The Individualism Fallacy: The Painful Costs For Diabetes
To move beyond "rugged individualism," it's time to unpack the logical fallacy of personal choice to see how diabetes touches so many aspects of life.
We have all heard the story in healthcare that goes like this: If someone works hard enough, makes the right choices, and wants to get better, they will. They’ll pull themselves up. They’ll succeed.
We see it in patient narratives and political and public health messaging. But this belief is not just oversimplified. It’s a logical fallacy called the Individualism Fallacy, and it quietly shapes how we see our patients, ourselves, and the systems we operate in.
What Is the Individualism Fallacy?
The individualism fallacy assumes that outcomes result from personal grit, willpower, or effort. Diet culture and weight-centric care repeat this assumption. If someone is struggling (to lose weight), they must not be trying hard enough. If they succeed, it must be because they’re exceptional (a weight loss unicorn!) This thinking hurts not just our efforts; it separates us from the context and conditions of their lives.
It sounds like:
“She just needs to take better care of herself.”
“If he followed the plan, he wouldn’t be in the ER again.”
“I did it. Why can’t they?”
However, success in managing diabetes, or accessing care at all, is not simply about trying harder. It is also about who has access to tools, time, safety, housing, healthcare, relationships, and a fair shot (including understanding the impact of generational trauma).
What Individualism Ignores
Individualism erases the influence of structural barriers like racism, classism, ableism, and anti-fat bias. It overlooks whose pain is believed, whose questions are answered, and who feels safe asking for help.
Historically, marginalized communities have been denied fundamental personal freedoms that dominant groups take for granted, such as access to voting, food, education, wealth-building, and healthcare. This struggle is with us today, and it is explained beautifully in books:
Weathering by Dr. Arline T. Geronimus,
The Sum of Us by Heather McGhee
My Grandmother’s Hands by Dr. Resmaa Menakem
We can’t ignore these realities. Silence only increases the risk of blaming individuals for problems that were never theirs to carry alone.
How This Shows Up in Diabetes Care
In your work, you might hear patients say:
“I should be able to do this on my own.”
“My family doesn’t ask for help, we just deal with it.”
Or you might catch yourself thinking, “They just don’t care about their health.” “Why don’t they just eat more vegetables.” “Why don’t they know how to cook?”
But what if we stepped back and asked: What if they’re not failing? What if the system is?
Assuming everyone starts from the same place is a false and dangerous premise. It upholds a version of care that rewards privilege and punishes vulnerability.
How It Drives Disconnection
More than ever, our society is facing an epidemic of isolation, disconnection, and depression. This is another painful cost that everyone pays when “Rugged Individualism” is promoted. This logical fallacy impacts client engagement, class participation, and patient visits. It is costly in ways that can’t be measured, but it directly affects our health. Belonging is a necessary condition for sustainable self-care. You can learn more about the four conditions for sustainable self-care by learning about the IDC Inclusion Pyramid.
How to Let Go of the Individualism Fallacy
Letting go of this fallacy isn’t about discounting hard work. It’s about seeing the invisible scaffolding that makes effort possible or impossible for different people.
Here are five ways you can begin to challenge individualism in your diabetes care practice:
Start with yourself.
Ask: Where have I assumed my patients should be able to do this alone? Where have I expected resilience without first ensuring support?Name the systems at play.
When reviewing cases or designing programs, ask: Who is being left out by this plan? Who has access to what this program assumes?Normalize seeking help.
When patients feel shame about needing support, reflect that back with compassion: “You were taught to do it all yourself. And diabetes doesn’t work that way. It’s OK to lean on others. You’re not failing, you’re human.”Advocate for structural change.
Systems of support are being dismantled more than ever. Diabetes is political, and we need to push for policies and practices that reduce barriers rather than just increase motivation. Meeting patients where they are isn’t enough, ;we must build paths to help them get somewhere new.Reconnect with your purpose.
You didn’t become a healthcare provider to reward willpower. You came to connect, care, and challenge systems that leave people behind.
You Are Not Alone in This Work
Acknowledging privilege does not diminish your achievements. It deepens your understanding. It helps you connect more authentically with clients, colleagues, and yourself. It also strengthens your ability to offer inclusive, equitable diabetes care that accounts for real-world complexity and leaves no one behind.
If you're ready to explore how systems of oppression intersect with diabetes care and how we can work together to create better outcomes for everyone, here are some additional resources:
Thank you for sharing!