LIFESTYLE MEDICINE: A THREAD.

I’d like to talk a little bit about lifestyle medicine please. For background, I am a GP. Over the course of several years I made many lifestyle changes that have improved my life in a number of ways.

I realised several things on this journey. One was that, even as someone as lucky and privileged as I was, I had no clue of the positive impact using that could have on my health and well-being.

Another thing I realised is that doctors know CRAP ALL about nutrition and physical activity. We get caught up on pointless minutiae - low carb vs keto and CrossFit vs marathons when people could benefit SO MUCH from a bit of walking or maybe switching to Coke Zero.

We easily fall victim to privilege and elitism, and think lifestyle change is about meditation retreats, kale and moral superiority. And you can understand why. For me, my issue was I hated exercise as much as I loved cake. Easy fix: bit more exercise, bit less cake. Done.

And naively I assumed, as so many do, that everyone else’s reasons for their lifestyle were the same as mine: “lifestyle choices”. One of the most ubiquitous oxymorons in play.

From my place of privilege, my lifestyle choices were all my own. But learning about lifestyle medicine taught me the extent to which this isn’t the case for the vast majority of people, and just telling people to change their lifestyle IS NOT GOOD ENOUGH.

Food inequality, education, social determinants of health, access to nutrition/exercise/nature/transport/safety are the key players. And that’s before we even touch on psychology, relationships with food, advertising/marketing/budgeting etc.

Unfortunately lifestyle medicine seems to have a dual identity at the moment. Some use it as a virtue signal to sell their diet books and feel superior to others because they don’t eat ice cream (LOL).

Others see it as making the best of the hand we are dealt, while also trying to change how the dealer hands out the cards. Empowering people to make changes they can make within their limitations to improve their health as much as possible, BUT...

Also using the recognition of the importance of these determinants of health to encourage top down change with regards to policy, funding etc so those limitations can change a bit too. We can’t change our genetics, but maybe we can change the other bits.

Like the icing on the cake. Important, but not the be all and end all. Can’t necessarily fix a broken cake but could make it a bit better, and if it doesn’t it was fun trying. I like cake analogies.

The trouble is, it’s not a protected term so when people scream lifestyle medicine it’s not immediately clear which side they’re on. Even as someone who is super “into” lifestyle medicine, it’s not easy to tell. It’s equally easy to assume people are on the wrong side.

So, if we want to be on the right side we need to be explicit when we talk lifestyle; that it’s not about blame/shame/morality, but that having an understanding that health conditions are impacted by how we live AS WELL AS medicine itself can lead to change on multiple levels.

We also need to be careful not to “oversell” it as a cure all, but remember it’s an adjunct to many other factors. And overall we must be realistic and honest, even if we get excited by something we know we benefitted from.

THE END