Where have all the teachable moments gone?

I am primarily working in the Cardiac Care Unit this week. Today, I had a 50-something year old, male patient whose cardiac issues were mostly, if not solely, related to his diet and obese status. My initial assessment of his nutritional status and diet history pretty much consisted of him and his wife complaining about the fact that he was only allowed to order from the cardiac diet menu. They both proceeded to tell me how he ate whatever he wanted before coming into the hospital and that there was absolutely nothing he could eat off the cardiac menu. The food off that menu was simply terrible and he could not eat a thing from it. Mind you, according to his nurse and the tray sitting next to him, he was eating 100% of each of his meals.

I informed him that his physician ordered that diet and that he would have to discuss changing the diet order with him. I attempted to politely hint at the idea that his doctor may have ordered that diet for a reason: Ahem (thinking, but not saying aloud)...the fact that he is now in the hospital, and not for the first time, due to heart-related problems that are directly linked to his diet and obese status. I also crumbled under the pressure and offered to send him Ensures if he was unable to eat any of the kitchen's food, as he needed to eat in order to heal his wound, get better, and leave the hospital.

If this man's current status did not create a teachable moment, what will? And what, as a dietitian, can I do to help him given his current "stage of change?"