“Skills before pills” approach for diseases

Health Corner“Skills before pills” approach for diseases

By Dr Attia Anwer

“If the physician is able to treat with nutrients, not medication, then he has succeeded”— Al-Razi, 900 CE.

Skills before pills is a term that was mainly used to learn coping skills and regulate emotions before using medicines or drugs. As lifestyle medicine advances and many chronic diseases are controlled or cured through lifestyle modification, its scope is widened. The use of specific tools to modify lifestyle and targeted therapies in the management of chronic diseases is evidence-based and supported by research studies. Many diseases, like metabolic syndromes or depression, can be controlled or cured without the use of medicines. It has been proved beyond any doubt that certain non-communicable diseases like diabetes, heart disease, and some autoimmune disorders are related to our lifestyle. Out of lifestyle factors, two things are most important.

“Whole plant-based food, exercise, and good sleep have caused remission in type 2 diabetes mellitus without any side effects”

They are the food we eat and the amount of physical activity we do. Stress and good sleep play their role in controlling appetite and the strength to do physical activity. Physicians know very well that without addressing these two factors and bringing about some lifestyle changes, we cannot help the patients combat the disease, as these are the root causes of the disease. Other lifestyle factors, like a good night’s sleep, are also related to them. Instead of starting everyone on medicines, we should help them change their lifestyle. It is a difficult thing to do than to say. There are three types of patients we encounter. The first group lacks awareness; they do not know that this food and lack of activity are the cause of their problem. Then there is a big second group that knows what is good or bad for them, they want to change, but find it very difficult to change. The third group of people knows about the bad effects of habits, but they do not want to change. First, simple education about a healthy lifestyle is important. Then it will be determined whether they will be able to change their habits by themselves or go into the second group. The second group of people needs our help most.

The human mind is studied extensively. Neurobiologists know the factors that are the basis of our behavior and the causes of resistance to change. We can use our happy hormones in our favor with little help. They can be sent for behavior therapy. Every sort of help, including CBT, should be offered to them before putting them on drugs or medicines. They should be given informed choices between therapy without any side effects and the medicines that have side effects.

The natural course of the disease after medicines should be explained to them. When people understand that their current way of life is going to lead to metabolic diseases. They want to change, but they do not need just “eat less and move more” advice, but more clarity and help. People do not want to be on the train of insulin resistance and metabolic syndrome, leading to cardiac disease and neurodegenerative disease. Giving importance to lifestyle modification more than prescribing a pill should be our goal. For this purpose multidisciplinary and holistic approach in managing patients is important. We should identify the roadblocks that are hindering the positive change, and support from relevant persons like nutritionists, physiotherapists, or psychotherapists should be recommended. General awareness about the root cause of different diseases and therapies other than medicine in the general population will help to spread the word. When people are convinced that there are reliable scientific treatments other than drugs that are equally or more effective and free of any side effects, they will lean toward that option.

An example is the treatment of depression by cognitive behavior therapy instead of antidepressants. CBT has been proven more effective than medicines in the long-term treatment of depression. If depression is mild, there is an excellent chance of responding well to psychotherapy alone. In case of severe symptoms, it is more important to consider medication earlier in treatment. Day-to-day stressors are also important in making you feel sad, lethargic, and worthless. So, different types of therapy should be used to combat depression. Antidepressant medication has some serious side effects. The long-term results of the patients who were only on medication were not very promising. Studies have shown that cognitive therapy is as efficacious as antidepressant medications at treating depression, and it seems to reduce the risk of relapse after discontinuation. These two types of treatment may engage in some similar neural mechanisms, as well as some mechanisms that are distinctive to each other. Those mechanisms, when understood completely, might be used to improve the outcome of patients.

Another example is a reversal of diabetes with lifestyle changes. That is also a fact and proven by different studies. People have become medicine-free after lifestyle changes. Studies showed that intensive lifestyle interventions like whole plant-based food, exercise, and good sleep have caused remission in type 2 diabetes mellitus without any side effects. This approach can lead to the elimination of prescription medicine, including insulin. Every patient who is diagnosed with diabetes should use this opportunity to modify their lifestyle. This will help them to get rid of medication, and they will reduce their risk of other diseases like high blood pressure, cardiovascular disease, and dementia. For metabolic syndromes, exercise and good food are the mainstay of treatment.

In conclusion, physicians should be ready to use skills when they are important and more effective than medicines on a scientific basis. A doctor’s prescription may only consist of regular exercise and diet, no drugs at all. Patients and the general public should be educated about this type of doctor-patient relationship. If we can educate a fraction of people, it will spread to all by the law of diffusion.

 

The author Dr. Attia Anwar is a consultant family physician with a postgraduate degree from the Royal College of GP UK. She is a strong advocate of health and well-being and wants patient participation in decision-making regarding health.The author, Dr. Attia Anwar, is a consultant family physician with a postgraduate degree from the Royal College of GPs UK. She is a strong advocate of health and well-being and wants patient participation in decision-making regarding health.

 

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