Why we keep putting off the health decisions we know we need to make

A Brisbane surgeon reflects on the pattern he sees most often in patients, and why the hardest part of improving your health rarely has anything to do with health itself.

Most people who are unhappy with their health already know they want something to change. They have thought about it, Googled it late at night, maybe even started a conversation with their GP, but never acted on it. The intention is there, but the follow-through keeps getting pushed to a more convenient time, after the holidays, once things settle at work, at the start of a new year.

But the “more convenient time” rarely comes, and what started as a plan slowly turns into something they just carry around.

Dr Justin Greenslade has spent more than twenty years as a surgeon at Brisbane Bariatric Centre, where the clinical side of his work is clearly defined, assessing patients, walking through options, performing procedures, and supporting recovery. 

But the pattern he comes back to most often has little to do with the surgery itself. It is the gap between when someone first thinks about doing something for their health and when they actually walk through the door.

"People aren't usually undecided about whether they want to change," he says. "They're undecided about whether now is the right time. And that question has a way of following them around for years."

It’s a pattern most people would recognise, and it’s not limited to weight or surgery. Big health decisions tend to come with a bit of friction, uncertainty about what’s involved, hesitation about what might come up, and the feeling that you should wait until the timing is right, but it rarely comes around.

Two-thirds of Australian adults are living with overweight or obesity, yet only a small proportion seek medical support. Access and cost play a part, but a large part of the gap comes down to hesitation, people meaning to act, but continuing to put it off.

One of the things that tends to keep people in that holding pattern is the feeling that they should be able to sort it out on their own first. It’s something Dr Greenslade hears all the time.

“There’s a lot of messaging out there that frames weight as a willpower problem,” he says. “So people spend years trying to fix it through effort, and when that doesn’t work long-term, they feel like they’ve failed, rather than recognising that they’re dealing with something more complex than a lack of discipline.”

By the time many patients make an appointment, they have already tried most of the available alternatives, sometimes for decades.

What often changes things, he says, isn’t a big turning point like a new year or a milestone birthday, even though those moments can prompt action. More often, it’s simply deciding to sit down and find out what the options actually are.

“The first consultation isn’t a commitment to anything,” Dr Greenslade says. “It’s just a conversation. A lot of people leave that first appointment wondering why they waited so long to have it.”

The lead-up to that conversation, about health, about weight, about needing help, is usually the hardest part. It tends to feel bigger in your head than it actually is once you’re sitting there having it.

In the end, it’s rarely about finding the perfect time; it’s about deciding to stop putting it off and see what comes next.