When I began my practice more than 30 years ago, I had the skills and information to help sick people get well and to help healthy people stay well, but I still had a lot to learn. I thought all I needed to do was take a careful medical history, perform a thorough physical examination, and prepare detailed diet and lifestyle recommendations. I thought my patients would follow my advice diligently and get outstanding results.

But it didn’t always work that way. I learned that people didn’t want to make drastic lifestyle changes or give up their bad habits. They did not quickly or easily give up cigarettes, coffee, alcohol, or other drugs, nor did they want to give up meat, fish, fowl, eggs, dairy products, oil, salt, or sugar.

My patients believed in magic. They believed that despite their bad habits, indiscretions, and lack of personal fortitude, the magic of modern medicine would somehow enable them to make a few minimal changes and that they would instantly overcome years of abuse to their health.

Many of these patients had been given poor advice by their doctors. They had been told that changing the color of their meat from red to white or being moderate while continuing their unhealthful habits was all they needed to do; some believed their problems were all in the head or the inevitable result of aging; many thought they might have no choice but to learn to live with it. It was frustrating to see people who were sick and dying, suffering needlessly, and hanging on to the very habits causing their problems.

Over time, I began to observe that the patients who did the best in the long run were those who had a reality-based philosophy of life. It was not enough to tell these individuals what to do; they wanted to understand how and why it worked. I realized at that point that my role as a physician would involve more re-education than I had previously thought.

During these past 30 years, I have had the pleasure and privilege of helping several thousand individuals learn to get healthy and stay healthy. I would like to share some of the information I have learned during that time so that you can stay healthy too. Let’s take a look at some of the things that influence our behavior the most. To a large extent, these influences on our behavior determine the quantity and the quality of our lives.

Going beyond Survival

On one level, humans are like any other animal: we are genetically programmed, biologically-driven organisms whose fundamental purpose in life is survival. By survival, I mean getting enough to eat and not being eaten by something else.

But there is more to our existence than survival. We operate on an entirely different level from other animals, and we have developed the most powerful tool that the world has ever seen—language. Language has allowed us to dominate the planet. Unlike other animals, who acquire knowledge only through direct individual experience, language enables us to accumulate knowledge and pass it on. Language is the power behind the success of our species. The knowledge that might take an individual a lifetime to accumulate can be passed on in moments by listening to someone speak or by reading their words. This enables us to benefit from the cumulative life experiences of those who came before us.

One outgrowth of our unique gift of language has been a mathematically-based system that we call science. The scientific method, while not perfect, is a tremendously powerful tool that helps us separate fact from fantasy. One of the direct benefits of this system is our ability to monitor and evaluate factors that either enhance or impair health.

Understand Pleasure versus Happiness

Most animals spend virtually all of their time trying to get enough to eat and not get eaten. But we humans have gained control over our environment to such an extent—especially in the more powerful, economically developed countries—that we have been able to get enough to eat, not get eaten, and still have time left over. Now that we can look beyond mere survival, we can explore what gives life meaning or, to put it another way, what makes us happy.

The problem is that confusing pleasure with happiness can lead to very unhappy results. Pleasure is a stereotypical response of your nervous system to specific stimulation. Food, sexual activity, and even drugs can stimulate your nervous system in such a way that you can experience pleasure. Happiness is not the same thing; it is an emotional state that occurs when you perceive the overall balance of your life experience as highly positive.

Many unhappy people, mistakenly assuming that they lack pleasure in their lives, go about trying to stimulate the pleasure-sensing mechanisms of their nervous system. Drug addiction is an extreme example of pleasure-seeking behavior. Drug addicts often will destroy their lives to induce a temporarily pleasurable response. Crack cocaine addicts reportedly have sold their infant children for a few rocks of cocaine. But no matter how much cocaine or other drugs they use, no matter how much the drug stimulates the pleasure-sensing mechanisms in the brain, they will never achieve happiness through drug use.

The Importance of Planning

To achieve happiness, we must develop a happiness strategy, which involves learning to delay gratification and not to be driven solely by short-term pleasure-seeking behavior.

Imagine a person with lumber and nails deciding to build a house. Suppose they begin randomly nailing boards together; how will that go? Without a plan, what are the chances that these random actions will result in a nice house? With careful planning, a good set of blueprints, and lots of hard work and patience, the likelihood of success increases dramatically.

We need to approach our health and happiness this way. Without a plan, we are unlikely to achieve happiness. And to make a plan, we need to understand the obstacles to our success.

Overcome Cravings for Concentrated Foods

There is an evolutionary reason we find some things pleasurable and others painful. Our survival once depended on distinguishing between what benefited and harmed us. But many behaviors that served us well in a natural environment, when our focus was survival, no longer serve us.

Consider our desire to eat foods with high concentrations of calories. The earliest humans lived in a natural setting where food was scarce. They needed to eat as much concentrated food as possible to survive. Those who were successful at getting enough food to survive passed that trait on to succeeding generations. We all still have this basic instinct, to eat concentrated food when it is available, in our genetic makeup. But now we live in an entirely different world.

Today, we live in an environment characterized by food excess, not scarcity. There are no chocolate chip cookie trees, hamburger bushes, or ultraprocessed foods in nature. But in our increasingly artificial world, we can order fast “foods” like these on nearly every corner. These processed products are designed to appeal to our genetically driven instincts, and they fool our natural senses.

In short, our natural desire to eat concentrated food whenever it is available no longer serves our needs because we live in a time when those foods are everywhere.

Recognize Unhealthy Illusions

It is not easy to be healthy and happy in an environment that seems designed to make us sick and miserable. It’s no wonder poor health and unhappiness are so common. How many people do you know who drive two hours in heavy traffic each day to jobs they hate, to work with people they dislike, to make a product they detest, for a company they despise, to make money to buy products they do not need, all under the illusion that if they could only cram a little more short-term self-indulgent behavior into their lives, they might be happy?

Why is it that so many of us continue to participate in behaviors known to cause pain, disease, and premature death? Why do we continue to use harmful drugs like tobacco, alcohol, and coffee? Why do we continue to eat animal products and junk food despite the known dangers? We do these things because they give us pleasure. And as I wrote before, many unhappy people confuse their unhappiness with a deficiency in pleasure; the more unhappy we are, the more susceptible we are to craving those things which give us temporary pleasure. While there is nothing inherently wrong with pleasure-seeking behavior, it can be destructive if it becomes the primary focus of life.

Our life of illusion begins when we are young and our parents teach us to depend on drugs, a dependency which we then pass on to our children: When we have a headache, we take a pill. When we have a fever, we take another pill. When we have a cough, we drink a syrup. When Dad has a hard day and needs to relax, he drinks alcohol. When we are so sleep-deprived that we can hardly get out of bed in the morning, we drink a nervous system stimulant called caffeine. We give this same addictive drug to children in the form of chocolate and soda.

Navigate Social Roadblocks to Health

Even after we understand and begin addressing the biological and psychological reasons we are drawn to unhealthy behavior, there remain many social barriers to making diet and lifestyle changes. I call these the social roadblocks to health.

The human nervous system is wired to recognize social conformity. When an individual challenges the social norm by being different, it can create psychological pain in people around them. This pain is called cognitive dissonance. People do not like how cognitive dissonance makes them feel, so they work very hard to eliminate it and, if necessary, you.

Because people evaluate by comparison, to feel better about themselves, they will either try to improve their lot in life or bring you down. Since most people do not get enough sleep, they are too tired to improve themselves. They may put what little energy they do have into trying to bring you down. When they see you trying to eat well, they may try to tempt you with a stimulating high-fat dessert or something else you no longer choose to eat. If you decline, they may comment along the lines of, “What’s the point in being healthy if there is no joy in life?” or “You are no fun anymore!” or “Don’t you think you’re carrying this health thing a little too far?”

Many people might also suddenly become nutrition experts. When you were eating hot dogs, fried chicken, cupcakes, or candy, no one said a thing, but just as soon as you start bringing healthy meals to work, you begin hearing comments like “You can’t live on that!” or “Where are you going to get your protein?” What they really feel but cannot express is discomfort. By improving yourself, you are making them feel uncomfortable about themselves.

Remember Your Goals

Successful individuals begin new projects with their goals in mind. They focus on what matters most to them and do not get distracted, regardless of how urgent those distractions might seem. If happiness is your goal, remember that health is an important foundation for happiness and that health results from healthful living.

Healthful living means taking responsibility for four primary areas of your life:

• diet—eating the right foods for the right reasons
• environment—maintaining a healthy home and workplace
• activity—getting enough exercise, rest, and sleep
• psychology—engaging in productive activity and developing interpersonal skills.

We are all different, but the equalizing factor in our lives is time. We all get 168 hours per week. At most, we have about 30,000 days left to live. The challenge is using our time effectively to promote health and happiness for ourselves and our loved ones, and that is the point of making smart goals and giving ourselves an achievable plan.