Lifestyle Medicine: Treating the Causes of Disease

Michael Greger M.D. FACLM · November 4, 2013 · Volume 15

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If doctors can eliminate some of our leading killers by treating the underlying causes of chronic disease better than nearly any other medical intervention, why don’t more doctors do it?

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Transcript

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Though I was trained as a general practitioner, my chosen specialty is lifestyle medicine. Yes, most of the reasons people go to see their doctors is for diseases that could have been prevented, but “[l]ifestyle medicine is not just about preventing chronic disease[s], but also about treating [them].” And not just treating the disease; it’s “treating the causes of disease.”

If people just did four simple things—not smoking, exercising a half-hour a day, eating a diet that emphasizes whole plant foods, and not becoming obese—that may prevent most cases of diabetes and heart attacks, half of strokes, and a third of cancers. Even modest changes may be “more effective in reducing cardiovascular disease, [high blood pressure], heart failure, stroke, cancer, diabetes, and all-cause mortality than almost any other medical intervention.”

The key differences between conventional medicine and lifestyle medicine is instead of just treating risk factors, we treat the underlying causes of disease—as described in this landmark editorial. See, “[t]ypically doctors treat ‘risk factors’ for disease such as giving a lifetime’s worth of medications to lower high blood pressure, elevated blood sugar, and high cholesterol.” But, think about it. High blood pressure is just a symptom of diseased, dysfunctional arteries. Yes, you can artificially lower blood pressure with drugs, but that’s not treating the underlying cause—which often comes down to things like diet and exercise, “the penicillin of lifestyle medicine.”

“Disregarding the underlying cause[s] and treating only risk factors is somewhat like mopping up the floor around an overflowing sink instead of [just] turning off the faucet, which is why medications usually have to be taken for a lifetime. If a floor is flooded as a result of a dripping tap, it is of little use to mop up [around] the floor unless the tap is turned off. The water from the tap represents the cost of disease, the flooded floor the diseases filling [up] our hospital beds. [Yet] medical students learn far more about methods of floor mopping than about turning off taps, and doctors who are specialists in mops and brushes can earn infinitely more money than…those dedicated to shutting off taps.” And the drug companies are more than happy to sell rolls of paper towel, so patients can buy a new roll every day for the rest of their lives. Paraphrasing Ogden Nash, modern medicine is “making great progress, but [just] headed in the wrong direction.”

Preventive medicine, is, frankly, bad for business. “When the underlying lifestyle causes are addressed, patients often are able to stop taking medication,…or avoid surgery.” We spend billions cracking people’s chests open, but only rarely does it actually prolong anyone’s life. In contrast, how about wiping out “at least 90% of…heart disease”?

“Think about it. Heart disease accounts for more premature deaths than any other illness and is almost completely preventable simply by changing diet and lifestyle.” And, those “same…changes can prevent or…reverse many other chronic diseases as well”—the same dietary changes. So, why don’t more doctors do it? Well, one reason is doctors don’t get paid to do it. “No one profits from lifestyle medicine, so it’s not part of medical education or practice….Presently,…physicians lack training and financial incentives…So they continue to do what they know how to do: prescribe medication and perform surgery.”

After Dean Ornish proved you could reverse our #1 cause of death—heart disease—open up arteries without drugs, without surgery, just with a plant-based diet and other healthy lifestyle changes, he thought that his studies would “have a meaningful effect on the practice of mainstream cardiology.” After all, a cure for our #1 killer! But, he admits, he was “mistaken.” Physician “reimbursement,” he realized, “is a much more powerful determinant of medical practice than research.”

Reimbursement more than research. Salary over science. Wealth versus health. Not a very flattering portrayal of the healing profession, but, hey, if doctors won’t do it without getting paid, let’s get them paid.

So, Dr. Ornish went to Washington arguing that, look, “If we train and pay for doctors to learn how to help patients address the real causes of disease with lifestyle medicine and not just treat disease risk factors,” we could save trillions, and that’s just talking heart disease, diabetes, prostate and breast cancer.” The “Take Back Your Health Act” was introduced in the U.S. Senate to “induce doctors to learn and practice lifestyle medicine”—not only because “it works better,” but here’s the critical factor: “physicians will be paid to do it.” The bill “died,” just like the millions of Americans will continue to do, with reversible chronic diseases.

Please consider volunteering to help out on the site.

Sources

Acknowledgements

Images thanks to mikebaird, Philocrites, hegarty_david and puuikibeach via flickr. Thanks to Dan Piraro for his kind generosity to use his amazing work.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Though I was trained as a general practitioner, my chosen specialty is lifestyle medicine. Yes, most of the reasons people go to see their doctors is for diseases that could have been prevented, but “[l]ifestyle medicine is not just about preventing chronic disease[s], but also about treating [them].” And not just treating the disease; it’s “treating the causes of disease.”

If people just did four simple things—not smoking, exercising a half-hour a day, eating a diet that emphasizes whole plant foods, and not becoming obese—that may prevent most cases of diabetes and heart attacks, half of strokes, and a third of cancers. Even modest changes may be “more effective in reducing cardiovascular disease, [high blood pressure], heart failure, stroke, cancer, diabetes, and all-cause mortality than almost any other medical intervention.”

The key differences between conventional medicine and lifestyle medicine is instead of just treating risk factors, we treat the underlying causes of disease—as described in this landmark editorial. See, “[t]ypically doctors treat ‘risk factors’ for disease such as giving a lifetime’s worth of medications to lower high blood pressure, elevated blood sugar, and high cholesterol.” But, think about it. High blood pressure is just a symptom of diseased, dysfunctional arteries. Yes, you can artificially lower blood pressure with drugs, but that’s not treating the underlying cause—which often comes down to things like diet and exercise, “the penicillin of lifestyle medicine.”

“Disregarding the underlying cause[s] and treating only risk factors is somewhat like mopping up the floor around an overflowing sink instead of [just] turning off the faucet, which is why medications usually have to be taken for a lifetime. If a floor is flooded as a result of a dripping tap, it is of little use to mop up [around] the floor unless the tap is turned off. The water from the tap represents the cost of disease, the flooded floor the diseases filling [up] our hospital beds. [Yet] medical students learn far more about methods of floor mopping than about turning off taps, and doctors who are specialists in mops and brushes can earn infinitely more money than…those dedicated to shutting off taps.” And the drug companies are more than happy to sell rolls of paper towel, so patients can buy a new roll every day for the rest of their lives. Paraphrasing Ogden Nash, modern medicine is “making great progress, but [just] headed in the wrong direction.”

Preventive medicine, is, frankly, bad for business. “When the underlying lifestyle causes are addressed, patients often are able to stop taking medication,…or avoid surgery.” We spend billions cracking people’s chests open, but only rarely does it actually prolong anyone’s life. In contrast, how about wiping out “at least 90% of…heart disease”?

“Think about it. Heart disease accounts for more premature deaths than any other illness and is almost completely preventable simply by changing diet and lifestyle.” And, those “same…changes can prevent or…reverse many other chronic diseases as well”—the same dietary changes. So, why don’t more doctors do it? Well, one reason is doctors don’t get paid to do it. “No one profits from lifestyle medicine, so it’s not part of medical education or practice….Presently,…physicians lack training and financial incentives…So they continue to do what they know how to do: prescribe medication and perform surgery.”

After Dean Ornish proved you could reverse our #1 cause of death—heart disease—open up arteries without drugs, without surgery, just with a plant-based diet and other healthy lifestyle changes, he thought that his studies would “have a meaningful effect on the practice of mainstream cardiology.” After all, a cure for our #1 killer! But, he admits, he was “mistaken.” Physician “reimbursement,” he realized, “is a much more powerful determinant of medical practice than research.”

Reimbursement more than research. Salary over science. Wealth versus health. Not a very flattering portrayal of the healing profession, but, hey, if doctors won’t do it without getting paid, let’s get them paid.

So, Dr. Ornish went to Washington arguing that, look, “If we train and pay for doctors to learn how to help patients address the real causes of disease with lifestyle medicine and not just treat disease risk factors,” we could save trillions, and that’s just talking heart disease, diabetes, prostate and breast cancer.” The “Take Back Your Health Act” was introduced in the U.S. Senate to “induce doctors to learn and practice lifestyle medicine”—not only because “it works better,” but here’s the critical factor: “physicians will be paid to do it.” The bill “died,” just like the millions of Americans will continue to do, with reversible chronic diseases.

Please consider volunteering to help out on the site.

Images thanks to mikebaird, Philocrites, hegarty_david and puuikibeach via flickr. Thanks to Dan Piraro for his kind generosity to use his amazing work.

Doctor's Note

By treating the root causes of diseases with plants not pills, we can also avoid the adverse side effects of prescription drugs, which kill more than 100,000 Americans every year, making them a leading cause of death. See my live presentation Uprooting the Leading Causes of Death.

For those surprised that policy makers wouldn’t support such a common sense notion as preventive health, check out The McGovern Report. What about medical associations? See Medical Associations Oppose Bill to Mandate Nutrition Training.

For those unfamiliar with Dr. Dean Ornish’s landmark work, watch the story about my grandmother in Resuscitating Medicare and Our #1 Killer Can Be Stopped.

There is another reason that may explain why the medical profession remains so entrenched; see The Tomato Effect.

For further context, check out my associated blog post: 4 Things to Help Prevent Most Disease.

In 2018, I published a series that starts with What Is the Optimal Diet? Check it out!

2023 Update: In my video The Negative Effects and Benefits of Plant-Based Diets, I talk about studies comparing medical costs of vegetarians and non-vegetarians.

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