Health Futures Trajectory Mapping
Visualize your health futures to turn abstract disease risk into urgent, daily action
Dr. David Unwin's clinical practice is built on the premise that every person has multiple possible health futures, and that current daily decisions—especially food choices—are the routing mechanism between them. Rather than citing disease risk statistics abstractly, the framework makes futures concrete: map the trajectory of continuing current behavior versus changing course, attach probabilities to each path, and identify the specific daily decisions that determine the outcome. His wife, clinical health psychologist Dr. Jen Unwin, has researched hope's role in clinical outcomes—finding that visualizing a specific achievable health future measurably affects adherence and recovery. This model converts vague health anxiety into directional, motivated daily action.
- Every person has multiple possible health futures—which one materializes is determined by present daily choices
- Hope is not wishful thinking; it is a clinical variable that measurably affects adherence and outcomes
- Connecting specific today behaviors to specific future outcomes converts abstract risk into actionable motivation
- Young people have the greatest opportunity because compounding works in both directions over a long timeline
- Doing nothing is not a neutral choice—it routes you toward the default future, which is often the worst one
- Audit your current metabolic baselineGet fasting blood glucose, HbA1c, and waist circumference measured. These three markers reveal which health future you are currently on course for, often years before symptoms appear.Pro tipThe waist-to-height test is free and immediate: your waist measurement should be less than half your height. If it is not, you are already on a metabolic risk trajectory.WarningWithout baseline data, the exercise of mapping futures is speculative. Real numbers create real urgency and real motivation.
- Map two concrete futures—current path versus intervention pathWrite a one-paragraph description of what your health likely looks like in 10 years if you change nothing, and a second paragraph describing the outcome if you make specific dietary changes now. Attach Dr. Unwin's reversal probabilities where relevant (93%, 73%, or 50%).Pro tipSpecificity matters more than precision here—'I will likely have fatty liver, elevated HbA1c, and early cardiovascular risk' is more motivating than 'my health will be worse.'
- Identify your 3 highest-impact daily routing decisionsList the specific daily behaviors that most determine which future you arrive at. For most people these are what they eat for breakfast, whether they consume high-GL staples at lunch and dinner, and baseline activity level. Name specific foods and habits, not broad categories.Pro tip'I eat cornflakes and toast every morning' is more actionable to change than 'I eat unhealthily.' The more specific the decision, the more concrete the swap you can make.WarningAvoid listing more than five behaviors at once—an overwhelming list creates inaction. Identify the 2–3 with the highest metabolic impact and address those first.
- Replace one high-impact behavior at a timeSelect the single routing decision with the highest metabolic impact and replace it with a behavior aligned with your desired future. Hold that swap for two to four weeks, monitoring one measurable proxy, before adding a second change.Pro tipReduced hunger and improved mental clarity within one to two weeks are early, reliable signals that blood sugar is stabilizing—use them to reinforce the new behavior.
- Review your trajectory quarterly with objective dataAt each three-month HbA1c retest, compare your current markers to your baseline and to the two futures you mapped. Confirm you are moving toward the desired future and adjust your target behaviors if progress has stalled.Pro tipLiver function, blood pressure, and waist often improve faster than HbA1c. Tracking these provides motivational evidence between the quarterly blood tests.
After 25 years prescribing medication and advising 'eat less, move more' while watching both his patients' health and his own waist expand, Dr. Unwin mapped his trajectory honestly: continuing his biscuit habit as a sedentary senior GP was routing him toward type 2 diabetes. Choosing the intervention path—low-carb dietary change alongside his patients—produced reversal across every measurable marker: waist, blood pressure, liver function, energy, and cognitive clarity within months.
Dr. Unwin saw two patients under 25 with poorly controlled diabetes—a situation he had never encountered in his first 25 years of practice. These cases illustrate the opportunity of the health futures model: young people have the longest timeline for compounding, meaning the same intervention applied at 22 versus 45 produces a dramatically different long-term health future and begins with the highest reversal probability (93%).
Extracted from The Diary Of A CEO, featuring Dr. David Unwin. The framework reflects Unwin's core clinical belief, shaped by 25 years of standard practice that failed to improve population health and the research of his wife, Dr. Jen Unwin, a clinical health psychologist specializing in hope's role in disease outcomes. Together they developed this behavior-change model when launching their Monday-night low-carb patient groups in 2013.