It's the unconscious that decides for them. The ego is just a collection of the unconscious content that comes to the surface.
To make the unconscious conscious is a bit tricky, but not impossible. The body impulses are different from the rational choices.
For example, you know that eating junk food can make you sick but you keep on eating it because it tastes good.
Without discipline, man is not any different than an animal. If you let your body choose for you, then it's your body that decides for you (no "free" will).