Reading this I felt that what we really need is to train docs in the psychology of the mental disorder that obese people have.  The bit where she claims to eat healthy then the doc uses FACTS to disprove that ('why are your enzymes so elevated, then?"). It sounds to me (amature) that for an obeast to accept they are fat and that the fatness is the heart and sole cause of their physical and emotional misery is an acceptance that will cause them massive amounts of shame. All sorts of mental disorders are based around the sufferer trying to avoid shame eg Nice Guy syndrome, PTSD. In those cases, showing the sufferer compassion and understanding is often a very effective wayto begin the therapeutic process - a process which does lead to genuine improvements.  However, improvement is always predicated on the sufferer's desire to get better. Obeasts turn their trauma into their identity. They feel like if they didn't have their obesity - they would have nothing and would not know who they are. So they refuse to accept what is right in front of them: the unshakeable truth that virtually everything wrong with them is caused by their obesity. Take this example - perhaps the doc did do something wrong during the op* - but how much more likely is it to be casued by obesity? You start by ruling out the most likely cause then move on to less likely ones if needed - this obeast wants to ignore the most likely cause (obesity). Of course the doc gets pissed. *How much harder must it be to operate on an obese person - all the extra effort - and the doc knows his effort is necessitated by the obeast's deliberate activity - no wonder docs get pissed off!