most people are the size they are because of factors outside of their control. It starts with childhood. Both my parents were big and fed me the same so I grew up big and as such was never that active as a child. By the time I had the ability to manage my own life I had my entire childhood to correct and I have never really succeeded.