You may have experienced this but being an outsider sometimes allows ‘clear’ perspectives on optier people’s issues.

Ie a person in a relationship with someone clearly toxic. Or experiencing domestic abuse. The external answer is ‘leave’, the person doesn’t.

The obese patient - walk, change diet.

The representing twenty year old with third presentation cannabinoid hyperemesis syndrome - pretty much every time you smoke pot you are going to experience abdominal pain and vomiting, you cannot smoke! How are you not getting the message!

The person spending 5 hours on a bus to work 2 shifts... ?? Is this a rational choice?

It's not a rational choice. There has to be some level of personal agency in this decision. Ms. Brown is only 28.