Though I am fortunate to be thin, I am in no position to judge people at the buffet line. I found out at age 28 that I have high cholesterol, which was a shock for someone who has always exercised regularly and has good eating habits on most days.
Of course I would be compassionate here, just like I would anybody else. Giving compassion to neighbors doesn't cost us anything. We can also be compassionate without encouraging unhealthy habits.
If the personal circumstances are especially troubling, the right words of compassion might be "Because I like having you in my life, I can't support you going against your doctor's advice."