My PCP is a size zero hyper maniac woman who doesn't understand obesity. I LOVE her for her expertise, intelligence, education and thoroughness however she just does not understand how my lifelong struggle with obesity (starting at the age of 10) and the efforts/money (starting with being put into Weight Watchers in 6th grade) have lead to where I am now. Her suggestion was to do the Eat to Live diet. 1 lb of raw vegetables, 1 lb of cooked veg and minimal protein for each meal. Ok, that would work however how realistic is that? I am an outside sales person and quite literally, I have to take people to lunch and sometimes dinner every day. I can and have made "good" choices. Her argument is that WLS doesn't work. If she wasn't SO GOOD from a medical perspective, wasn't so in tune (other than the obesity) and attentive I would fire her! But she is really good. (BTW, my boyfriend is a MD and he agrees at how good she is however he had to write my medical clearance letter because she wouldn't- yes he examined me and looked at the labs).So, bottom line, my experience is, if you PCP won't clear you and it is a legitimate need, find a PCP that will. Remember, it is your life, you own it and you are genuine in your efforts to improve your life.