Guessing I am going to have trouble getting medical necessity letter from PCP

I visited my PCP today, armed with letter in hand asking for assitance/support in obtaining WLS. Well, turns out he offers weight management programs. One with pills and one with dietary supplements. I stressed that I felt WLS was the best option for me and that I was not making a hasty decision. I have to go back in two weeks for follow up and he indicated he would speak with me then about the surgery. Any thoughts/ideas etc. about how I can further state my case. What happens if I can't get my PCP to provide me with a letter of medical necessity because he'd rather I do his weight management program?

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