I'm saying that health is an exceptionally broad concept and people can be healthy by some metrics and unhealthy by others because the body isn't one thing (i.e.,
https://en.wikipedia.org/wiki/Anna_Karenina_principle). "Healthy" people are all alike, perhaps, whereas unhealthy people are unhealthy in all manner of different ways, not all of which are immediately identifiable.
I'm not going to advocate someone take up smoking for a lot of reasons but it's not as though even it's a guarantee to get cancer (and certainly plenty of people around my age are smoking stuff, just not necessarily tobacco) and it's not like shaming someone who might actually be trying to quit smoking or be frustrated at themselves for the habit is a particularly fruitful act. Similarly someone who's fat and
being active isn't necessarily more unhealthy than someone who's a more normal weight, but most people don't look at someone who's got the build of, say, Dan Olson and think "wow, obviously dude is out of shape" or whatever, at least not on this level. And yet accounts
abound of people who are fat getting shamed at gyms, for example.
You could look, at say, some people who do stunt/professional weightlifting. These are people who are for their job doing things most normal people consider exercise, and are obviously stronger than the gen. pop. baseline. By some metric they are "in shape". But, like, those whole things where people are carrying a car put obvious strain on people's joints and ligaments. For that matter, people who are trying to bulk up, and aren't doing it mainly for Terry Crews show-muscles, are going to look more like the lady in the OP than they are your average fashion model.