This is a question I’ve been asked both by friends and colleagues. As a GP, I will routinely give patients information about what they can do to improve their medical condition, such as eat less salt or exercise more. But lifestyle medicine is much more than that.
The American College of lifestyle medicine (1) define it as evidence based lifestyle therapeutic approaches to prevent, treat and often at times reverse lifestyle related chronic diseases, such as diabetes, high blood pressure and obesity.
80% of all premature deaths are attributable to three factors: -tobacco -poor diet -lack of physical activity
The lifestyle medicine approach includes a predominately whole food, plant based diet, regular physical activity, adequate sleep, and the cessation of risk behaviours such as smoking. There is also particular recognition that all the components of ones life can impact upon health, so there is emphasis on forming and maintaining positive relationships and managing stress.
At the centre, and unlike other holistic modalities the advice that is offered is based on evidence based scientific studies and current research, and it’s purpose is to work alongside current medical practice rather than instead of it, such as is the case in alternative therapies like homeopathy or Chinese medicine.
As a working NHS GP, it is my job to take a history and get information about a clinical problem, then like pieces of a jigsaw puzzle, I put it together and usually offer a solution, most commonly in the form of a tablet. As most people are aware GP’s have significant limitations on their time, which is as frustrating for the doctor as it is for the patient. There are a lot of things that need covering within 10 mins, and disappointingly there often just isn’t time to discuss lifestyle changes. It is not uncommon practice for me to say to someone who is overweight as they are walking out the door – please try and exercise more. Therefore it’s no surprise when their condition doesn’t improve, the medication doesn’t work, people don’t loose weight and they come back again and again with the same problem.
In the UK and around the world there is a growing trend of a new generation of doctors looking at medicine from a broader perspective. It’s recognising that people are not just simply a condition like diabetes or hypertension. One size does not fit all and that looking at a person as whole, addressing all their needs, be that mental, physical, or social and then tailoring advice based on current scientific evidence, is a more effective form of medicine. Whilst some may argue that lifestyle medicine is being presented as the ‘emperors new clothes(2)’ and this is something doctors routinely do, I disagree. My generation of doctor’s were not adequately trained in offering advice on diet, sleep or stress management. We were also not taught essential communication skills like coaching and or using CBT to support sustained behaviour change. It is however really encouraging to see that lifestyle medicine is now being weaved into the medical curriculum, and more and more medical schools are teaching it to undergraduate medical students.I also feel that when your own doctor gives lifestyle advice to you, it feels more personal and credible than if you were to see a dietician or nutritionist. This is why I am currently training to complete an internationally recognised diploma offered by the British Society of lifestyle medicine. I have found the knowledge that I am gaining, has transformed my clinical practice and my patients seem to be more satisfied. I also thought this blog would be another portal where I can share evidence-based lifestyle advice.
For me lifestyle medicine is the future and it is the way as doctors we should be managing all our patients. I would love to be able to see patients either individually or in a group and offer specific treatment options such as nutrition or sleep advice, that are personalised to them and their individual needs. In doing so, this will encourage and support people in making sustainable and meaningful change and live more active, healthier lives. Hopefully as more doctors become aware of the principles of lifestyle medicine and learn to incorporate into their clinical work we could see big shifts in the health of our patients and in our communities and hopefully help one day to save the NHS.
What are your thoughts on lifestyle medicine? Are you involved in any way? Do you think it can help the NHS? I would love to hear your views, please leave a comment below.
1. ACLM. What is lifestyle medicine 2015 5/21/2018 Available from: http:/www.lifestylemedicine.org/what-is-lifestyle-medicine.
2. Lifestyle medicine: a new medical specialty? BMJ 2018;363