People visit doctors when they are unwell. This means they are likely to be ‘treated’, usually with medication. This also means they are followed up, given strict instructions such as how to take the medicines, when and with what, what to do during the course of the illness (rest, drink fluids) and so on. And then…. they hope to be ‘cured’.
End of story!
So what happens when they are not “ill”?
Mostly they go about their merry way, eating and drinking as they please, or worse, eating some latest ‘fad diet’ that promises incredible weight loss in ridiculously short periods of time. Or, they choose a really easy way out by buying into fat loss aids and unnecessary supplements. They refrain from regular exercise, rarely meditate and live on a prayer that their bodies will somehow continue to support their decadent lifestyles. Unfortunately, that’s just what it is, a Prayer.
Today we see more and more diseases that are related directly to how we lead our day-to-day lives. What we eat, how much we eat or drink, how physically and mentally active we are and if we exercise, practice relaxation and safe sex. If we take time out to nurture ourselves. If we are mindful and avoid substance abuse. All the above have a close, inextricable relationship with our Quality of life.
I am not even referring to being just ‘thin’ or of a certain weight. In fact, I am not referring to weight on the scale at all. I am talking about being healthy and well enough to be able to do what we would really love to in life. To travel, work, play, to be creative, be special and see our kids grow.
All that is required to change a person’s course of health, be it improvement in a disease status, weight loss or simply her Quality of life is a change in ‘lifestyle’. Not medication, surgery or any other invasive intervention, but a genuine change in habits.
For instance, a woman with back pain, weight gain, difficulty in conceiving and low mood will benefit greatly from a ‘prescription’ of regular exercise and appropriate nutrition to strengthen the back as well as to lose weight. Instead, she is often put on painkillers, told to rest, with antidepressants added for good measure. She may be advised surgery. Or, she may be prescribed physiotherapy and passive assisted exercises, heat therapy, ultrasound, hot packs and other methods that provide temporary relief but are certainly not long-lasting remedies.
The patient is usually quite thrilled with this mode of management. This essentially means she is ‘ill’ and the whole wretched situation is quite out of her control. She can therefore safely assign responsibility to another, such as a person of medicine, to take care of her health. In fact, if she were told to come in for a review after six weeks of just a change in lifestyle with the incorporation of a simple strength training routine and a balanced, more sensible diet, she will probably never return. What sort of doctor doesn’t prescribe pills?
The truth however is that several of the diseases we see today benefit far more from lifestyle interventional change and rehabilitation than from drugs. The change has to be well orchestrated. If you are not guided properly, especially in the initial stages of a ‘change in lifestyle’, much could go terribly wrong such as injury and or nutritional deficiencies. If you don’t have a supportive environment to make that change, it is going to be a steep uphill climb for an already difficult task.
Change has to be Slight, Significant and Sustainable.
Slight so your body does not protest violently and doesn’t see it as a threat to its very existence. For example – A 20-30 minute walk every day to begin with for an inactive person or, cutting down portion size gradually for someone used to consuming large quantities.
Significant enough for the human body to be forced to make the necessary internal adaptations to the change. An overweight individual who has never exercised will benefit even from a slow a5 minute walk. A fairly fit, young person will need to be pushed harder to for her body to register change.
Sustainable in clever ways so results are long lasting. If for instance you are told to eat a diet that leaves you hungry and irritable half the time, the likelihood of you being unable to follow through is very high. If you are made to exercise so hard on your first attempt that your body goes into minor shock, it’s likely you will begin to detest exercise.
The problem with most attempts at exercise or healthy eating is that they are seen as closed ended methods of management. They are viewed like a prescription for, lets say, Antibiotics – to be taken for an X number of days at a stipulated time and dosage and then stopped. This may work for an acute illness. Lifestyle diseases unfortunately, cannot be managed this way. The ‘prescription’ for lifestyle management is on-going, for life! The actual methods used to stay fit may be altered with age and time, but they still need to be in place to keep us agile, strong and fit along with being disease free.
Medication, surgery, intervention are absolutely necessary. But not all the time! Being an Obstetrician, I intervene everyday to ensure the safety of the mother and child at childbirth. At times one has to step in with the necessary armamentarium available to us in modern medicine. I do believe however that a healthy dose of “lifestyle Medicine” will go a long way in not just enabling one to be disease free for as long as possible, but in improving Quality of life.