No, they're making a choice between the long-term negative effects of not losing weight naturally, vs the possibility of long-term negative effects of using artificial methods. This isn't polemic, as even things as basic as birth control and advil have negative long term effects.
I think we’re saying the same thing? The only difference is that I personally don’t believe that self-control is sufficient for everyone to lose weight. If you do believe that, then the risk estimates become much easier.
Some people cannot lose weight naturally. So the question stands: what is the least bad alternative?