Psychology of Health Pt I - Intro

In The Psychology of Money, Morgan Housel does an excellent job articulating a simple idea:

Happiness ≈ Expectations – Reality

The gap between what we expect and what actually happens determines a large portion of how satisfied we feel with our lives.

The same concept applies to health and the healthcare system.

Over the next few articles, I want to explore how expectations vs reality shapes how people perceive their health, their fitness, and ultimately their well-being.

Two Common Health Perception Problems

When it comes to health, people generally fall into one of two categories.

1. The Perfectionist

These are often individuals in the top 5% — sometimes even the top 1% — of overall health and physical capacity.

Yet they feel miserable.

Why?

Because their internal expectations are undefined or impossible.

When you ask simple follow-up questions like:

• What does “enough” look like?

• What exactly do you want to achieve?

The answer is usually unclear.

If your definition of success is undefined, you will never reach it.

You’re chasing a moving target.

2. The Blissfully Delusional

Then there are people who believe they are in the top 1%, but reality says otherwise.

We’ll leave that one at that.

The Jiu-Jitsu Reality Check

This dynamic shows up very clearly in Brazilian Jiu-Jitsu.

The average male who has never been involved in physical conflict often assumes they could defend themselves or “handle themselves” in a fight.

Then they step on the mat.

Within about 60 seconds they are exhausted, repeatedly submitted, and confronted with a very blunt meeting with reality.

It’s not that they’re weak.

They were just uninformed about their actual level of capacity.

Health works the same way.

Most untrained people simply don’t know where they stand.

Youth: The Grace Period

When you’re young, both health and wealth give you something magical: Time.

You can make a lot of health mistakes when you’re young—poor sleep, poor nutrition, inactivity—and for a while you still feel pretty good. Wealth works the same way.

If you start early, time compounds your progress.

But eventually, reality catches up.

Why Many Young People Avoid Primary Care

Younger populations have been visiting primary care less frequently.

There are many reasons:

• The rise of direct-to-consumer health products

• The growth of online pay-to-play clinics

• And frankly, not enough positive experiences with traditional primary care

Another issue is that true health assessment takes time.

A quick visit rarely allows for a comprehensive evaluation of:

• metabolic health

• body composition

• lifestyle habits

• long-term trajectory

Yet those are the factors that matter most.

Two Ways to Handle Reality

When it comes to health, people usually choose one of two paths.

Option 1: Avoid Reality

You can bury your head in the sand and avoid objective assessment.

No testing. No metrics. No feedback.

For a while, this feels comfortable.

But comfort doesn’t change outcomes.

Option 2: Get an Honest Assessment

The better option is to:

1. Understand where you are

2. Develop a plan

3. Move forward intentionally

Most people don’t actually have a plan.

They’re just wandering.

You can wander through life aimlessly, or you can explore with intention.

Personally, I think the best approach is: Know where you're going — and explore a little along the way.

A Machine That Tells the Truth

The body composition machine in my office has no emotions.

It doesn’t care about your feelings.

It doesn’t discriminate.

It simply reports objective information.

And people often have very strong opinions about what it says.

Objective assessments can be uncomfortable because reality can hurt. We thought we were here and we really are there. 

But discomfort is not the same thing as danger.

Pain happens every time we feel it.

Confidence is realizing:

Just because something hurts doesn’t mean you can’t get through it.

Listening: The Real Job

Much of my job is simply repeating back what patients tell me.

This is called listening.

Sometimes when I repeat it back, people say:

"That’s not what I meant." Great. Then let’s clarify.

Because understanding what someone is truly trying to express is the starting point for solving the problem.

Humans Are Bad at Self-Assessment

Human insight is not nearly as good as we think.

Some people feel like they’re dying tomorrow even though their health is objectively strong.

Others are in terrible health and feel like they rule the world.

It’s fascinating.

Mindset Matters Too

This dynamic mirrors the difference between abundance and scarcity mindsets.

An abundance mindset believes:

• improvement is possible

• change is possible

• the future can be better than the present

A scarcity mindset believes:

• nothing will change

• improvement is impossible

• you are permanently stuck

Sometimes people truly are stuck.

And when that happens, they may need:

• a hand to pull them out

• or simply a map to get not lost

Where Expectations Should Meet Reality

The long-term goal is simple:

Bring your expectations closer to reality.

Some people argue the solution is lowering expectations.

That’s one approach.

But there’s a better option:

Improve your reality.

The Practical Approach

Humans have many weaknesses when it comes to perception:

• biases

• faulty memory

• emotional distortions

The solution is to build systems that help us see clearly.

1. Get curious.

2. Observe.

3. Write things down in real time—because memory is unreliable.

4. Compare notes.

5. Look for discrepancies with humility.

And if your vision is blurry, the solution is simple: Get better glasses.

3 Point Summary

• Happiness and health perception are largely determined by the gap between expectations and reality.

• Many people either hold impossibly high standards or dramatically overestimate their current health.

• Objective assessment combined with curiosity and humility helps close the gap between perception and reality.

3 Practical Takeaways

1. Get an Objective Health Baseline

Know your numbers:

• body composition

• metabolic labs

• strength and fitness markers

• sleep quality

You can’t improve what you don’t measure.

2. Define What “Enough” Looks Like

Ask yourself:

• What does good health mean to me?

• What is the target I’m actually aiming for?

Undefined goals create permanent dissatisfaction.

3. Replace Judgment With Curiosity

Instead of reacting emotionally to data, ask:

• What does this mean?

• What can I improve?

• What small step comes next?

Curiosity turns reality checks into progress.