We’ve likely all seen these people on the high street or in the mall: very fat and riding a mobility scooter with one or two amputated limbs. It’s incredibly depressing. Yet, for every one you see, there are probably dozens or hundreds who never go outside. Many who stay indoors are blind as well. This is the end result of poorly controlled diabetes (Type-1 or Type-2).
When I see these people, and the damage they have inflicted on themselves and continue to inflict on themselves, one word pops into my head: Why? Why do certain people continue making the same unhealthy choices that led to the scooter and hundreds of pounds of fat? The answer is, of course, that there are many reasons unique to each person: addiction to sugar and carbs, lack of will, parents followed a terrible lifestyle and passed it on, etc. Yet, there is one thing I believe that these people all have in common: a short-term approach to life.
Austrian School economists call this high time preference and use it to explain things like interest rates, production and consumption. It is also called presentism, orientation in the present or short-term behaviour. Analysing this mindset can also be used when examining social phenomenon like crime, drug use, poor health and family dysfunction. Put simply, those who live in the present and do not think about their long-term future are more likely to commit crimes, abuse drugs, be unemployed, be sexual promiscuous and make poor health choices. What do these types of people choose instead? Instant gratification.
A great book written on the social ills of the short-term mentality is Edward C. Banfield’s The Unheavenly City. When discussing the short-term mentality, Banfield observes:
If [the present orientated person] has any awareness of the future, it is of something fixed, fated, beyond his control: things happen to him, he does not make them happen. Impulse governs his behaviour, either because he cannot discipline himself to sacrifice a present for a future satisfaction or because he has no sense of the future. He is therefore radically improvident…He works only as he must to stay alive, and drifts from one unskilled job to another, taking no interest in is his work..He is careless with his things…and, even when nearly new, they are likely to be permanently out of order for lack of minor repairs.
If we examine those diabetics who still gobble down really unhealthy food, do no exercise, pack on more pounds and have poor blood glucose control, you will very likely find this mentality. The pack of crisps, the chips, the fried chicken, the Whopper, the cola, the Dairy Milk bar all taste good. And they taste good NOW! The negative results are in a hazy future for the present orientated person if he thinks about the future at all.
Banfield also observes this mentality when it comes to health “His body, too, is a thing “to be worked, but not repaired.”
In contrast, the future orientated person (i.e., someone with a low time preference) is ready and able to avoid instant gratification and consider long-term consequences. This has been a significant impulse driving me to achieve optimal health even though I’m a Type-2: I want to be healthy at 75 or 80. If I make the right choices now and do the right things now, I won’t go blind or have painful nerve damage or amputated limbs, or all the other things that come with poorly controlled diabetes. In practice, that means an HbA1c that must be 5.8 or less. Not 6.0 or 7.0.
The economist John Maynard Keynes famously quipped “In the long run, we’re all dead.” That is true, and some use that mentality to argue life is better lived in the moment with little thought of the future. All I can say is good luck with that. I choose looking to the future.