I try my best to avoid fatties in the office. I don't take government insurance, which excludes a bunch of you neets and welfare queens.
Sometimes I'll have a rich trust fund whale that gets through with cash pay or private insurance. But If they don't have the willpower to not eat, they likely won't have the willpower to do what I tell them, for which I literally get docked money from the government for not meeting "core measures."
The only other time I see them is if I'm on call in the hospital and can't refuse them due to CommunistCaid (Which I HAVE to have in order to maintain hospital "privileges..." even if I'm never going to see these fat fucks again). In that event, they're likely already dying from the diabeetus or heart failures and won't make it long enough for diet and exercise to make a difference anyway.
Fire your doctor and get a nutritionist, private chef, and a shock collar if you want to lose weight.