Lifestyle Medicine – a New Weapon in the Fight Against Obesity? Dr Sue Kenneally

Poor lifestyle choices……. Cause the majority of non- communicable disease Create 50-70% of primary care workload Reduce healthy life expectancy

Current management??

Lifestyle Medicine………. the application of environmental, behavioural, medical and motivational principles to the management of lifestyle related health problems in a clinical setting including self-care and self-management ‘From cell to community’

Conventional Lifestyle Medicine…… Medicine….. Disease oriented Health oriented Specialised to individual markers Looks at root causes Same treatments/protocols Can be individualised Based on symptoms Based on systems Early detection of disease Preventive approach Doctor is in charge Patient is in charge Emphasis is ‘what?’ Emphasis is ‘why?’

Primary, secondary and tertiary prevention…. ‘If I had first concentrated on heart disease prevention, rather than saving the lives of 150 people I could have saved the lives of 150 million people’ Professor Christiaan Barnard

If I made a drug………….. Reduces risk of heart disease, some cancers, diabetes and dementia Improves survival/quality of life, in people with many of these Proven benefits for many mental health problems Associated with increased life expectancy and healthy life expectancy No side effects when taken as prescribed Not taking it is as bad for health as smoking 20 a day Pre-approved by NICE!!!

Disease Determinants DISTAL MEDIAL PROXIMAL MARKERS DISEASE Environment Stress Diet Obesity (Physical, Anxiety Inactivity BP Cancers Political, Depression Smoking Lipids CHD Economic, Technology Alcohol/ IGT Stroke Socio- Occupation Drugs ALT Diabetes Cultural) Relationships Pollution hsCRP Inequality Sun exposure

Assessing Lifestyle……… Environment Exercise Sleep Sunlight Infections Genetics Stress Diet

10 minute consultation: conventional, within a typical primary care setting Shared medical appointments: Groups of patients discussing aspects of their condition with medical supervision Health retreats/eduventures: taking groups of people out of their situation and living a healthy lifestyle with them, leading by example In Practice………

http://www. fit-fish. co. uk/retreats/weekends/house-of-bread-2018 http://www.fit-fish.co.uk/retreats/weekends/house-of-bread-2018.html

Does it work?

The Future……….. 1 2 3 4 Challenges! Make the message consistent Keep in touch with BSLM 3 Save the date – Saturday 12th May, first BSLM Wales conference 4