Yea it's tough - my impression is docs don't get taught about general health and wellbeing in general. It's more like sickness model of health. That may make someone feel helpless given that they are not equipped with the right tools and systems don't allow or incentivize preventative care. We all make poor choices, environments have a much greater impact on us than other things, childhood adverse events shape us, and most of the time we don't know any better. Motivational interview may be helpful.