Is this an argument that you should use crutch and everyone ever will always read it as version b?

It might be more good faith to just pick language that is more clear. The alternative feels a lot like pretending to be one thing while trying to make people think something else - it rings just like a bad faith "Im just asking questions"

I'm a bit confused. Would you mind clarifying whether you think using "crutch" is the more clear vocabulary, or whether alternative vocabulary would be more clear?

To be clear, version a is referring to literal (non-metaphorical) crutches, and is not the version being used here because GLP-1 agonists are not literal crutches. Version b is the only possible use of the word being used in this conversation, and is always pejorative. "Oh, you broke your foot, you're getting around on a crutch" = Always version A, literal, non-pejorative. "Oh, you're obese, you're using medicine as a crutch to cure it" = Always version B, metaphorical, pejorative. There's no confusion.

> relied on heavily or excessively

That _OR_ is doing a lot of work. I believe that 'or' makes the word not objectively pejorative. Context is important. A no-true-scotsman insinuation, or an insinuation that the crutch will never be removed does lack empathy and would seem pejorative to me.

Though, an empathetic concern that the crutch will never be removed - is not necessarily pejorative IMO. Either way, the crutch is a tool to "healing." Context matters.