I was truly surprised that when I finally asked my physician about gastric bypass surgery (after I ended up in the hospital for diabetes and hypertension) that he said it was a good idea for me and a number of his patients had had the surgery with excellent results. I was surprised because if he thought it a good idea, and had seen excellent results in his own patients, then why hadn't he approached me with at least a discussion about it. The surgery was the best thing that I ever could have done to loose weight. I wish that I had done it sooner.
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My physician was very honest about it. He didn't tell me I was obese, but I hadn't went in to see him until after I'd lost about 40 pounds. He told me that I was overweight but I'd already spoken to him about the fact I was trying to lose weight. He was very helpful; I told him I didn't want any medications to assist me, and as I went in for monthly check-ups when I still had insurance, we kept track of my weight together and he always praised me when I'd have dropped a few pounds by the time I visited again. If I hadn't, he would encourage me to work harder the next month. My visits focused more on my chronic pain, but we was still really supportive and kept track of my health as far as my weight went.
I think it helped that I was completely open to talking about it - he recognized that and it made him more comfortable discussing it. I think a lot of physicians might be too sensitive and worry about the sensitivity of their patients.
On top of that, in a world where patients issue lawsuits left and right over very petty things, physicians have to be more careful.