Lifestyle Prescriptions

Posted: January 29, 2015 in Uncategorized
Tags: , , , , , ,

I read a comment online recently from someone saying they would not be as bothered by doctors “prescribing” lifestyle changes- diet or exercise changes, if they were actually done in a very specific way.

It got me thinking about some of the issues with these lifestyle prescriptions, and more specifically how we treat health.

Now, if you’ve read my blog before you know I’m not fan of measure the success of such lifestyle changes by weight loss, but I certainly think that diet and exercise have a tremendous impact on overall health.

The first problem I think this person did touch on- doctors are often vague about what it meas to eat better or exercise more, doctors don’t often get a lot of training on those topics, which also means that even if they are more specific they may not be basing those recommendations on any research demonstrating the effectiveness of that. If for example, there is research indicating exercise can help with condition X, we would need to know exactly what sort of exercise was shown to be effective- type, intensity, duration, and frequency. Otherwise what is implemented by the patient may not line up with what the research shows to be helpful at all.

An even bigger problem I think though, is the financial issue. A doctor can “prescribe” these changes, but for the most part insurance won’t pay for it. So if you have someone with condition X and research showing that 30 minutes of moderate intensity exercise a day is just as effective at reducing symptoms as the standard first line medication Y. But if the patient with condition X would be paying much more for a gym membership or exercise equipment than generic medication Y that insurance pays the majority of the cost of, that creates an incentive for the patient to just want to take medication Y.

I hear people complain that people are just lazy and want the easy solution- “just give me a pill”. But this completely ignores the structural influences. People don’t exist in vacuums. I think it is better to try lifestyle adjustments like diet or exercise changes that are shown to be effective before medications, cutting out a food allergen, or walking 30 minutes a day, typically has fewer side effects than pills. But for people to choose these over pills, we really need structural changes to how we approach healthcare. If our healthcare systems favor pills over lifestyle, then how can we expect that patients as a group will be different?

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Comments
  1. Sarainthebathroom says:

    I totally agree.

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