"Lifestyle medicine?"

Have you heard of “lifestyle medicine,” which is apparently new? A definition online suggests “evidence-based, person-centred care,” of which the pillars are: 1) healthy eating 2) mental wellbeing 3) healthy relationships 4) physical activity 5) minimizing harmful substances and 6) restorative sleep. Doctors can do extra training to become “lifestyle physicians,” which bothers me quite a lot because…doesn’t this concept sound an awful lot like family medicine?

Doctors are considered pill pushers sometimes, yet we have been talking nonstop about lifestyle since, well, the beginning of time. I emphasize smoking cessation so much that patients have said things like “You finally harassed me enough to quit.” People know, or should know, about harmful substances like tobacco, alcohol, caffeine, and cannabis, yet continue to misuse them and suffer the consequences. Is addressing that problem something new?
      I've promoted exercise endlessly, since it is pretty much the answer to everything for health. The only thing that makes peoples’ eyes glaze over more than talking about potential downsides of their cannabis use is talking about their lack of exercise. “I’ll exercise when the weather’s nice,” people say, in a community where it’s winter 9 months of the year. It’s too cold/icy/snowy/hot/rainy/buggy. I tell them it will improve their pain, mood, sleep, falls, strength, and brainstorm easy ways to fit activity into their days. Is anybody listening?
      Doctors discuss diet frequently. Want to know about benefits and potential risks of plant-based, low-preservative, low carb, high protein, DASH, Mediterranean, low residue, keto, or reduced-calorie diets? Most family MDs pick up information about diet at conferences, courses or in journals; dietitians, present on most health care teams, spend their entire education learning about these things and are widely available. Finally, are people listening to the information about diet from “lifestyle physicians” any more than anyone else, in a climate of climbing costs for high quality food?
      In family medicine, conversations about mental health occur daily. The way it contributes to physical symptoms, ways in which to improve it. We encourage different branches of treatment, of which medication is only one (frequently requested, and sometimes necessary).
      Sleep is an incredibly common topic for family doctors. You cannot just tell someone, of course, to get more/better sleep, without gathering a lot of information and providing many tools. It’s a long conversation and requires life changes, which are difficult for people. Again, many say “I just want you to give me something to make me sleep.”
      What bugs me about “lifestyle medicine” is the idea that it is different from family medicine. If seeing a “lifestyle doctor” makes someone more likely to commit to healthy change, I’m all for it (although, why does the name matter so much?). I am decidedly NOT in favour if:
-It suggests that family physicians and pediatricians aren't practicing this way already
-It makes patients think that lifestyle has not been addressed within medicine until now
-It promotes nutraceuticals and supplements as essential components of a “healthy lifestyle”
-It leads to “gurus” who then charge money for advice and interventions that we are all qualified to do under OHIP—creating a two-tiered system
-It leads to “blaming the patient” if illness does occur; even those with excellent lifestyles can get ill or injured, for a large variety of reasons.
      There is no one-size-fits-all solution in medicine. The six pillars listed are almost always key to overall good health, and they are addressed regularly by most, if not all, physicians. I’d like everyone to understand that their family physician is someone with expertise in “lifestyle medicine.”
 
Source of definition: https://www.rcgp.org.uk › your-career › gp-extended-roles