There is currently a debate ongoing in healthcare about whether genetics or environment is a more powerful influencer of our health and wellness—but as Dr. Falcone recently wrote, the factor that has fallen almost completely out of the discussion is our own personal responsibility.
Except, how does one exercise personal responsibility when there are so many interests out there spending millions to influence our decisions?
You may have heard? Everything from social media platforms to food companies vying for our attention, trying to influence our decisions, and ultimately aiming to hack our brain’s capacity to exercise its own good judgment.
We know many of the most fundamental factors influencing your health are matters of behavior: what you eat, whether you have a movement routine, and others. But making the kinds of changes that are important for our long-term health and wellness, and avoiding and even reversing chronic disease, are often just really hard to implement.
Why? It’s not just that discipline is hard. It’s that discipline is harder when there are so many companies trying to get you to behave in certain ways, with millions of dollars in advertising, legions of data scientists, even psychologists learning how to get us hooked. And then there is all the money spent influencing our society at large—its laws, regulations, which food we subsidize and which we don’t. All of these have an impact on how easy or hard it is for us to make healthy decisions.
That’s why it’s important to understand how these companies aim to hack and influence our decision-making. The more you think about it, the more examples you can come up with. But, let’s start with food, because it’s so fundamental to our long-term health.
Food companies use market power, money, and food science to influence to get us hooked on processed food that is sugary and sweet
People in the food industry use language like “cravability,” “snackability” and “moreishness” to describe foods designed to make a person consume as much as possible. Even more frightening is that processed foods can actually cause reduction in brain volume, likely due to the shrinkage of blood vessels in the brain. Less blood flow means less nutrients to nourish the cells of your brain leading to overall brain shrinkage and higher rates of listlessness and fatigue, and higher rates of dementia in the long term.
Don’t let food companies do it! In the industry, they talk about the “bliss point,” a term coined by American market researcher and psychophysicist Howard Moskowitz. What is the bliss point? It’s the amount of an ingredient, such as salt, sugar or fat, which optimizes tastiness so we’ll keep buying more.
When we go the grocery store to think about which food to fill our homes with, just understand that a lot of what is processed and packaged doesn’t just come with added salt and sugar, it comes with the perfectly tailored amounts of salt and sugar as determined by armies of food scientists and exhaustively tested.
That’s why Michael Pollan’s old advice to eat food, mostly plants, not too much is such a good shorthand for healthy eating. It gets you out of the processed, packaged food section and into the fruits and vegetables section. For more on how to think about nutrition, read Dr. Falcone’s post, Nutrition—the first path to longevity.
But it’s not just food companies. Take a few more examples:
Drug companies. Drug companies routinely use their influence to control and influence decision-making in healthcare. One way is by creating monopolies over certain drugs, preventing generic versions from entering the market, and pushing for legislation that would make it harder for patients to access generic medications. Drug companies also influence the decision-making of doctors by controlling the research and information they have access to, limiting doctors' ability to make independent decisions about what treatments and medications their patients should receive. All of these actions by drug companies seek to limit patient autonomy and benefit the pharmaceutical industry at the expense of patients.
Health insurance companies. Health insurance companies influence the decisions of patients and doctors through the insurance products they offer, and what they decide to reimburse. This can be particularly problematic for those with chronic illnesses—and an integrated approach that takes into account your nutrition, mental health, and other factors is often furthest from their list of priorities.
Social media platforms. Obviously, social media platforms have been getting a lot of bad attention recently for the mental health harms they are contributing to, especially in teens, and teen girls in particular. When our mental health is such a key driver of overall wellness, we absolutely need to understand that these platforms are designed by scientists to keep us addicted. This includes everything from the color of the heart notifications triggering chemicals in our brain to the pull down motion we use to refresh pages and check for new alerts—it’s the same principle casinos use to keep people pulling the lever on the slot machines, hoping for just a little hit of dopamine each time they do.
The “wellness” industry in general. There are no shortage of “solutions” to your chronic health problems which involve spending a lot of money on a new product, a new subscription, or a new drug. And, sometimes it is important to get a supplement, or to use a pharmaceutical intervention for a chronic condition. But always remember, while “healthcare” may be very expensive in this country, being healthy usually follows from a series of cheap or free decisions: going for a walk, getting enough sleep, eating simple foods, including grains, legumes, fruits, and vegetables, and developing a spiritual or mental health practice. If you think the solution to your chronic health problems is an expensive new consumer product, that is probably procrastination talking.
The examples are practically endless. It can be tough even to recognize many of the things in our daily life that we take for granted, but which are actually the result of profit-minded incentives behind the scenes.
What can be done about it?
Strategies to protect your autonomy over your healthcare decisions
There are a few things you can do to protect your autonomy, preserve your independence, and try to make the best possible decisions about your health.
Listen to your body, practice independent thinking. Research and ask questions. Try to be informed about your health condition and treatment options. But also, it’s important to find a physician who can work with you, and is not locked in to one particular approach, and one who respects your autonomy. At Dignity Integrative, we view the provider-patient relationship as a partnership, one in which we come together to investigate the root causes of chronic conditions and work together on a plan to set you on the right path to health and wellness.
Making changes to the food we eat, our movement routines, our sleep, and our mental health is hard! It’s important to experiment with what works for you personally—and in doing this experimentation, an integrative medicine doctor can be an important partner in your journey.
But the gains will compound over weeks, months, and years, and your whole life. It’s important not to let the many companies and self-interested organizations of the world hack our ability to make those changes.
Ultimately, it is up to us to become armed with the knowledge of what we need to do to save ourselves from a life of chronic disease. In the immortal words of David Goggins: "No one is coming to help you. No one’s coming to save you."
In the end that is a choice you control.