Addiction, poor choice and medications

Definition of Addiction

Addiction is a complex condition characterized by compulsive engagement in a behavior or substance use despite harmful consequences. It typically involves:

• Loss of Control: The inability to stop or moderate the behavior even when one desires to.

• Compulsion: A strong, often overwhelming urge to engage in the behavior.

• Negative Consequences: Continued engagement despite negative health, social, or financial effects.

• Tolerance and Withdrawal: Increased need for more of the substance or behavior over time, and experiencing distress when it’s unavailable.

Addiction vs. Poor Choice

To differentiate between addiction and poor choice, consider the following:

Ketogenic Diet & Food Choices

When discussing a ketogenic diet in the context of food addiction or poor choices, the key issue often revolves around carbohydrate consumption. Many people struggle to reduce carbs because of physiological (insulin and blood sugar regulation) and psychological (habitual preferences, cultural influences) factors.

• If a person knows they feel better on a ketogenic diet but keeps reverting to high-carb foods despite negative consequences (such as energy crashes, cravings, or health issues), food addiction may be a factor.

• If someone eats high-carb foods but does so occasionally without strong compulsions or negative consequences, it’s likely a poor choice rather than an addiction.

How to Discriminate Between the Two?

1. Ask: Can You Stop?

• If you cannot stop eating sugar/carbs even with conscious effort, addiction may be present.

• If you can stop but sometimes choose not to, it’s a poor choice.

2. Assess Physical and Emotional Responses

• Do you experience intense cravings, mood swings, or withdrawal-like symptoms when avoiding carbs? If so, addiction may be involved.

• If you simply enjoy carbs but don’t feel emotionally or physically dependent, it’s likely a preference or habit.

3. Look at the Consequences

• If eating certain foods leads to significant health issues, mental distress, or disruption of goals but you continue anyway, it may indicate an addiction.

• If occasional carb indulgence doesn’t lead to major consequences, it’s likely just a choice.

Understanding Poor Choices: Why Do People Make Suboptimal Decisions?

Poor choices, especially when it comes to nutrition, fitness, and lifestyle, often stem from a mix of knowledge gaps, perception of consequences, habits, and psychological factors. Let’s break it down.

1. Lack of Education & Awareness

Sometimes, people don’t understand how a choice leads to certain consequences or the significance of those consequences.

• Example: Someone may eat a high-carb diet without realizing how it affects insulin, energy levels, or inflammation.

• Why it happens:

• Incomplete or misleading information (e.g., mainstream dietary guidelines promoting high-carb, low-fat diets).

• Lack of personal experience with a better alternative (e.g., never having tried a well-formulated ketogenic diet long enough to see benefits).

Solution:

Providing clear, evidence-based education about the mechanisms behind choices and their outcomes can help individuals make more informed decisions.

2. Diminished Perception of Consequences

Some people are aware of potential consequences but don’t see them as significant enough to change their behavior.

Example:

• Someone understands that sugar contributes to inflammation but doesn’t feel the effects strongly enough to justify quitting.

• A person knows a ketogenic diet could improve their metabolic health, but they don’t see their current situation as “bad enough” to commit.

Why It Happens:

• Delayed Consequences: Many health issues (insulin resistance, inflammation, metabolic dysfunction) develop over years, so the feedback loop is slow.

• Tolerable Discomfort: If the negative effects (like energy crashes or bloating) aren’t debilitating, they may not seem urgent.

• Social & Cultural Factors: Food choices are often influenced by tradition, convenience, and peer pressure, which can override concerns about long-term health.

Solution:

• Shorten the feedback loop: Help individuals connect daily choices to immediate outcomes (e.g., tracking blood glucose, mood, and energy levels after meals).

• Reframe the significance: Show how small choices compound over time, leading to either long-term resilience or decline.

3. Emotional and Habitual Patterns

Not all poor choices are purely logical—many are emotionally or habitually driven.

• Example: Someone may eat sugary foods not because they lack education but because they associate them with comfort, stress relief, or social connection.

Why It Happens:

• Emotional Triggers: Stress, boredom, and social situations often drive people to make choices that go against their long-term goals.

• Hardwired Habits: If someone has eaten a certain way for decades, change requires rewiring deeply ingrained neural pathways.

• Addiction-Like Responses: Some foods (especially processed carbs) hijack dopamine reward pathways, making them difficult to resist even when we know they aren’t ideal.

Solution:

• Build Awareness of Triggers: Encourage mindful eating and tracking patterns (e.g., recognizing when stress or emotions drive poor choices).

• Create Alternative Habits: Replace less optimal choices with healthier, satisfying alternatives that still address the underlying need (e.g., keto-friendly comfort foods, stress management strategies).

4. Lack of a Strong ‘Why’ (Motivation & Values Conflict)

People often make choices based on what matters most to them in the moment, and if health isn’t their highest priority, they might not act accordingly.

• Example: Someone values enjoyment and convenience over long-term metabolic health, so they consistently choose fast food over home-cooked meals.

• Example: A person may intellectually know keto is healthier for them but prioritizes social ease (e.g., eating like everyone else at gatherings) over their personal goals.

Why It Happens:

• Competing Values: Health is important, but so are taste, convenience, and fitting in with social norms.

• Lack of Immediate Motivation: If someone doesn’t have a pressing reason (like an urgent health crisis), they may not feel compelled to change.

Solution:

• Clarify Deep Motivations: Why does optimal health matter? Is it about longevity, performance, avoiding disease, or looking/feeling a certain way?

• Identity Shift: Encouraging someone to see themselves as a person who prioritizes health makes choices easier and more automatic.

5. The Role of Medications in Enabling Poor Choices

Medications can be lifesaving, but they can also reduce the perceived consequences of poor lifestyle choices, making it easier for people to continue unhealthy behaviors without immediate repercussions. This is not to say that medications are inherently bad—many are necessary and beneficial. However, they can sometimes act as a safety net that prevents people from addressing the root cause of their health issues.

How Medications Remove the Need for Change

Modern medicine often treats symptoms rather than underlying causes, allowing people to maintain habits that lead to chronic disease. Let’s look at how this works in different health conditions:

A. Type 2 Diabetes and Blood Sugar Medications

• Example: A person develops insulin resistance due to a high-carb, processed food diet and lack of exercise. Instead of addressing the dietary cause, they are prescribed metformin or insulin, which helps control blood sugar.

• How It Enables Poor Choices: Since blood sugar readings improve with medication, they may see no urgency to change their diet. They can keep eating the same way without facing the full metabolic consequences—until complications (neuropathy, kidney disease, vision loss) arise.

• Missed Opportunity: Instead of viewing medication as a temporary bridge to lifestyle change, it becomes a long-term crutch that enables dietary habits that continue to drive insulin resistance.

B. High Blood Pressure and Antihypertensives

• Example: A person has high blood pressure due to poor diet, high stress, and a sedentary lifestyle. They are prescribed beta-blockers or ACE inhibitors, which lower their blood pressure effectively.

• How It Enables Poor Choices: Since their numbers look good at the doctor’s office, they might not feel the need to address inflammation, stress, sodium-potassium balance, or weight—all of which are root contributors to hypertension.

• Missed Opportunity: Instead of using lifestyle changes (such as low-carb diets, stress management, and exercise) to naturally lower blood pressure, they rely on medication and continue behaviors that keep the problem present.

C. Statins and Cholesterol Management

• Example: A person has high LDL cholesterol due to poor metabolic health and chronic inflammation. Instead of dietary intervention, they are prescribed statins, which lower cholesterol levels.

• How It Enables Poor Choices: Because the numbers on their blood test improve, they may believe they are “safe” and continue eating ultra-processed foods, assuming the medication protects them from heart disease.

• Missed Opportunity: Instead of addressing inflammation, insulin resistance, and oxidative stress—key drivers of heart disease—they focus only on cholesterol numbers, which are just one piece of the puzzle.

The Psychological Effect of “Fixing the Numbers”

When medications improve biomarkers (blood sugar, blood pressure, cholesterol) without requiring lifestyle change, it creates a false sense of security. People think they are healthier than they actually are because the numbers are “controlled.” But in reality, the disease process often continues beneath the surface.

• Short-Term Relief, Long-Term Decline:

• Medications suppress symptoms, allowing disease progression to continue unchecked.

• By the time secondary complications arise (nerve damage, kidney failure, heart attacks), it’s often too late.

• Reduction in Personal Responsibility:

• If medication is seen as the solution, there’s less motivation to engage in diet, exercise, and stress management.

• Patients may be told, “Just take this pill,” without a conversation about root causes.

The Medical System’s Role in Enabling This

While individuals bear responsibility for their choices, the healthcare system also plays a role in enabling poor decisions.

• Reactive Instead of Preventative:

• Doctors are often trained to treat disease rather than prevent it.

• Many patients never receive nutrition and lifestyle counseling—they just get a prescription.

• Time Constraints and Systemic Issues:

• A 10-minute doctor’s visit doesn’t allow for deep conversations about habit change, mindset, and metabolic health.

• Insurance often covers drugs but not nutrition counseling or personal training—reinforcing the medication-first approach.

Conflicts of Interest:

• Pharmaceutical companies have an interest in lifelong medication use, not in making people metabolically healthy.

• Food and drug industries are interconnected—processed food drives disease, which drives the demand for medications.

The Role of Health & Wellness Coaches in Filling the Gap

This is where health and wellness coaches play a critical role in shifting people away from dependency on medication and toward true, long-term health transformation.

1. Education & Awareness Beyond the Doctor’s Office

Doctors often don’t have time to educate patients on the “why” and “how” of lifestyle changes. A health coach bridges that gap by providing personalized, actionable steps for real change.

• Example: A doctor tells a diabetic patient to “eat healthier.” A coach translates that into practice, helping them navigate food choices, meal planning, and blood sugar monitoring.

• Example: A doctor prescribes blood pressure medication. A coach helps the patient implement stress reduction, movement strategies, and targeted nutrition to reduce the need for medication.

2. Behavior Change & Accountability

Knowledge alone isn’t enough—people need consistent support and guidance to break old patterns and build sustainable habits.

Coaches provide:

• Regular check-ins to ensure progress.

• Mindset coaching to address emotional eating, stress, and motivation.

• Practical solutions to make healthy choices easier and more sustainable.

3. Addressing Root Causes with Lifestyle Intervention

Instead of managing symptoms, a good coach helps clients resolve the metabolic, hormonal, and behavioral issues driving disease.

• Example: Rather than relying on statins, a coach helps someone improve inflammation, insulin sensitivity, and dietary patterns.

• Example: Rather than simply lowering blood sugar with drugs, a coach helps a client reverse insulin resistance with a ketogenic diet, strength training, and stress management.

4. Shifting from Dependency to Self-Empowerment

One of the biggest issues with the medication-first model is that it keeps people passive in their health journey. Health coaching shifts people from a patient mindset to an ownership mindset.

• Instead of: “I have high blood pressure, so I take a pill.”

• It becomes: “I’m taking control of my health through movement, nutrition, and stress management, so I don’t need a pill.”

How to Break the Cycle?

The key is shifting from symptom management to root-cause resolution. This requires:

1. Education: Understanding the real drivers of disease and the role of lifestyle in reversing them.

2. Accountability & Guidance: Having a coach or mentor to help implement change and navigate challenges.

3. Personalized Nutrition & Lifestyle Change: Using food, movement, sleep, and stress reduction to create real, lasting health.

4. Coaching as a Complement to Medical Care: Instead of waiting for disease to develop, coaches help people proactively prevent and reverse health issues.

Final Thought: Medications as a Tool, Not a Crutch

Conclusion: Why Do Poor Choices Happen?

It’s rarely about just one factor. A poor choice can stem from:

1. Lack of Knowledge (not understanding the consequences).

2. Minimizing the Impact (thinking the consequences don’t matter enough).

3. Emotional and Habitual Patterns (comfort, stress relief, deeply ingrained habits).

4. Conflicting Values (prioritizing short-term pleasure or convenience over long-term well-being).

5. Medications in Enabling Poor Choices (reduce the perceived consequences of poor lifestyle choices, making it easier for people to continue unhealthy behaviors without immediate repercussions)

Medications aren’t inherently bad—they can be lifesaving. But they should be used as short-term aids while addressing root causes, rather than lifelong Band-Aids that mask poor choices. When people view medication as a permanent substitute for healthy living, they unknowingly give up control over their own health.

A strong partnership between doctors and health/wellness coaches ensures that people get both medical oversight and the hands-on lifestyle coaching needed to make sustainable, long-term changes.