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The Sims 4 is a fantasy game, but there are ways to make sims lose weight such as diet, exercise, or spending rewards for making your sim skinny; although, some people might be overweight or obese in real life for various other reasons besides unhealthy food and inactivity such as some types of drugs might cause weight gain (also known as medication and one such example is SSRIs which is an antidepressant drug), hypothyroidism (more common in females than males), PCOS (females only), cardiovascular disease, diabetes, depression, slowed down metabolism from getting older (although this does not start until middle age or older), and possibly genetics (such as for example both parents are overweight/obese might increase the likelihood of their children being the same way) to name just a few examples of this.
Otherwise, TS4 is allergic to slender sims.
I did not know that and that is coming from someone who uses the MCCC mod and has used it for a long time. Also, speaking of fat sims I sometimes struggle with keeping my sims skinny because of not dieting properly and/or not exercising enough. For example, when trying to focus in other areas besides weight such as dieting and exercise it is easier for my sims to gain weight as well. On the one hand I like realism at least to some extent when it comes to weight on The SIms 4 not being frozen, but on the other hand keeping sims skinny can be challenging sometimes and especially without mods. Cassandra Goth for example when playing as her (especially as a young adult and old enough to get married and not live with her parents anymore) starts skinny but can become fat if not doing enough diet and exercise.
It would be better if the game mechanics functioned realistically in this sense. However, they don't. Even if you feed your sims reasonably, they'll eventually incline toward obesity just for..well, eating.
Increasing muscle mass through exercise won't reduce body weight. Only jogging or a treadmill will have that effect. Although, if you continue to simply feed your sims when they're hungry, it won't do them any good since weight reduction is a slower process by aerobic type exercise than is weight increase by eating meals (apart from garden salad, if I'm to understand). In essence, the ratio doesn't work accurately, so we're bound to see larger and larger sims over the course of gameplay.
I don't watch many YTers but I enjoy interesting Let's Plays. I'd followed Deligracy's Tiny Town Challenge LP and just about every of her sims had grown obese throughout the LP challenge (except for the final sim) as they kept preparing and eating meals autonomously. But none had done any exercise autonomously.
If you DO want to change your sims weight or muscle mass at any point with the MC freeze physique flag, you may still use the Modify in CAS cheat to make any changes. The flag prevents auto changes but doesn't prevent you from making desired changes with fulleditmode enabled.
As example. I'd thought it appropriate to max the muscle mass of my female werewolf, although she and her sisters are MC flagged with physique and appearance freezes.
Edit: Also, I did send my werewolf to work out on strength building machines during gameplay so it would justify gradual changes I'd made to her body mass until she reached maximum. I'm particular about realistic gameplay in that I don't want sims to mirror our own reality, but that seemed more realistic to me than how the game functions.