Let's assume for a moment that liderully everything she's ever said is true. (I know it's painful to suspend your disbelief that much, but do it for science.) So let's just say that she has all these conditions and disorders and addictions, and that exercise actually does seem to make her gain weight and that her calorie reporting is 100% accurate, etc. etc. etc.
In other words, let's grant that all of her excuses are legit.
There is still no excuse for how she is right now. If she had any condition or disease on earth and her doctor said, "Do X" and she didn't do X, then you'd have to accept that she's embracing the consequences, whatever they are.
If AL had lung cancer and her doctor said to do chemo, we'd all be taken aback if she refused chemo. If she refused because she was praying for a miracle, we'd all shake our heads and walk away. If she was refusing because she knew it was her time to go and was prepared to die, then we'd all shake our heads sadly and walk away. But if she was refusing purely because she was addicted to nicotine and refused to stop smoking...
To this day, there are people -- professional or otherwise -- offering her a way out of this. Even that shitty MLM that we all knew was doomed to failure would (theoretically) have worked to take at least some weight off if she'd stuck to it.
But not only will she not give up nicotine, she's consciously refusing to even try giving smoking specifically. And she won't take her doctor's orders.