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Health Behavior: From Paradox to Paradigm

Editor’s note: This article is adapted from the address of the American Diabetes Association President, Health Care and Education, given in June 2000 at the Association’s 60^th Annual Meeting and Scientific Sessions in San Antonio, Texas.

In preparing to speak with you today, I did a great deal of thinking about what I wanted to share. And I kept coming back to behavior. Health behavior is fascinating. How people make decisions is truly a puzzle. Each one of us has only to look at our own informed health decisions to realize that there are many paradoxes in health behavior. We end up murmuring to ourselves about our own food choices or lack of exercise. What was I thinking? Indeed, was I thinking?

The following dialogue is an example of why I believe health behavior remains a puzzle . . . Imagine that you are seated in an airplane, and you overhear this conversation between two women near you.

First woman: "...Did you tell him that?"

Second woman: "I don’t know what I told him. I’m never in control of what I say to doctors, much less what they say to me. There’s some kind of disturbance in the air."

First woman: "I know exactly what you mean. It’s like having a conversation during a space walk, dangling in those heavy suits."

Second woman: "I lie to doctors all the time."

First woman: "So do I."

Second woman: "But why?"¹

Why? Yes, that is the question that fascinates us. And it may surprise you that I found that conversation reprinted in the Annals of Internal Medicine several years ago.

Please come with me on a brief personal journey. First, we will look at some paradoxes in diabetes health behavior. We will then look forward to an emerging paradigm for diabetes . . . [Full Text of this Article]

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