Blame the "body positivity" movement. If she complained about weight related issues, the doctor would definitely discuss it or refer her, but even with a giant whale like her a number of doctors do not want to upset or embarrass the patient. A fair amount has been written on the topic both ways (as in "doctors afraid to talk" and "any comment about weight by doctor is body shaming!"). Her interactions with non-bariatric docs have included some weight loss stuff, but nothing serious. Remember the contest or whatever?"Real doctors?" LOL yeah that makes sense no "real" doctor would say anything about their patient weighing 600 lbs? wtf?
I also don't think that's true for psychiatrists/therapists, not when the patient is morbidly obese. Much if not all of her "mental theeengs" are situational. She wouldn't be a depressed shut-in if she wasn't 600 pounds. She wouldn't have anxiety about going in public if she wasn't 600 pounds. etc.
I do not know Big Ambs in real life, but I bet two doughnuts that she would frame her weight related issues as mostly dealing with discrimination and bias against a beautiful "big" "gorl". She might say anxiety, but anxiety people do not shake their 550 pound selves for all of the world to see. Anxiety people piss in gatorade bottles because someone knocked at the door 10 minutes ago and they are afraid person might still be out there. Amberlynn is dumb as heck, but she knows how to control the situation. Just look at how many idiots on youtube believe that she is actually trying to lose weight and get healthy. Or how see uses anything any health care professional says as evidence that the person does not know what they are talking about so she can return to what "works for [her]."