It's all about risk V benefit. There are of course risks from taking this drug. When you weigh it up against the risk of obesity, diabetes, hypertension, high cholesterol etc, suddenly it seems worth the risk.
If none of those apply, then it doesn't seem worth it.
That's why there are criteria.
I understand your point, you're so close to the criteria, but there has to be a cut off somewhere.
My BMI is now 28 and I won't be stopping MJ anytime soon as it has turned my life around. I started with a BMI of around 34.
However my weight fluctuates year to year, in 2019 my BMI was 42. In 2022 it was 27.
I'm hoping MJ will help me maintain a normal weight without those extreme fluctuations, which are bound to have harmed my health.
I've completely messed up my hormones and metabolism clearly - or they were always messed up which caused my weigh issues - I guess we will never know! But that's why I need MJ.