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At the heart of general practice since 1960

‘Lifestyle medicine’ could revolutionise patient care

Dr Ayan Panja and Dr Rangan Chatterjee

The sequencing of the human genome was meant to crystallize our understanding of the critical roles that genes play in health, but we have discovered the opposite.

Genetics only accounts for about 10% of disease risk, the remaining 90% being due to our lifestyles, behaviours and environment. Deep down, we GPs know this, and see it first hand when it comes to conditions like type 2 diabetes. But a paradigm shift has been going on largely out of sight of doctors looking at the role of lifestyle as medicine.

Now I know what you are thinking. ‘Lifestyle medicine’; it’s a real buzz phrase at the moment, but it is just a bit of stop smoking advice, diet and exercise, right? Actually, there’s a lot more to it. There are reams of literature, which tell us about how food, movement, sleep and rest affect our wellbeing - down to a molecular level.

How does that help us as GPs? When applied carefully just like any intervention, it’s an effective way to tackle, prevent and sometimes reverse non-communicable disease, including autoimmune conditions. Imagine being able to accurately prescribe lifestyle medicine; well, now it’s possible.

This is an intervention that is safe, low cost and easy to apply in practice. Along with increasing numbers of doctors, we have both practised this model of care for many years. As well as patient satisfaction, our own clinical satisfaction has immeasurably improved.

Lifestyle driven chronic conditions are growing and the truth is that many clinical presentations can be managed effectively by using a simple framework - no more complex than a basic consulting model. It’s about thinking more broadly about the patient and prescribing targeted, personalised interventions. It is about joining up the dots in their systems biology, rather than getting carried further downstream with each new or added symptom and feeling the pressure to ‘hold’, prescribe or refer (e.g. migraine headaches, IBS symptoms, aches and pains, tired all the time, brain fog etc).

We both feel strongly that NHS GPs should know about this kind of work and be able to roll it without effort into our impossibly busy days. You can find out more at our one-day RCGP-accredited CPD course ‘Prescribing lifestyle medicine’ next January.

Dr Ayan Panja is a GP in Hertfordshire and Dr Rangan Chatterjee is a GP in Cheshire

 

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Readers' comments (8)

  • This is about proper lifestyle medicine. Not just a tick box exercise. "Dietary advice given" If doctors could only realise and believe in the power of lifestyle change rather than looking to pharma ( who can't provide disease reversal just suppression of symptoms )
    Unfortunately it's not all in our hands though. We need everyone to realise that crappy cheap food and stressed out lifestyles are causing a very expensive chronic disease epidemic.

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  • It is true that lifestyle changes impact many diseases, as well as impacting subjective wellbeing. However. most lifestyle recommendations apply to the entire population, not just to the patient in the chair. One-to-one discussion in GP consultation is therefore likely to be an unnecessarily time consuming way to communicate lifestyle advice. Systems for mass education are required.

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  • Agree that life style medicine has tremendous impact on peoples health.But the the practical difficulties are the service user our patients ,How many of them ie % will take home our message and adhere to them? NHS UK pt's expectations are high and different.Personnel responsibilities of individuals are low.Unless the "culture" changes in user and provider no amount of increased resources can meet the demand.

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  • agree with the comments - that is why mental health clinicians have so much longer consultations: trouble is,they seem to do worse than GPs and rely even more heavily (and definitiely unecessarily) on addictive pharma drugs instead!

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  • So a bit like Yoga and Ayurveda?

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  • We've been pushing lifestyle advice down our patients' throats for decades, yet obesity levels continue to soar. It's naive to think that yet more lectures on diet & exercise will somehow reduce the bingeing on pies, pizza, fags, booze & Sky.

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  • Problem is the latest brand of 'lifestyle medicine' is poorly evidence based clap trap such as telling people to put coconut oil in their coffee and never eat grains. The other trend is to criticise doctors for prescribing too many medicines and then go and prescribe vitamins and supplements that don't work.

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  • Poorly written. At least make an effort to illustrate with example. Doctors sre trained to do drugs and surgery.

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