Is Your Doctor Helping You Optimize Your Health? Or Just Managing Disease?
Think Beyond the Bell Curve. Challenging Medical Paternalism.
This piece is not supposed to be controversial because the logic is straightforward, but knowing how easily people get offended on social media, I'm sure some will find a way to take it personally.
I'm more concerned about people with authority fucking up than someone without.
I'll share a story about a doctor on X at the end of this article. But before that, let's tackle the main topic.
I take a strong stance against the outdated and paternalistic mindset of certain 'experts' that "Medical testing should be done selectively and only when there is a clear medical necessity to avoid unnecessary anxiety, misinterpretation, and overtreatment."
Two reasons why:
I'm a health-and-fitness-conscious person meaning I aim for optimization of health, performance, and longevity - not just the avoidance of disease.
I know enough math and statistics.
Most of these people are, unsurprisingly, not healthy and fit themselves. It appears they view the world through the lens of their own health and lifestyle choices. They encourage others to follow the same path to validate their own approach. They preach what they practice, imposing their own limited perspective and insecurities on others under the guise of expertise. They mistake their personal preferences for universal truths.
On one side is paranoia and overdiagnosis, but on the other, ignorance and a false sense of security. On one side is obsession and overtreatment, but on the other, neglect and complacency. How do you balance it? Through education.
Let me tell you a secret: there are no health and fitness 'experts'. Your only chance at a healthy life is if you take ownership, agency, and educate yourself to autonomy.
For both health and fitness, you must take ownership. Generic advice is worthless if you don't want to be treated like just another nameless, faceless statistic in a system that doesn't see you. You deserve better.
At this point in time, people should know that the field of health and fitness is so vast and intersectional that there are no experts in the field, including doctors, coaches, and therapists. They are educated professionals who can serve as guides with specific problems, but don't confuse any of them for experts.
If someone calls themselves an expert, it's either because they cannot see beyond their bubble or it's just plain narcissism. There are no experts. None.
The medical system has taught you to be either passive or reactive instead of being proactive and this goes against the ethos of health-and-fitness-conscious people. It's "too little, too late." Health-conscious people want to be in control of their bodies and choices.
They have this desire to track every aspect of health and they want to be self-aware. The "wait-until-you're-at-risk" approach, it's not for them. This doesn’t mean going against general medical guidelines, but rather supplementing it with personal vigilance. Being responsible for your own health and fitness!
Remember what I said about outsourcing your health and fitness? It doesn't work. You cannot outsource your health and fitness.
Health and fitness require regular practice. Regular practice requires behavioral change. Behavioral change requires mental conditioning. Mental conditioning requires education and the consumption of relevant content and the company of like-minded people to rewire one's brain and reinforce those ideas repeatedly. Building your health and fitness requires your 100% emotional involvement. You can, however, accelerate the process by hiring and consulting good educators, coaches, and doctors and creating accountability, but these external supports will only work if you approach them with the mindset that you must eventually become autonomous. Self-improvement requires self-investment to ultimately become self-sufficient. In the end, it's intrinsic motivation that makes the difference - the internal drive that pushes you to show up every day, even when the external rewards or pressures are gone.
Imagine if, in education, everyone was told to follow the same curriculum, regardless of their abilities, interests, or aspirations.
Imagine if, in your career, you were required to follow a set path with certain milestones, promotions, or skill developments at specific ages, regardless of your abilities, experiences, or ambitions.
Imagine if there were societal guidelines about when you should enter into a relationship, get married, or have children, based on average age ranges or milestones.
Health-conscious individuals seek more than just prevention - they want to optimize their health, performance, and longevity. Rather than waiting until guidelines suggest it’s necessary, they choose to monitor specific aspects of their health proactively (e.g., tracking metabolic markers, hormone levels, or even performing early DEXA scans for bone health). From a proactive health standpoint, health-conscious people often seek early detection, prevention, and optimization, which can be stifled by guidelines designed for the general population.
While general health guidelines are designed to reduce disease risk, they don’t usually focus on optimization. Health and fitness-conscious individuals typically aim for optimal health, performance, and longevity - not just the avoidance of disease. General guidelines tend to dictate screenings or treatments only when risk thresholds are crossed.
General health guidelines are designed for large populations and based on epidemiological studies that examine how certain behaviors, interventions, or risk factors affect health outcomes in the majority of people. While they are evidence-based, cost-effective, and prevent over-testing and over-treatment, they are not personalized to individuals. These guidelines are based on averages - what’s statistically best for the majority of people.
If you’re health and fitness-conscious, you might not fall into the "average" category that guidelines are designed for. By recognizing that the current guidelines are based on where the majority of people fall (within ±1σ or ±2σ), we understand why they might not address the needs of individuals who want to be proactive and who might not fall into the same distribution as everyone else.
General guidelines provide a solid foundation. They should be seen as the minimum standard for health, but they cater to the middle of the distribution - the majority. This creates a passive approach where people wait until they hit a risk threshold (e.g., reaching a certain age) to get tested or take preventive measures.
Imagine that in your age group, the majority of people have developed lifestyle disorders - whether it's obesity, hypertension, or diabetes - because they follow a sedentary lifestyle, eat poorly, and neglect regular exercise. The general health guidelines for your age group are based on this average population, focusing on managing these common conditions and suggesting basic screenings once they hit certain risk thresholds.
But if you’re someone who is health and fitness-conscious, maintaining a nutritious diet, exercising regularly, and tracking your health metrics, these general guidelines won’t address your needs. You’re already far from the "average," and being assessed by the same parameters or waiting until you hit a risk threshold doesn’t make sense for you. Instead, you'd want to be assessed by more advanced, preventive measures to fine-tune your health and catch potential issues early - before they manifest into something serious.
If the majority of people in your group are dealing with lifestyle disorders, why would you want to be lumped into that same category for health assessments? You would instead aim for proactive health optimization, with lab tests and screenings customized to your unique needs, not based on the average, unhealthy majority.
So the question becomes: Would you want to be assessed on the same parameters as the majority, if you’re clearly living outside of their distribution in terms of health? The obvious answer for any health-conscious person is no. This is why personalized, proactive testing is essential - it acknowledges that you don’t fit the standard profile and allows you to take ownership of your health instead of waiting for issues to arise like the rest of the population.
A health-conscious person must be aware of their initial values to set a personalized reference range - a baseline that helps track their progress and understand what optimal health means for them, not the average population.
People follow general health guidelines due to helplessness (they have no other choice) or limitations in their knowledge or access to technology, rather than because those guidelines are truly optimal.
It’s often easier to follow a well-established, widely-accepted path than to navigate the complexity of personalized approaches. General guidelines provide structure, even though they may not be optimal. For many, this provides a sense of security and eliminates the need to research more deeply.
General guidelines serve as a safety net, but definitely not an optimal strategy.
The future of health and fitness is personalized, and the sooner you move away from the one-size-fits-all approach, the better. While it may take some effort, one of the most rewarding aspects of investing in your health is that the more you engage with it, the more you’ll understand about biology and biochemistry - an invaluable tool for long-term well-being.
Reject passivity and don’t wait for a reactive healthcare system to flag issues; instead, feel confident in pursuing early testing, preventive measures, and optimization, even if you fall outside the standard risk categories. Taking charge of your health means staying ahead, not just avoiding illness.
Now, referring to the story I mentioned earlier, a doctor proudly shared on X how he casually missed a critical opportunity to address the very real threat of childhood obesity and future health risks. The story? A diabetic patient brought his son along to show him what living with this disease looks like. The father, doing the responsible thing, warned his son that because of his genetic risk, he needs to choose a healthier life early on. But instead of reinforcing this urgent message, the doctor chose to sugarcoat the reality.
His words? "Don’t worry about some condition you might get in the distant future. None of us leave this earth disease-free." Really? In the middle of a global childhood obesity epidemic that’s directly leading to more cases of diabetes, heart disease, and other lifestyle disorders, this doctor thinks it’s okay to let a kid off the hook? This is exactly the kind of soft, irresponsible attitude that contributes to the problem. We have kids developing diseases that used to be seen only in adults, but apparently, this doctor thinks telling them to "enjoy life" is the solution.
What he should have done is talk about how childhood obesity has dramatically increased in the past few decades. How lifestyle choices, even in childhood, directly impact their future health. How unhealthy eating and lack of exercise are literally setting them up for a lifetime of preventable diseases. But no, he decided to be the “cool” doctor, skipping over the hard truth to protect the kid’s “joy” while ignoring the very real danger creeping closer every day.
This is certainly one of the reasons why we’re seeing skyrocketing rates of obesity and diabetes in younger populations - because even the people who should know better are downplaying the urgency of the situation. Sure, it’s easier to dismiss it and send the kid home with a smile. But when that boy is struggling with diabetes as a young adult, will this doctor still feel proud of his passive, feel-good advice? Probably not.
Beyond just knowing the science of diabetes management, if this doctor isn’t practicing healthy habits in his own life, he should not be considered an authority on overall health and fitness. Daily practice of good health habits is critical to understanding the full scope of health. Health is about more than managing diseases; it’s about embodying healthy principles every day. Without that personal commitment to fitness and well-being, his advice is limited and out of touch with what it takes to truly live a healthy life, which is why I said in the beginning,