A lifestyle change is something that you need to actively pursue forever. It's not just a one time decision and action. I can't tell if you're being intentionally obtuse, or you actually can't see the difference.

And yes, all the issues listed are ones that can (usually) be corrected by action of the person involved. But the _level_ of action is on a totally different scale.

>I can't tell if you're being intentionally obtuse

Given this guy's attitudes towards vaccines, I doubt it's intentional.

Then we agree - these are are healthcare choices where people fail to make the right one?

> What you call lifestyle changes I call “need to make a decision”.

Well I'd suggest not downplaying it that way. Going from a junk-food-and-soda diet to a healthy one is a huge shift in lifestyle. You don't just make a decision one day and that's that. You have to make that decision several times a day, every day, for the rest of your life.

Not getting enough exercise? You don't just sign up for a gym membership and consider it done. No, that's just the first step. Now you need to show up at the gym several times a week, and put the work in over and over again.

An alcoholic doesn't just decide to stop drinking one day, then poof they're cured. That decision is just the beginning. What follows is some mix of white knuckling in the beginning and an ever-present vigilance to maintain sobriety. It's not just "I don't drink anymore", but also "I need to come to terms with this issue or that relationship", and "I can't hang out at the bar every night anymore". It's a long-term project, not just a decision.

Getting a vaccination is not like that at all. It really is a single decision, once made, and never thought about again.

Obesity is also way more complex than taking a shot. Its not as simple as "eat as much as your neighbor". Minor systemic differences in metabolism can have huge long-term weight implications.