I read his book 2 years ago, and I don't remember him placing primary importance on physical fitness, he gave it a cursory review, and as a Doctor I found that to be a shirking of his responsibility.
I don't know of any diet book that places fitness first, otherwise it would be an exercise book not a diet book :) I'm not a doctor but I play one in a health food store btw hehehehe and all I meet are lazy people. They don't want to eat less and exercise.