Honestly, I've spoken to a LOT of doctors and they fucking hate it. They are so frustrated. For them its a losing battle. And now with the fat acceptance movement, if a physician pushes a patient about their weight, they're accused of "fat-shaming". It's fucking ridiculous. For them, if you have no intention of heeding the medical advice of your doctor, then why are going to see a doctor in the first place?  My doctors seem to really like me. I think because I fully embrace the reality that weight is the number 1 medical factor with pain issues. And I take responsibility for it. Something that should be obvious, but just doesn't seem to happen in their clinic. I was actually concerned they wouldn't give me the referral because I'm one of their smallest (if not their smallest) patients. But they were completely sympathetic and willing to do whatever it took to get the weight issue resolved. Even if it was only 10 lbs. My doctors are awesome. In truth, when I got to diabetes center, I assumed the nutritional clinic would be full. Because I assumed it was a required part of their treatment. So I was shocked to see the waiting room empty. I guess the lesson here is that you can't make people do the right thing.