Self-Induced Disease: Why the #1 Killer of Americans May Surprise You

There are many paths to a happy healthy life—here are some of one doctor's favorites
BY Patricia J. Sulak TIMEMarch 19, 2019 PRINT

As a practicing physician for over 30 years, I realized that more and more of my patients were becoming unhealthier and unhappier. This was often due to a self-induced lifestyle, including an unhealthy diet, physical inactivity, substance abuse, financial irresponsibility, and an inability to deal with the usual stressors of daily life. As a medical school professor and researcher, I also had the latest data on the declining health of our nation, confirming what I was seeing in my practice: The #1 killer of Americans is an epidemic of self-induced disease and disability.

When I graduated from medical school in 1980, about one in 10 Americans were obese compared to one in 3 today. This high rate of obesity is leading to diabetes, high blood pressure, abnormal cholesterol levels, heart attacks, strokes, destruction of joints, higher rates of some cancers, including breast and uterus, and numerous other costly medical illnesses.

How did this happen? Two key contributors: our food is unhealthy, and we are leading a sedentary lifestyle.

I was also seeing an increasing number of my patients on pain medications for all sorts of chronic conditions. It’s not that we have new diseases that cause pain. We appear to have less of a tolerance for the pain.

less of a tolerance for the pain
Illustration (Motortion Films/Shutterstock)

Growing up on a farm, we often hurt ourselves working, and my mother had severe degenerative joint disease. But we didn’t even have an aspirin in the house. Pain medications have become so pervasive that the U.S. Centers for Disease Control and Prevention (CDC) announced in 2013 that we have a “prescription painkiller epidemic among women.”

There are almost one million emergency department visits annually by women for drug misuse and abuse. About 15,000 deaths among women annually are attributable to drug overdoses. That’s more than deaths from ovarian cancer.

And despite all the conveniences of everyday life, an ever-increasing percentage of my patients are stressed out, in unsuccessful marriages and relationships, often depressed, requiring medications for anxiety, mood disorders, and sleep disturbances. The statistics are alarming. The CDC has announced there are now more deaths from suicide than from motor vehicle accidents, with the suicide rate increasing 30 percent since 1999 in middle-aged people ages 35-64.

We currently have an abundance of self-induced diseases the medical industry is failing to adequately address. Of the 2.5 million deaths that occur annually in the United States, hundreds of thousands are preventable. Besides the two major lifestyle causes—poor diet and lack of exercise—the other leading contributors to premature death and disability are substance abuse such as smoking, alcohol and drugs, and stress.

Increasingly, Americans are spending billions on “health” products or relying on their health care providers to manage self-induced problems through prescription medications, procedures, and surgeries, rather than altering the behavior that caused the problems to begin with.

As a doctor, I became frustrated with my inability to help solve the problems. There wasn’t enough time in a short office visit to discuss all the preventive measures along with suggestions for implementation. The situation was made worse by my lack of training in wellness issues.

To be honest, I was not a prime example of wellness myself, often stressed out, angry, and definitely not eating well. My marriage was not ideal either. Frustration with my patient’s health status and my own drove me to seek out a new positive direction. My physician husband and I decided to focus on being healthier and happier. I began investigating all aspects of wellness, spending several years reviewing literature, reading books by respected authors, attending seminars, personally conducting conferences, and most importantly, implementing the concepts I was teaching into my own life. The result: my husband and I are now healthier and happier than ever, and our marriage of 35 years has soared to levels we never thought possible.

Here is a summary of everything we learned about leading a life of health and happiness, detailed in my national presentations and my book, “Should I Fire My Doctor?: Eleven Essential Elements to Living Well Aware.”

1. Normal Numbers Now

I’m referring to cholesterol, blood sugar, blood pressure, and body weight. Getting these numbers in optimal range is critical to preventing premature death and disability. Know your numbers and get them normal now. Check out my website and download my “Partner with Your Provider” worksheet which lists all the values you should know and their normal range.

2. Critique Caloric Consumption

Bio Healthy food, herbs and spices
Eat a rainbow of seasonal, nutrient-rich produce. (Shutterstock)

We all need to critically critique what we eat. It’s not about going on a diet. It’s about eating healthy. The truth is most people consume more than they burn off while consuming unhealthy food, often full of sugar, unhealthy fats, salt, and preservatives. It’s not about giving up what you love. It’s about getting rid of what’s killing you! The Mediterranean Diet has the most data on health benefits.

3. Make Movement Mandatory

We all need to move. It’s one of the most important things we can do to decrease disability, depression, death, and even dementia. The problem: technologic advancements have greatly decreased our need to move. The solution: we have to be creative in putting movement into our schedule. It’s not difficult, and definitely doesn’t require a killer boot camp or gym. We just need to move and in healthy ways working on stamina, strength, balance, and flexibility. It’s also important we don’t hurt ourselves in the process.

man jogging outside
(Jenny Hill/Unsplash)

4. Address Adverse Addictions and Harmful Habits

All of us do things that are not in our best interest. Sometimes it’s serious addictions. Often, it’s a harmful habit such as overeating, overworking, anger, overspending, excessive time on Facebook, or watching hours of mindless TV. We need to determine what helps us and ultimately what harms us. Harmful habits need to take a hike.

5. Meticulously Manage Money and Minutes

We can say, “Ok, I get it. See my provider; get to ideal weight; critique what I eat; move; halt harmful habits.” Should be easy, right? Not. We all have excuses. “I don’t have enough time,” you might say, or “I don’t have enough money.”

That’s why you must meticulously manage money and minutes. Using our time and money to serve others and ourselves well is an important element to health. If you’re blessed to have more than you need, deciding what to do with that excess is critical to your well-being. Money and minutes need to be managed. What are you doing with yours?

6. Graciously Give Your Gifts


Eleanor Roosevelt said it best: “When you cease to make a contribution, you die.” If we continually work on growing and striving to be the best model we are capable of being, our contributions will soar as we use our time, talents, and treasures to help others. Or, as was so humbly stated by Gandhi, “The best way to find yourself is to lose yourself in the service of others.” The more I am concerned about others, the more I am at peace with myself. If I give and expect nothing in return, I avoid self-servitude and will never be disappointed.

Here’s the kicker. We have to inconvenience ourselves. We are truly giving when we sacrifice our time, talents, and treasures for others. Stopping to help a neighbor, visit someone in a nursing home or prison, volunteering at a crisis pregnancy center—you name it. Why do I want to strive to give more and more? I want to be happier and thus healthier. Make true giving an integral part of your living.

7. Forgive Friends, Family, Foes—and Yourself

Holding no grievances is essential to optimal health. Anger destroys. Forgiveness heals. Our body is a chemical factory releasing neurotransmitters and hormones. Keeping them in balance helps us function optimally. When we are angry, our entire body is affected by the immediate release of these substances. In the past, I could get upset in a heartbeat. Now, when I see myself having a grievance, a warning light goes off. Being angry is not going to help this situation. To quote the Buddha: “You will not be punished for your anger. You will be punished by your anger.” Every religion has a major focus on forgiving. Forgiveness is a mandatory component to optimal health, taking away anger, guilt, and stress. Give and forgive, so you can move forward.

8. Passionately Pursue Purpose and Priorities

Who am I? What is my purpose in life? Without a healthy concept of why we are here, we can find ourselves going through each day not satisfied, depressed, and anxious. Our priorities may be out of whack because our purpose in life is not defined. Who am I? It’s a critical question that requires an accurate answer.

(Jens Johnsson/Unsplash)

Who is Patricia Sulak? I strive to be a loving, energetic force that lifts others. By defining myself, I can use my time, treasures and talents to help others. I want to love, not hate; be energetic not lethargic; lift others, not bring them down. I want to be guided by a higher power, not my culture driven ego. When I’m living my purpose, I’m at my best. When I’m not, I’m allowing my ego to create havoc in my life. Who are you? That’s a question you must answer for true health and happiness.

9. Stifle Stress, Sever Suffering

Stress. Do any of us go a day without feeling stressed? Stress is defined as emotional tension resulting from adverse or demanding circumstances. What determines if something is adverse or demanding? You! What one views as demanding, another may view as exciting. It’s not what happens to us in our life; it’s the meaning we attach to it.

I think of stress as a conflict between my inner self that wants a life of peace, joy, and love and my ego that is driven by power, prestige, and possessions. Our ego also wants total control over life events—a set up for stress. We need to stifle stress, and try to sever suffering. This can help us be the creative, amazing people we are meant to be.

10. Periodically Pause, Ponder, Plan, and Pray

How can we get off the path of harmful habits and onto the road of healthy habits? Call it whatever fits your world: pausing, pondering, planning, praying. For me, it’s about RPM: reflection, prayer, and meditation. It’s the toughest essential element I face. I get caught up in things I think I need to do and find that life itself is passing me by. I am so focused on the future, I miss out on the present.

Practitioners of Falun Gong, sit in meditation in New Zealand in this file photo. (
Practitioners of Falun Gong, sit in meditation in New Zealand in this file photo. (

I am now in the daily habit of taking time to be by myself—no noise, no electronics, no distractions. I start out with simply being grateful for my life, embracing the expected and unexpected, the gains and losses, the joy and sadness. I focus on what I am called to do, who I can lift up, who I need to forgive. I then simply focus on breathing as I mindfully meditate. We can find meaning in all events, creating a greater awareness of who we are and what we need to do. I call this living well aware.

11. Seek and Secure Support

We have to invest in the best wellness information, implementation, and inspiration in all aspects of our life. We must question everything. There are no new problems. Thousands, if not millions, have had the same problems we have. They’re all recycled. And the true answers are out there. Find them by seeking and securing support! Who’s on your team? Where are you getting your information? Are you investing in your health?

Patricia J. Sulak is a medical doctor and author. Visit for more information. This article was first published on

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