Intended for healthcare professionals

Feature

Lifestyle medicine: a new medical specialty?

BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4442 (Published 25 October 2018) Cite this as: BMJ 2018;363:k4442

Teach students lifestyle medicine, as it is the basis of medical care rather than its own specialty.

This article echoes recent findings by a paper published in the Lancet[1]. The leading causes of ‘estimated years of life lost’ are commonly associated with lifestyle factors. This highlights the vital need for integration of lifestyle medicine into all medical specialties rather than forming one of its own.

A vast amount of the NHS budget is spent on preventable conditions such as some of those mentioned in the Lancet paper. Despite the increased number of medications available, the burden of disease is not declining. For example in type 2 diabetes the risk of complications is not reduced by drug glucose control[2]. Why then is the focus still in these pharmacological areas?

The British Heart Foundation stated this summer that heart attacks and strokes were set to ‘surge in the next 20 years’ due to a continuing rise in obesity, often associated with type 2 diabetes[3].

Uninformed lifestyle choices, as such, set off this tumbling domino chain of medical conditions. The concept of lifestyle medicine can therefore tackle the cause of these conditions. It does not simply treat the problems if they arise.

A quote in the article states that “advising citizens and patients about evidence based alterations to diet or exercise to prevent and treat disease has been part of the medical curriculum for decades”. In my experience as a medical student, it has barely been addressed over my last 3 years of study. Its involvement in the curriculum does not extend much beyond the words ‘advise patient on a healthy lifestyle’.

We must support people to improve their health generating habits. Therefore, I think students should be given the resources to enable the individual patient to understand from their own perspective how they could benefit from the change. In my opinion, this kind of behavioural change forms the foundations of lifestyle medicine although is a difficult aspect of the consultation.

From my own experience and shadowing I have not gained good insight into how to deliver positive change generated by the patient’s own understanding.

References

1) Steel, N. et al. Changes in health in the countries of the UK and 150 English Local Authority areas 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 2018. DOI: https://doi.org/10.1016/S0140-6736(18)32207-4 [Accessed 27th October 2018]

2) Boussageon, R. Pouchain, D. Renard, V. Prevention of complications in type 2 diabetes: is drug glucose control evidence based? British Journal of General Practice. 2017. 67(655); 85-87. DOI: https://doi.org/10.3399/bjgp17X689317 [Accessed 27th October 2018]

3) The British Heart Foundation – Growing diabetes epidemic could trigger ‘sharp rise’ in heart attacks and strokes by 2035. Available from: https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2018/au... [Accessed 27th October 2018)]

Competing interests: No competing interests

30 October 2018
Judy Havinga
Medical Student
Birmingham