There is a lesson here. The doctor can try to maintain a friendly, non confrontational relationship with a patient, and collect the "rent" on the problems that will develop over the years, or can risk alienating the patient by trying to affect change. As a physician I always try to choose the right medical advice, for the best patient outcome, and this is what I have taught over the years.

Believe me, in these cases, it is the weight that is the problem! There is another issue however. If the doctor deals with the problem by pushing the patient in the direction toward better health, the doctor will risk losing the patient to someone who will coddle the patient and find reasons not to discuss the weight.

We need our doctors to be there for us when we are sick, and to prevent us from getting sick. If your doctor is unwilling to be critical and identify things that you could do better to preserve your health, perhaps it is time for a switch. If you are the patient, and at some time, even we doctors are placed in this role, you need to decide whether your doctor is being a bit too gentle and enabling your bad behavior. While we all like the doctor to be a "friend" that is not what he or she is there for. We don’t need a doctor to give us uncritical affection. We have puppy dogs for that.