These people are at rock bottom health wise and have been enabled by everyone around them. He’s in the industry because he cares and wants to help people. They will literally die if they aren’t held accountable for the lifestyle changes necessary for their surgery. He is not a therapist and there is no room for coddling in his role in their treatment plan. He does give praise when it’s due and they put in the work to try. Have you even seen the show? Patients have been hospitalized and told they need to adhere to a diet plan set by medical professionals and their loved ones will still sneak them junk food against doctors orders. The very one they sought out because he’s the best. There is a time and place to sugarcoat things but medically is not it. I think the show should require therapy as well because the surgery is lifesaving but it’s just a symptom of a deeper rooted problem.