The so-called optimism bias can hinder a healthy lifestyle.
Indeed, media messages about nutrition are often confusing and inconsistent, but many Americans know what constitutes a healthy diet. Does anyone really think that drinking brown sugar water is good for the body? The problem is that they don’t seem to be putting their knowledge into action.
Why is it so difficult for people to change their eating habits? Ignorance and confusion may be a factor, but the motivation to change may be far more important. Indeed, we live in a world where we are forced to eat whatever we want, regardless of the long-term consequences. “One of the big challenges in getting people to change their behavior is that you have to make them aware of the need for change.”
For example, if you ask people how much meat they eat, or how much fatty food, eggs, sweets, alcohol, or butter they eat, they will claim that they eat less than the average person. Therefore, people who think they are at lower risk than others may ignore advice to eat healthier and think they are already eating healthier. Is there a possibility that this will actually happen? No, people rated their eating behavior as healthier on average, even when their actual eating habits were terrible. For this reason, perhaps health promotion campaigns need to make people aware of how bad their diets are. But once that’s done, something strange happens. When faced with the reality of what the average person actually eats, people change their answers to make it seem like they’re still healthier than average.
When people are threatened with positive comparisons about a risky behavior, they tend to not only lower their estimates of how often they perform that behavior, but also downplay the importance of that behavior (“Oh, I don’t eat that much meat!”). “Meat isn’t bad for you anyway.” This is the same “personal fable” that smokers tell themselves. Research shows that smokers have a strong tendency to underestimate smoking-related risks, creating a series of illusions and false beliefs that support their choice to continue smoking.
Why do so many people continue to smoke, even though smoking is harmful to their health?For many of the same reasons, people continue to eat unhealthy foods. First, they convince themselves that their risk is lower than others who do the same thing. In addition to this optimistic bias, smokers underestimate how much smoking increases the risk of lung cancer, believing that two-pack-a-day smokers only have a five-fold risk of developing lung cancer, when the actual risk is twenty-fold. This can be seen below and at 3 minutes and 10 seconds of my video “Why Don’t People Eater More?”Many smokers also believe that lung cancer is primarily determined by genetics.
Many of the risks associated with the foods we eat share this same “optimism bias,” including heart attacks and heart disease (our number one killer), obesity, and diabetes. People often find very clever reasons to believe that their own risk is less than the risk of others. So public health advocates may need to understand where this unrealistic optimism is coming from and be similarly inventive in finding ways to help people better understand their own vulnerabilities. All sorts of efforts are being made to reduce or eliminate this bias, but as people begin to realize how much risk they actually face and how much of their responsibility is, “we need to consider the possibility that reducing optimism bias may lead to lower self-esteem and psychological well-being.”
This is a reminder that medical professionals have to walk a tightrope in telling people how much power we all have to beat cancer. There is a well-cited paper that calculates that about 90% of human cancers may be preventable. The phrase “current trends” refers to the 1960s, when this paper was published, but it still applies more than half a century later. “Genetic factors are not the main cause of chronic disease.” Researchers used identical twins to examine how much disease risk was actually genetic and found that among 28 chronic diseases, cancer had the lowest genetic component, with only about 10% due to bad genes. It is a bad habit that runs rampant in the family.
But when we tell everyone the good news about how powerful it is to prevent cancer, what happens to those who already have cancer? When diagnosed with cancer, people often ask, “Why me? Did I do something wrong? Is this my fault?” So you can imagine how harmful a message of “oh well, well, well” can be for patients and survivors. In other words, messages aimed at empowering people and promoting prevention may only end up making cancer patients feel guilty.
But the truth is the truth, no matter how difficult. What doctors must do, then, is guide patients to “switch from a guilt approach to a ‘responsibility’ approach.” They have personal control. They can make different choices from this. Physicians need to give them a sense of agency in their own lives. However, it is better to try to take these steps before you get cancer.
doctor’s note
For more information about personal responsibility, see Why you should care about your nutrition and your personal responsibility for your health.
