What is Lifestyle Medicine?
It's a question I get asked quite a lot, mainly because Lifestyle Medicine is a relatively new term, and it's an area and an approach to delivering medical care which is still in its infancy. When you read on to understand what it means, you'll realise that the idea that this should be a new approach is utterly bonkers. In fact, when I talk to people, the response is often 'but aren't we doing that already?', or 'isn't that just old-fashioned medicine?' The reality is that Lifestyle Medicine is not practiced commonly, and for this reason, the numbers of patients suffering with chronic conditions is on the rise. Seem like a bit of a rash statement? Let me explain.
The UK has a fantastic health service. I do mean fantastic. Our medical training is second to none, we have an NHS which is everything to all people, providing healthcare from cradle to grave, and free at the point of delivery to every single soul accessing it. Our super-efficient streamlined service mean that we have specialists and sub-specialists who are absolutely brilliant in their field. These subject matter experts and the research they do, are forging paths to new medical discoveries, and solving detailed, complex issues with new medications and protocols. But, amidst all the complexity, there is a growing body of patients who are not served by the system, who have chronic disease such as diabetes or heart disease, or who present with warning signs for future issues, signs such as high blood pressure or high cholesterol, whose intervention does not need to be complex. To these we give medications, perhaps some advice, for some there are excellent support groups - but little more. They are not 'acute' and the system doesn't need or have the resources to save them right now; resources follow urgency, and that always translates to prioritising life-saving treatment. It is more efficient and cost-effective, we think, to spend a few minutes writing a prescription for medication, than to spend an hour understanding what has brought that person to require that medication. This chronic disease population is left largely to fend for themselves, and it is a growing population; a ticking time bomb for further down the line, when these chronic conditions inevitably begin to worsen if lifestyle factors are not considered.
Now, it is easy to lay the blame at the door of the individuals - their choices, their problem. But it isn't as simple as that. Most people know that to lose weight they need to follow a healthy diet, to consume less calories than they burn, and maybe to move a bit more. If it was that simple though, why isn't everyone in great shape? Many factors - cultural, environmental, social, psychological, physical, and more - play into this equation. They're factors that aren't often considered in the black and white of 'what works' in the medical consulting room - and if they are, there is often too little time to give them the full consideration that they deserve, however well-intentioned and enlightened the healthcare professional in that room may be. Lifestyle Medicine gives a home to these patients. It works by giving patients time, time to tell us about their life: their worries, their burdens, their choices, their hopes, their dreams. By doing this, we unearth many of the underlying causes of the external symptoms we see, and this is where Lifestyle Medicine can do its work. Once we discover these causes we can create a collaborative, shared plan with the patient. A plan that fits the patient - the person behind the name on the clinic list. A plan that works to gently turn that person in the direction of ways of living that serve them and their body better. No quick fix, but a slow, transformative process that aims to give that person rewards that last a lifetime, not just for the three months they managed to stay on that diet, or managed to attend a few spinning classes a week.
In a nutshell, a Lifestyle Medicine doctor works with the patient to understand all of the factors that contribute to their whole health picture, recognising that much of our health is underpinned by modifiable lifestyle habits and behaviours, such as the food we eat, how much we move, how well we sleep, how stressed we are, and by how happy we are in general. In conjunction with the 'stats' (blood tests, blood pressure measurements, weight - whatever is relevant for that individual), we get the whole picture and this means we can make a holistic plan. When done well, a Lifestyle Medicine consultation is delivered with a coaching approach, aimed at empowering the patient to walk their own path to better health, but providing all the support and belief they need to make those steps. It's stripping everything back to simple medicine, conjoining the scientific knowledge we have of 'what works' with the precious gift of time, allowing us the opportunity to understand how to make ‘what works’ actually work for the patient in front of us. It's an incredibly effective approach for all manner of conditions, from high blood pressure to heart disease to erectile dysfunction.
Lifestyle Medicine is a positive step back from complexity, an approach that allows the whole picture to be seen, and one in which a partnership between doctor and patient is forged. By supporting people to make lifestyle changes, by helping them to understand the numbers, the risks of continuing as they are, and the benefits of change, the mission of Lifestyle Medicine is to minimise the effects of chronic disease where it already exists, and to prevent it occurring where it doesn't. In our modern-day society, it's a much-needed approach.
If you think you might benefit from this approach, whether that's because you've been given a new 'lifelong' medication to start, or if you've been diagnosed with diabetes or coronary artery disease, are struggling to get the weight off, or have a family history of heart disease (to name just a few), do get in touch. I'd be delighted to work with you.