The Medicine or The Cure
Updated: Oct 22, 2019
Once we understand what Lifestyle medicine is (read What is LSM?), many among us might feel confused as to where LSM stands with respect to the conventional medicine (medication and surgery). Should we go for LSM, or for medication, or both? Let’s try to decode this.
Cause management vs disease management
Lifestyle medicine focuses on understanding the root cause of illness, which is likely to be related to suboptimal lifestyle habits. Treating illness at this level allows for true healing.
Conventional medicine, on the other hand, mostly manages the disease process itself, that is, it tackles the symptoms and manifestations. This can provide relief from acute symptoms, (which is sometimes crucial), and possibly (hopefully) delay the progress of complications. However, the underlying pathology still resides inside us, and unless its treated by lifestyle modification, it will continue to progress.
Let’s look at an example to understand this better:
For a patient who has suffered a heart attack, stenting will be crucial, even a lifesaver in an emergency. However, it will not prevent future heart attacks. On the other hand, clinical studies have proven that intensive lifestyle modification can lead to reversal of blockage of arteries.
The spectator vs the creator
So, you visit a doctor, get instructions to have a battery of tests done on you and start taking a number of pills. And most of the times you feel better after taking the pills, which you should. The process involves you trusting the doctor, who 9 times out of 10 would be a stranger to you. I am not saying you shouldn’t, in fact it’s crucial to trust your doctor. But this makes you more or less a passive spectator, bearing the brunt of the disease but not actively doing something to combat it. You’re the one affected by the disease, shouldn’t you be the one to fight it too?
What about taking charge of your own health, knowing you could beat your disease by adopting the correct practices? Not only this, you would be happier, smarter, and more energetic!
Lifestyle medicine is a partnership between the doctor and the patient, one in which the doctor becomes the coach, guides the patient and provides the essential tools that enable him/her to manage his/her disease with confidence and strive to attain complete health.
The frontline story of side-effects
A drug will, by definition, always have some kind of untoward effect on the body. The Health Authorities (FDA, EMA) approve drugs to enter into the market, as long as their benefit outweighs the risk. For e.g., drug X increases chances of stomach bleeding. Now if X is being prescribed for headache, the potential benefit may not surpass the potential risk, and the drug may never enter the market. However, if X was developed for battling cancer, a small risk of bleeding would be well worth the benefit of a longer life.
Lifestyle medicine on the other hand, would not have any side effects, provided you follow its principles correctly. In fact, it may improve several of your health parameters at the same time, even the ones you might not have intended to improve, or even thought of. So, the only (positive) side-effects you would have would be improved body image, increased confidence, and happiness.
What am I treating?
For many patients, their diagnosis is just the tip of the iceberg, as patients with one diagnosed lifestyle disease (LSD) will have increased risk of other LSDs as well. So, patients who are obese can develop diabetes, then hypertension, then coronary heart disease and so on. However, we would not treat a disease just because it has a likelihood of occurring. We, as physicians, handle each disease at it manifests. So, while one drug is used to manage one risk factor of the diagnosed LSD, one LSD at a time; LSM not only targets multiple risk factors of the LSD, but also reduces the chances of you being diagnosed with another LSD.
This is the great advantage of lifestyle medicine over conventional medical therapy, with LSM you can not only help bring your disease (for e.g., cardiovascular disease) under control, you can also help prevent another (for e.g. diabetes) from occurring.
Let’s take an example:
An obese patient, taking losartan for hypertension and simvastatin for cholesterol. These two drugs address their respective risk factors for cardiovascular disease. They do not address other risk factors, like weight, diet, lack of activity. And they definitely do not do anything with respect to other LSD such as diabetes. In fact,
This, right here, shows how much more powerful LSM is, compared to medication.
Thrive vs survive
On conventional therapy, taking multiple pills a day, and living through the subtle side effects of these pills, living through brain fog, most people with Lifestyle diseases are just surviving.
However, there’s a chance for them to possess a clear mind and an active body, to improve their quality of life, and to thrive, if they choose LSM.
The story of primary and secondary prevention
If you are at high risk for developing LSDs, LSM provides a golden opportunity to turn back the clock and reclaim your health. This is something unique to LSM, as pills/conventional medicine have limited role in prevention.
This is a very significant aspect, and we will be discussing the details in a separate post.
The dilemma of choice
So, now that you are aware of the differences, you would be thinking, “Should I go for conventional therapy, or LSM”? Well, we can make this easy for you.
LSM should be the foundation for the treatment of chronic diseases, period.
The need for conventional therapy would depend on the stage of the disease and can be tapered/discontinued once the patient is able to achieve stable parameters by following the principles of LSM.
Conventional therapy without adopting LSM would do nothing to halt the progression of the disease, and that would mean more pills, more suffering, more complications, and more diseases.
The choice, always, is yours.
01 October 2019
 Dean Ornish. Intensive Lifestyle Changes for Reversal of Coronary Heart Disease. JAMA, December 16, 1998—Vol 280, No. 23