How to stop being afraid of getting sick

Omar Elalfy, BSc MB BCh MPH Co-founder, The Wellness September 2026

I have never met a healthy person unable to find a good reason to believe they were sick. Every one of them has something. A cholesterol number they’ve been told is a little high, a parent who died young, a pain in the chest that appears now and then and goes away again. Any of the healthy people I know could sit down and make a convincing case that something is wrong with them, and the interesting thing is that none of them ever does. They’ve got better things to do.

Now study the people who aren’t well, or who don’t feel well, and you’ll find that they have made that case many times over. The fellow who is going nowhere with his health has always had a bookful of reasons for it. He’s got the bad family history, the bad genes, the bad luck, the bad age. The healthy fellow could make every one of those excuses and doesn’t.

That’s what this essay is about. The difference between these two kinds of people is not found mainly in their blood tests. It’s in a habit of mind I’d call waiting to get sick. Good news: it’s a habit, which means it can be broken. In my experience this shows in four forms. “But my health isn’t good.” “But my genetics are just bad.” “But it’s too late for me,” or its cousin, “I’m too young to bother.” And “my family all got it, so it’s only a matter of time.” I want to take these one at a time, because there’s a cure for each, and most of the cure is simply knowing the facts.

How the fear gets a hold on you

Fear of getting sick works the same way any other bad thinking habit works. At first you know, more or less, that it’s only a worry. Then you repeat it. You say it to yourself in the shower, you say it to your partner over dinner, you type it into a search engine at 2 in the morning. Every time you repeat it, it gets a little more convincing, until one day the worry has turned into a belief, and the belief has started running your life. You stop doing the things that would actually make you healthier because you’re too busy looking for what’s wrong.

If you think this describes only a few nervous people, look at the numbers. When researchers screened more than 28,000 people attending hospital clinics in London and the English Midlands, about 1 in 5 turned out to have significant health anxiety, and in the neurology clinics it was nearly 1 in 4. When they went back to the same hospital 4 years later the figure had risen from roughly 15% to 20%, and they blamed a good part of the increase on people looking up their symptoms online.

I don’t blame anyone for this. You can type any sensation you’ve ever had into your phone and within a minute be reading about the worst thing it could possibly be. But it’s worth being honest about what the fear costs. It costs you sleep. It costs you attention that could have gone to your family or your work. It changes how you eat and how you move and how you talk about yourself. And it spoils good news, because when the results come back clean the worrier doesn’t feel relieved. He feels the doctor missed something.

The question you bring to the test

Anybody who has a test done usually does so because of an underlying question. Any good doctor knows this, and learns to hear it before he hears anything else. Some people arrive asking, “What’s wrong with me?” Others arrive asking, “What can I improve?”

If you have to bring one of those two, let it be the second one. It changes everything, even though the test, the laboratory, the doctor and the Tuesday morning stay the same. Asking “What is wrong with me?” turns any result into a verdict, and not a good one. Asking instead what you can do to improve will turn your results into a map. Remember this, everything else in this essay depends on it. A test tells you only where you are today, not what or who you are.

“But my health isn’t good”

Let me tell you about two people I know. I’ve changed their names.

I met Daniel at a dinner in Palo Alto last year. He was forty-one, he ran a software company with about eighty people in it, and he had a second child on the way. Somewhere between the first course and the second he found out I was a doctor, and he told me, the way people do once they know, that he was certain something was wrong with his heart. He’d already seen two doctors. Both had listened to his chest and told him it was fine. What he wanted to know was whether he should see a third. What he really wanted, I think, was for somebody to finally find the thing wrong with his heart.

I told him to stop asking doctors to listen to his chest and to go and get himself properly measured instead. A full blood panel, blood pressure, a resting ECG, body composition, and a fitness test on a treadmill. He did. His heart was fine. But his fitness was in the bottom quarter for a man his age, and his 3-month average blood sugar was creeping toward the top of the normal range. Neither of those is a disease, but both can be drastically improved.

That was the moment Daniel changed his question. Nobody could find what he was looking for because there was nothing actually wrong with his heart. What he actually got was a short list of things to improve and a date to measure them again. He wrote to me 90 days after his first tests. His fitness had gone up a full category and his blood sugar had come back down. But that wasn’t in the letter. Instead, he told me about how his company had just closed the best quarter in its history, that he was getting home at 6 instead of 8 most nights, that he’d taken his son to the park every Saturday morning since our dinner, and that he’d stopped checking his pulse in bed. The numbers were just how he got there.

The second person I want to mention is Rachel. I met her through a mutual friend the year after she finished treatment for breast cancer. She was forty-six, a partner in a law firm, with two children in school. If anyone had a right to be afraid it was Rachel, and she wasn’t. She told me that somewhere in the middle of chemotherapy she’d decided that when it was over she was going to become the healthiest she’d ever been in her life, and she wanted numbers to prove it. So she had everything measured, built a plan with her doctors and checked her numbers a few weeks later. Last winter she went skiing with her children for the first time in 3 years, and she outlasted both of them.

Rachel wasn’t in denial. She knew precisely what had happened to her. She had simply worked out that a diagnosis is a fact about the past, and that the only part of her health she could do anything about was the part in front of her. I’ve thought about her a great deal since, and I’ve come to believe that a good attitude and a bad knee will beat a bad attitude and two good knees every time.

Since meeting Rachel I’ve paid attention to how people carry the same condition, and they seem to me to drift toward one of two extremes. Take two men, both with type 2 diabetes. The first one retires from his own life the day he’s told. He talks about his diabetes to anybody who’ll listen. He’s afraid of the wrong food, the wrong weather and the wrong amount of exercise, so he does very little of anything. His real trouble isn’t diabetes. His real trouble is that he’s agreed to be an invalid. The second man treats his diagnosis as one more number to be managed, like the numbers in his business. He checks his blood sugar, he adjusts, and he gets on with his day. He runs a company, he coaches his daughter’s team on Sundays, and I’d be surprised if half the people around him know he has anything at all. Same condition, two entirely different lives.

History is full of the second kind. Franklin Roosevelt led a country through a depression and a world war and couldn’t walk. John Kennedy ran for president with a back so bad he could hardly stand for long, and he never once let it be an excuse. Either one of them could have hidden behind his health, but neither of them did, and neither would have amounted to much if he had.

“But my genes are bad”

The second form of the habit is quieter and harder to argue with, because it sounds like biology. “I’ve got the family history.” “I’ve got the gene.” “My father had it, so I’ll have it too.”

Here’s the fact that ought to settle the matter. The World Health Organization estimates that about 80% of premature heart disease, stroke and type 2 diabetes could be prevented by changes in diet, physical activity and smoking alone. Read that again and think about what it means. Four fifths of the diseases people most fear inheriting are decided mostly by what they do, and what they do is the part they own.

Even the genes we’re most frightened of turn out to be far more negotiable than people think. The strongest common genetic risk factor for dementia is a variant called APOE4, and roughly a quarter of us carry it. A team at Yale followed 4,765 people over sixty for 4 years. Among the carriers, the ones who held positive beliefs about growing older were 49.8% less likely to develop dementia than the carriers who held negative ones. Their risk over those years was 2.7% against 6.1%. Same gene, half the risk, and the difference between the two groups was a belief, which is the one risk factor nobody has to inherit.

What really matters is not how much good health you were born with but what you do with the health you’ve got. I’ve watched men with ordinary genes who did the plain things every week for 10 years run rings around men with superb genes who did them for 10 days. Consistency is 95% of results. An interest in your own numbers, the kind that makes you look forward to seeing them again next quarter, is worth more than anything you were handed at birth.

Most of us make two mistakes about our own health.

1. We underestimate how much of it is in our hands.

2. We overestimate how much of it has already been decided.

Both mistakes lead to the same place. They make a person sit still at exactly the moment he ought to act.

“But it’s too late for me” and “I’m too young to bother”

Age is the excuse that cuts both ways, and both halves are wrong.

Take “too late” first. When Cleveland Clinic followed 122,007 people who’d taken a treadmill test, the greatest benefit from being very fit turned up in the people you’d least expect it to, the ones over seventy and the ones with high blood pressure. In a Lancet study of nearly 140,000 adults across seventeen countries, grip strength predicted death more accurately than blood pressure did, and every 5 kilograms of strength a person had lost was tied to a 16% higher risk of dying. Strength can be added at any age. So can fitness. The body doesn’t stop responding to effort at fifty or sixty or seventy. It stops responding when you stop asking it to.

Now take “too young.” Daniel was forty-one and his blood sugar was already on the move. The particles that cause heart disease, which we measure as ApoB, do their damage over decades, which means the plaque that matters at sixty-five is being laid down at thirty-five. The best time to know your numbers is while there’s nothing wrong with them, because that’s when they’re cheapest to change.

Think, too, about how much time you actually have. If you’re forty, you’ve got 35 working years ahead of you and probably another 20 after that. The question is never whether you’re the right age to start. The right age to start is whatever age you are.

“But my family all got it”

The last form is luck, and it’s the most seductive of the four because it asks nothing of you. “My family all got it.” “Some people are just unlucky.” “There’s nothing to be done.”

The people who stay well don’t believe in luck. They believe in cause and effect. And they’re right to, because the evidence for cause and effect in health is about as strong as evidence gets.

I think a positive outlook is the most valuable thing a person can bring to his own health. I also think it’s the best-evidenced, and that’s the part most people miss. In 2019 researchers at Mount Sinai and Harvard pooled 15 studies covering 229,391 people who’d been followed for an average of nearly 14 years. The most optimistic among them had a 35% lower rate of heart attacks and strokes and a 14% lower rate of death from any cause, and the size of the effect was in the same range as the classic risk factors doctors spend their careers treating. In the same range, in other words, as blood pressure.

Another Yale study followed 660 people for 23 years. The ones who held a more positive view of their own aging lived 7.5 years longer, after allowing for age, sex, income, loneliness and how healthy they were to begin with. Low blood pressure and low cholesterol were each worth about 4 years. Not smoking was worth 1 to 3. Outlook beat all of them.

And there’s a stranger finding still. Ask a person to rate his own health on a four-point scale, from excellent to poor, and his answer predicts how long he’ll live. A review of 27 community studies found this single question predicted death on its own, even after every specific measurement the researchers had was taken into account. People who called their health poor had about twice the mortality of people who called it excellent.

These are observational studies, and I won’t pretend they prove that changing your outlook changes your biology all by itself. Optimistic people almost certainly exercise more, sleep better, and see a doctor sooner. But that’s exactly the point. The person who believes he can be healthier behaves like a person who can be healthier, and behavior is where biology gets decided. A family history is a probability, and probabilities move. Luck doesn’t come into it.

What I’d do if the news were bad

Some people reading this have already sat in the room where the doctor closes the door before he speaks. So let me tell you what I’d do, in order, if I were told tomorrow that something was wrong with me.

First, I’d get checked properly by the best people I could find, and then I’d accept what they told me. If good doctors and a full set of scans said my heart was sound, I’d stop looking for a fifth opinion. Worrying about a sound heart is one of the few reliable ways to give yourself a bad one.

Second, I’d learn how much of the way I feel is driven by stress, sleep and fear rather than by anything a scan can find. A surprising share of what walks into any doctor’s office has no physical cause at all, and worry about illness can produce most of the symptoms of it. Understanding that would take half the weight off before I’d lifted a finger.

Third, I’d resolve to live until I die. Every minute a person spends dreading the end is a minute taken from the middle, and the middle is where the children grow up, the business gets built, and the trips get taken. Why be only half alive?

Four things you can do about the fear of getting sick

The best protection I know against the fear of getting sick is to crowd it out with something more useful. Take these four in order.

1. Stop talking about your health as a problem. The more you describe your body as something going wrong, the more it seems to go wrong, and it wears out the people who love you. Try a month without it. Talk about what you’re working on instead.

2. Trade worry for measurement. Worry is a way of thinking about your health without learning a single thing. Measurement is the opposite. Get a baseline of the things that respond to effort, then measure them again in 90 days. Progress you can see is the most reliable source of optimism there is, because you earned it.

3. Be grateful your health is as good as it is. Right now, without any help from you, your heart is beating, your liver is cleaning your blood, and your immune system is winning fights you’ll never hear about. Most of it works, most of the time, for most of your life. That’s worth being grateful for, and gratitude is far better company than fear.

4. Remind yourself often that health is for using. Life is precious and the days are counted, and the reason to be healthy is to spend those days on the people and the work you care about. Nobody looks back and wishes he’d saved himself for a tomorrow he was afraid of.

What to measure and what to move

Advice that stays general changes nobody, so here’s what I’d measure this month and what I’d do about it.

Measure your blood pressure and resting heart rate. Measure ApoB, which counts the particles that cause heart disease, and HbA1c, which is a 3-month average of your blood sugar. Measure ferritin, vitamin D, thyroid and your hormones. Measure body composition, grip strength and VO2 max, which is how much oxygen your body can use when it’s working hard. Nearly every one of these numbers moves, and most of them will move inside 90 days once you change what you do.

Then focus on the simple things, do them well and do them every day. Daylight within an hour of waking. 7 to 9 hours in bed at the same times each night. 150 minutes a week of steady exercise at a pace where you can still hold a conversation, plus two sessions a week of lifting something heavy. About 1.6 grams of protein per kilogram of body weight. Limit your alcohol as much as possible. These things have real and measurable impact. Implement them every day.

Don’t be discouraged by how small the weekly gains look. Get 1% fitter each week, which is too little to notice, and by the end of the year you’re 68% fitter. Health compounds the way money does, and the people who end up rich in it are the ones who kept making small deposits.

Then find a doctor who tells you what to do next. Not just what’s wrong, and not just that nothing is. A result without a plan is a piece of paper. A result with a plan and a date to measure again is the beginning of a different year.

Life is yours to enjoy

The goal is a long life, but more than that it’s a full one. A body that will do what you ask of it, and a mind that isn’t giving its best hours to fear.

That’s what The Wellness is for. We’re a doctor-led clinic and a technology platform, and we work with the best laboratories, imaging centers and specialists we can find. We measure, we explain, we tell you what to do next, and then we check whether it worked. If you come to us asking what’s wrong, we’ll look properly and tell you the truth. But we’d much rather you brought the other question.

What if you could be healthier? You almost certainly can. Ask the right question, and let the data show you where to begin.

thewellnesslondon.com

About the author

Omar Elalfy is a co-founder of The Wellness. He trained in medicine at Cardiff University (MB BCh) after a BSc in Neuroscience, completed a Master of Public Health at Harvard, and has carried out AI research at the University of Oxford. He is a GMC-registered doctor and splits his time between London and Palo Alto.

References

Rozanski A, Bavishi C, Kubzansky LD, Cohen R. Association of optimism with cardiovascular events and all-cause mortality. JAMA Network Open. 2019. https://pmc.ncbi.nlm.nih.gov/articles/PMC6777240

Levy BR, Slade MD, Kunkel SR, Kasl SV. Longevity increased by positive self-perceptions of aging. Journal of Personality and Social Psychology. 2002. https://psychiatryonline.org/doi/10.1176/pn.37.18.0022b

Levy BR, Slade MD, Pietrzak RH, Ferrucci L. Positive age beliefs protect against dementia even among elders with high-risk gene. PLOS ONE. 2018. https://pubmed.ncbi.nlm.nih.gov/29414991/

Idler EL, Benyamini Y. Self-rated health and mortality, a review of twenty-seven community studies. Journal of Health and Social Behavior. 1997. https://pubmed.ncbi.nlm.nih.gov/9097506/

DeSalvo KB et al. Mortality prediction with a single general self-rated health question. Journal of General Internal Medicine. 2006.

Mandsager K, Harb S, Cremer P, Phelan D, Nissen SE, Jaber W. Association of cardiorespiratory fitness with long-term mortality among adults undergoing exercise treadmill testing. JAMA Network Open. 2018. https://pmc.ncbi.nlm.nih.gov/articles/PMC6324439

Leong DP et al. Prognostic value of grip strength, findings from the Prospective Urban Rural Epidemiology (PURE) study. The Lancet. 2015.

World Health Organization. Preventing chronic diseases, a vital investment. 2005.

Tyrer P et al. Prevalence of health anxiety problems in medical clinics. Journal of Psychosomatic Research. 2011. https://www.psy.ox.ac.uk/publications/1028092

Tyrer P, Cooper S, Tyrer H, Wang D, Bassett P. Increase in the prevalence of health anxiety in medical clinics, possible cyberchondria. International Journal of Social Psychiatry. 2019. https://journals.sagepub.com/doi/10.1177/002076401986623

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