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How Do We Decide?

  • Main Ideas

    Learning Objective

    Small choices, invisible behaviors, that we make literally shape our future.

    Behavioral Objective

    Analyze choices for how they'll effect you in the future.

    Key Thought


  • Main Ideas

    Learning Objective

    Small choices, invisible behaviors, that we make literally shape our future.

    Behavioral Objective

    Analyze choices for how they'll effect you in the future.

    Key Thought



There are some elements that must be present for us to be able to take an action. For instance, I may want to drink a Frapuccino, but if it is not availble IN MY ENVIRONMENT, then I cannot execute the behavior.

3 Elements of a Decision...

  • Motivation- "I want..."
  • Ability- "I can..."
  • Trigger- "Do it now..."

So here's a case study with a doughnut:

This patient of mine named Sue. "Sue" was very obese diabetic. High blood sugars in the 200s and over the course of six months her weight finally fell below about 300 pounds. Her blood sugar's actually moved into a normal range where she did not need prescriptions; and all of this was done not using any drugs. Her work performance and overall happiness were improving. She actually got promoted to an area of responsibility in the Shipping Department.

To celebrate her promotion, oddly enough, her boss brought in donuts over the weekend shift. Everybody was very busy, working overtime and what did she do? Well, she told me that she ate a half of a donut because she didn't want to offend her boss. I asked her, "How did that make you feel?" and she said, "I felt terrible for an hour and a half. I haven't eaten like that in months. My energy crashed and I felt like my brain was in a fog." And I said, "How many people were in that meeting, the donut meeting?" and she said "About fifteen."

So, you can imagine what effect this had on those fifteen people. And so the price of a doughnut is pretty dang expensive, when you look at it from that angle. Fifteen people are being fed something that causes their performance and abilities to decline and we're doing these things to ourselves, probably every day.

Root Causes

Physiology as a root cause?

What we need to understand is that the small food choices that we make, small behaviors that we make, have big impacts in our physiology. Understand that some of these foods that we eat aren't actually foods and that they have a profoundly detrimental and stressful effect on your body's physiological functioning. It's that physiologic functioning that you feel in terms of mood changes and lower energy. It shows up on your blood work as diseases, like high cholesterol, blood sugar problems, and metabolic syndrome. It can manifest itself as depression and anxiety... all sorts of different ways.

  • Disease based whether traditional Doctor's Medicine (MD) or Complementary and Alternative Medicine (CAM).
  • CAM has less risk; supporting physiology.
  • Both are Expensive: attempting to address multiple interacting dysfunctional paths.

Behavior as a root cause?

And really behavior is at the root of a lot of this physiology. Human behavior is complex, but one thing is that humans always respond to their environment. If there is not a fancy frozen sweetened coffee drink here in my environment then, regardless of whether I want one, I can't eat it.

  • Human behavior is very complex.
  • Humans always respond to the environment.

How Do We Choose?

We are really looking at attempting to find ways to help people make better choices because we care about them. We don't want to "tell" them what to do. But we do want, and really need, them to make reasonable choices. The fact is that, regardless of what we think as free Americans, our decisions effect the lives of the people around us... and groups of people impact communities which impact societies...

There are a lot of different theories out there on why humans behave the way they do and this is a field called behavioral economics. One of the concepts is that of a rational actor, meaning that humans are rational and we are always making decisions that are in our best interest. But do we? What does the observation of the doughnut, of the cinnamon roll tell us? It really reflects choices.

Chess is won ONLY by making good choices.

Can we WIN AT LIFE by making better choices?

Well how do we choose? Humans make decisions based on 3 main things, their experiences, the information that they have, and prompt feedback from that decision that they've made or choice they've made, the action that was taken.

Good Choices:

  • Experience
  • Good Information
  • Prompt Feedback

What if you don't have these choices?

What if we don't have experience in something or what if we don't have access to good or accurate information, or what if we don't get prompt feedback from that decision? Well, the degree to which we lack these three things is the degree to which we might continue to make a poor decision that has far-reaching negative effects on us, but without realizing that that decision is those little decisions with slow feedback leaving us down a path where we'll have some regrets and something someday.

Feedback Cycle

So, let's look at this simple feedback cycle. Mark, at the age of 18, described himself as healthy, energetic, lean. Then things happen in life; choices built up, such as eating Donuts or some kind of equivalent every day or every other day or once a week or whatever it is. He had went through college, had stress, marriage, ate food choices, had his church and other relationships, work, and his growth into an adult. And 20 years later, he's found himself with high blood pressure, cholesterol problems, fatigued, being overweight... And this is a 20 year cycle.

It's really hard for the 18-year-old Mark to look into the future and say, "Hmm. If I eat this donut today, it's going to affect me when I'm 38." Because the truth is eating one donut at age of 18 will not affect him at the age of 38, but the idea of eating the donut and other things similar repetitively over a 20-year period does have its consequences.

So in this case, we have a donut that has a 20-year feedback cycle. It's almost impossible for a person to realize that the donut did it.

So we can change by improving the feedback cycle. We can change by improving the quality of the information that we're getting and believing it to be so. We can improve our decision-making by gaining better experiences or borrowing the experiences of other people who know better, and believing that what they're telling us is true.

Get more rapid feedback. So, if you're aware of what you're eating, then you can be aware of how you feel after you eat. And as a general simple rule, the only thing you should feel after you've eaten is not hungry. You shouldn't feel brain fog, fatigue, bloated. You shouldn't have abdominal pain. Nothing should hurt. And you should just carry on. You shouldn't be thinking about food thereafter.

fresh avocado sliced into halves fresh avocado sliced into halves

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The Activities section contains easy and fun, personal activities that enhance learning and encourage participation and discussion. Activities help to turn the knowledge acquired from the Read, Watch and Quiz sections into personal actions that over time become sustainable, healthier lifestyle behaviors.

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