I wrote a blog piece for my medical group a few years ago that I continue to get positive feedback on where I talk about “The 3 Components of Maleness” and “The 3 stages of Male Health Breakdown.”  Recently someone reached out to me and said:

“Your blog piece on men’s health was right on and it got my husband to start eating healthier…something I’ve been trying to do for years.  Thank you!”

So in honor of June being Men’s Health month, I’ve decided to revise and re-release this post.  Feel free to share with the man in your life who you care about, but who refuses to take care of himself!

The 3 Components of “Maleness”

Speaking as one guy to another, I have a few questions I ask myself when it comes to men’s health. As an internal medicine doctor, I often wonder what drives some men to lead unhealthy lives? Why do many men only see me in the office for their physical after their wives schedule their exams or drag them in kicking and screaming? Why will men only read this blog after their wives have forwarded it to them and why will even more men hit “delete” after they read the title? Why do some of my most successful, intelligent, driven male patients have such worrisome health IQs and no motivation towards improving their health?

Let’s start by discussing the 3 key components of the maleness:

1. Denial: Think back to your college days when you felt invincible. You could eat a large pizza and barely gain a pound. You could pull all-nighters consecutively for a week before final exams and recover after sleeping in a full day. You didn’t have to think or plan when it came to sleep, food, or vigorous physical activities because your young body had tremendous resilience and healing capacity. You could be so much more spontaneous.

Unfortunately, many of us are in denial and still think we can accomplish these types of lifestyle behaviors without paying a price. However, our bodies have changed.

Intermittent moments of spontaneity are fine, but if you are regularly staying up late and eating and drinking at free will on business trips and on most weekends, then you end up paying a price.

2. Internalization: Part of being a guy is taking the hits and moving on. There may be personal and professional obstacles causing tremendous emotional stress, but we usually internalize them and move on. To some extent, this can be considered resilience, but keep in mind that persistently stored up tension and anxiety manifests in other ways. Irritability, anger and stress, for example, may manifest as poor sleep and unhealthy eating.

Bottling up emotions, which is especially a tendency in my Asian and Indian patients, has been repeatedly shown to increase the risk of heart disease and cancer, as shown in this article

Emotional repression is also a major risk for developing mental health conditions like anxiety and depression.  Having someone to share your feelings with, whether it’s your spouse, a family member, close friend, co-worker or a professional therapist can really help you blow off some of that pent up steam.

This is a skill I’m learning late in my life, but I am definitely teaching it to my boys early on.  At the dinner table or while shooting baskets I will often engage them in heart-to-heart conversations about all kinds of topics I never shared when I was an internalizing kid.

Exercise, sports, outdoor activities like nature hikes, and meditation are other ways to cope with internalized stress.  Go here for some of my past posts to help you manage your stress.

3.The Male Ego: This can be a tough one to crack. I had to put aside my own male ego in writing this blog piece. Many of us guys know our lifestyles and habits aren’t optimal, but we refuse to change and resist advice from others, especially spouses and close family members.  Advice with good intentions turns into “nagging” and sometimes our behaviors are almost defiant. We want to make changes on our own terms, not because someone told us to.

Kind of sounds like a toddler, doesn’t it? This is why I describe guys as grown up kids and if that describes you, then schedule an appointment with your doctor and let him or her tell you what you need to hear. Most guys are OK with having their doc tell them what to do rather than their wives or partners.

Characteristics of confidence, resilience, independence and drive may make us successful in the workplace, but unfortunately a residual feeling of invincibility from youth often leads to unhealthy behaviors with direct consequences on our health.

For the males I see in my clinic, it’s between age 30 and 40 that things start breaking down in guys who neglect their health.  Our warranty starts to run out.  In fact, due to our increasingly sedentary behavior and poor eating habits, the male body is breaking down even earlier than this with 20-year-old males complaining of aches, pains and presenting with early onset health conditions like diabetes and abnormal cholesterol.

3 Stages of Male Health Breakdown

I’ve broken the deterioration of the male body into three stages. Your goal is to intervene as early as possible:

Stage 1: If your waistline is expanding and you’re getting more aches and pains, these are warning signs of premature aging, a common condition I see here in Silicon Valley, and which I blog about in this post.  My patients who take care of themselves have little to no aches and pains and maintain a normal body weight and size, regardless of age.

Remember, aging is more a consequence of your lifestyle, rather than how many years you’ve inhabited planet earth.

Stage 2: Abnormal biometrics. In addition to your weight and waistline being abnormal, your other critical numbers like blood pressure, cholesterol, and blood sugar are now out of range. But heck, you aren’t having chest pain or shortness of breath. You still feel fine other than your Stage 1 symptoms. In addition, most of your guy friends also have a potbelly and take a drug for cholesterol, so that makes it feel more “normal” or acceptable.

Despite the wonders of modern medicine, a University of California, Los Angeles study found that 75 percent of heart attack patients have normal cholesterol levels and many of them were already taking cholesterol drugs like statins!!

Medications treat numbers, but they can’t overcome the much more adverse effects of being overweight, inactive and under chronic stress.

Stage 3: This is a significant health event, resulting from poor lifestyle choices and you being stubborn enough to ignore the Stage 1 and 2 signs. For example, you might receive a diagnosis of diabetes, experience a heart attack, or suffer a herniated disk from being overweight and out of shape.

I’ve looked into the eyes of men after these types of events. Male ego is wiped out completely and fear, vulnerability, and depression often take its place. All of a sudden that impossibly busy schedule magically opens up and these men find 60 to 90 minutes to exercise, eat healthier, live lower stress lives and spend more time with loved ones, without sacrificing their income.  They actually become professionally more productive and successful as a result of making these changes which may have felt like a “waste of time” in the past.

Which stage are you in? What’s going to motivate you before you advance to the next stage?  I tried to be tactful and exclude Stage 4, which you can guess is the most tragic consequence of ignoring your body’s warning signs!

“It’s My Body and I Can Do What I Want!”

If you’ve got a family and others who depend on you, refusing to change is a selfish decision. I take care of entire families and often kids and spouses spend time, money, and emotional energy caring for family members who refused to take care of themselves when they were younger.  Maybe they said or behaved in a manner that expressed the notion that “it’s my body and I can do what I want.”

I’m thinking of one particular patient’s family where the father is paralyzed from a stroke and is wheelchair bound, with end-stage kidney disease from uncontrolled diabetes. His highly educated daughter had to quit her well-paying job to drive him to kidney dialysis and multiple physician appointments. Back in his heyday he was a strong, independent man who ate what he wanted and refused to exercise despite warnings from his family.  He definitely exuded the attitude of “it’s my body and I can do what I want.”  What felt like his own individual lifestyle decision then, is now having severe repercussions and creating emotional and financial stress for the entire family.

Think of Your Children

Your health is not just about you. In fact, your children are modeling their behaviors after you. Kids are more obese and inactive than ever. They desperately need healthy role models to reduce their risk of chronic diseases later in life. Playing organized sports like soccer and basketball doesn’t guarantee a lifetime of activity.

Many of my high-risk patients were star athletes in high school and even college, but are now unhealthy due to inactive lifestyles and a poor diet.

Don’t just tell your kids to be active while you sit all day. Play sports with them. Let them see you exercise and have them join you. Make family time active. When you leave to exercise, let them know “daddy’s going to the gym” or “going for a run.” They need to know that in the midst of your busy, adult life you are making healthy eating, physical activity and quality family time a priority.

Put Things Into Perspective

I often ask older patients, “When you reflect back on your life, what things would you have done differently?” Answers are typically,  “I wish I took better care of my health.” Or ” I wish I spent more time with my family.”

No one has ever said they wish they had worked more hours, made more money or exercised less.

Are you going to look back and wish you spent more quality time with your smartphone or did a better job grooming your Facebook page? Probably not. However, right now most of us are spending a large part of our lives doing just that.

Minimize your future regrets by prioritizing your health now, by being a role model for kids and family and by contributing to your community. And please…don’t wait for stage 2 or 3 to start making changes.