I discovered these downsides when, on my third day with the bike, I got a flat tire and had to carry it onto the subway with me for those last few miles back to my apartment. The cause of the flat is unknown; the bike mechanic who eventually fixed it didn’t see anything wrong with the rims. But the experience of trying to maneuver an almost 40 pound e-bike on and off a crowded subway car during rush-hour is not one I can recommend.
There are individuals who claim to have lost considerable amounts of weight by using an electric bike. A recent prospective cohort study however found that people using e-bikes have a higher BMI. By making the biking terrain less of an issue, people who wouldn't otherwise consider biking can use the electric assistance when needed and otherwise pedal as they are able. This means people of lower fitness levels or who haven't cycled in many years can start enjoying the many health benefits E-bikes have to offer.