An HMO requires a referral from the primary care physician before they will cover a visit to a specialist. A podiatrist is considered a specialist.
I'd say that the doctor would recommend to 1: to start a low-calorie, low-fat diet, 2: devote time to follow a workout plan, and possibly 5: Join a weight-loss support group, but I'm not sure about that one.
The reason the doctor wouldn't recommend 3 is because you're supposed to eat several servings of fruit per day, not once a week, and the reason the doctor wouldn't recommend 4 is because an increase in food consumption would add on to the patients problem of being overweight rather than help it.
