Ok, I'll bite. How exactly does Big Pharma pay doctors to prescribe their meds? They can't even get cheap throwaway pens because of the Sunshine Act. This is an urban myth. Unless the Doctor is a paid speaker/representative for a medical device company or pharmaceutical, The Anti-Kickback Statute will drop said doctor's ass in jail.  The real reasons why docs don't spend a lot of time discussing weight loss with fatties are 1. It's useless. They are fatties. They lie to doctors about how much they eat, how much they exercise, etc. All advice goes in one ear, out the other. After a while this gets old and it's easier to focus efforts on patients who will follow suggestions.  2. Primary care physicians get paid  crap for a follow up visit by HMOs ( in the US). $40 for 15 minutes in which they have to address myriad health concerns. Why would they spend even more time telling a fatass to put down the donut when said fatass is just going to ignore them?