You need help. You seek help. Your health provider makes recommendations, and your problems persist. Then the provider reluctantly admits, "I can't help you." Health providers rarely make that explicit admission. That doesn't mean they don't think it. And that doesn't mean you don't think it.
Health care is phenomenally successful in many areas, most of which involve relatively acute problems that can be corrected as a result of precise imaging and surgery. But health care is abysmally poor in combating many chronic conditions. For instance, the three leading causes of death in America - heart disease, stroke, and Alzheimer's Disease - all are lifestyle sensitive. Every one of the big three can be caused or exacerbated by stress, excessive alcohol, faulty nutrition, and sedentariness. My not-so-big revelation is that your health provider cannot live for you.
So, how are you living? I mean real living, not rationalized living. One example should be sufficient to make my point. Everyone knows that exercise is essential for health. You see your doctors, they ask about exercise, and you tell them what you do. What do studies say about how truthful exercise-related patient-doctor dialogues are? Take a guess. Ten percent? Fifteen percent? No and no. Andrea Gurmankin Levy and colleagues (2018), for example, found that as many as 81% of patients lie to their doctors about how often they exercise. (They were equally likely to lie about the amount they eat). Why? The researchers suggested that most often the lies were due to desire to avoid judgement and embarrassment.
There undoubtedly are other reasons for lying to doctors about lifestyle. But what is the bottom-line implication?
I believe that lying to your doctor about lifestyle usually betrays an external locus of control. It is as if the patient feels that she/he has to please their doctor, and nothing could be further from the truth. The sad reality is that most doctors move rapidly from patient to patient. They do not have the time, the energy, or the desire to ruminate about you.
Don't worry about your doctors' opinions of your lifestyle. Don't bother to lie to them. Don't bother to lie to family, friends, or associates about your lifestyle. Adopt an internal locus of control. Once you do that, you become the only target for your lifestyle lies. And if you believe you can lie to yourself with impunity, you are wrong. Sure, failure to adopt a healthful lifestyle will harm you, whether you have an external or internal locus of control. But an internal locus means that you cannot avoid responsibility for unhealthful lifestyle consequences. Perhaps that unavoidable "pressure" will help motivate you to make the changes you need.
One final suggestion. You often are advised to set lifestyle goals for yourself. And that is good advice. But goals are of little value if they are not paired with clear, employable strategies to reach them. Make sure that you have thought through the strategies, and that you consistently act consonantly with them. When you approach your lifestyle that way, you no longer will need to lie to doctors, nor will you need doctors to help you with common sense lifestyle-oriented health practices. You will reach your goals by being faithful to your strategies.
Reference
Gurmankin Levy A, Scherer AM, Zikmund-Fisher BJ, Larkin K, Barnes G, Fagerlin A. Dishonesty in patient disclosures to healthcare providers. JAMA Network Open 2018; 1(7):e185293. doi:10.1001/jamanetworkopen.2018.5293
