The musings of a final year medical student

Friday, 14 December 2018

Lifestyle Medicine backlash



Is there a backlash against Lifestyle Medicine? It’s a movement I feel passionate about, so I was taken aback to hear more and more doctors seeming dubious and critical of it.

I was surprised when Margaret McCartney, GP and previous stalwart BMJ columnist Tweeted last month: “Please stop promoting ‘lifestyle medicine’ as a new thing. It’s basic social and human care, and should not be a conduit into non ebm [and] private healthcare.”  

I didn't know how to react to this. This is a person I really respect and have enjoyed her columns, who now seems to poo poo an area I believe in. There was a mixed response to her view. Firstly, I wasn't aware that doctors were using it to promote private healthcare. After a bit of Googling, I can see what McCartney is getting at. It's not ethical if HCPs are promoting Lifestyle Medicine with a veiled ulterior motive and potential financial gain. To my knowledge, this only represents a tiny proportion of those who wave the Lifestyle Medicine flag. 

A lot of the arguments I have heard against Lifestyle Medicine include the feeling that 'eating well and exercising is common sense'. It absolutely is not. We are constantly bombarded with misinformation and a culture that praises dress size, calories and aesthetics over health.  Lifestyle Medicine is just as equally about dispelling nutribollocks, as it is providing evidence-based advice. However, doctors don't receive enough formal education on nutrition, exercise or mindfulness. While doctors learn plenty about the social determinants of health, what actual practical advice are they taught that can be given to patients? In a 2017 survey published by the British Journal of General Practice, only 20% of GPs were broadly or very familiar with national physical activity guidelines. We all know we should eat healthily and exercise, but how do we execute that? How do we incorporate that into our busy lives? This is what birthed the concept of Lifestyle Medicine. 

Are sensible recommendations for eating and exercise a new concept? Of course not! But now more than ever, we need our health care professionals to be a reliable, knowledgable group of people that are clued up on all these fads so we can go to them to help us understand what to believe. And if we do want to be healthier, we need advice on how to do that safely. That is what Lifestyle Medicine is.
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