Sean, my wife's first husband (gay) was fat. Obese, even. When he went through gastric bypass surgery, part of it was to make himself "healthier" (he had been through surgery for prostate cancer) but he also wanted to be "attractive." Alas, Bill went from a jolly fat man (really, he was fun to be around) to a serious (damn grumpy, according to his niece) thin man (who could no longer eat a "real meal," he complained). And in the end, the loss of weight and joy did not help when his prostate cancer returned and metastasized. But his gay friends and ex-lovers still loved him whatever size he was — my wife and I were invited to his memorial celebration/wake/pool party, where we got to hear "Bill stories" told with great affection.

So yes, toxic standards can indeed be fatal.