Thread by @DipeshGopal

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🧵 THREAD on critiquing lifestyle medicine from

article from @dnunan79 @dnblane @mgtmccartney just published in @BJGPjournal: bjgp.org/content/71/706…

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🗣️ "... we focus on the unintended consequences of uncritical endorsement and application of lifestyle medicine including the infiltration of pseudoscience, profiteering, and the potential for widening health inequalities by a continued focus on the ‘individual’."

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🗣️ "We have two main concerns here:

1⃣ the opportunity taken by some to link alternative medicine practices to lifestyle medicine

2⃣ the association of some ‘lifestyle medicine practitioners’ with commercial opportunities"

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🗣️ "‘Lifestyle medicine’ needs a clear consensus on what constitutes evidence based practice, with organisational
standards and leadership commitment to the removal of bad science, and of financial and ideological conflicts."

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🗣️ "The concept of individual ‘choices’ and ‘changes’, and by proxy ‘control’, plays a central role in many working definitions of lifestyle medicine. We are concerned about the potential for widening health inequalities when conceptualised and delivered in this way."

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🗣️ "...the growth in private services are unlikely to yield benefits for people at highest risk of premature mortality from non-communicable diseases.

Those in greatest need of support with health behaviour change are least likely to receive it."

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🗣️ "Lifestyle medicine’s continued emphasis on the individual as the change agent most likely results in the people at lowest risk having the greatest amount of intervention, while people carrying the greatest risk are not receiving the support they need."

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I have been to a lifestyle medicine course and it was good @PLMcourse but I was worried lifestyle medicine would reinforce inverse care law.

It's the people we can least reach that have the worst health outcomes - least access to the resources to change their 'lifestyle'.

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Is health is fully meritocratic? thelancet.com/journals/lance…

🗣️ "First, meritocracy expresses a certain idea of freedom; our opportunities should not be fixed
by the circumstances of our birth.

Second, “it gestures to the hope that what we achieve reflects what we deserve”"

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There will be backlash to this article: why?

People have built careers/businesses on 'lifestyle medicine': educational, consulting via books, courses, podcasts etc.

It's not about right/wrong - we need better policies on STRUCTURAL DRIVERS AND 'lifestyle change'.

@threadreaderapp unroll please