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Episode 205:
Show Notes 


In this episode, Dr Lucy Burns and Dr Mary Barson delve into the interplay between lifestyle choices and medical interventions in promoting health and treating illness. They explore the concept of lifestyle medicine and its significance in healthcare, emphasising the importance of incorporating lifestyle modifications alongside conventional medical treatments. 

Defining Lifestyle Medicine: Lifestyle medicine encompasses various interventions aimed at improving health and preventing diseases through lifestyle modifications. Dr Lucy elaborates on these modifications, including dietary changes, regular physical activity, stress reduction techniques, adequate sleep, and avoidance of harmful substances like tobacco and excessive alcohol. She emphasises that lifestyle medicine targets the root causes of chronic conditions to optimise overall health and well-being.

Time Constraints in Healthcare: Dr Lucy discusses the time constraints doctors face during patient consultations due to busy schedules and high patient loads. She notes that this limited time may hinder comprehensive discussions about lifestyle factors and preventive measures. Consequently, doctors may prioritise addressing acute symptoms or prescribing medications over exploring lifestyle recommendations.

Constantly Evolving Medical Knowledge: Dr Mary highlights the dynamic nature of medical knowledge, characterised by continuous research advancements, evolving treatment guidelines, and emerging medications. She explains that doctors must stay abreast of the latest evidence-based practices to provide optimal care for their patients. This ongoing learning process ensures that healthcare providers can offer the most effective treatments and interventions available.

Patient-Doctor Communication: Dr Mary emphasises the crucial role of effective communication between patients and doctors in building trust and understanding individual healthcare needs. She encourages patients to express their concerns and actively participate in their healthcare decisions. Dr Mary also stresses the importance of doctors listening attentively, providing clear explanations, and offering tailored guidance to each patient.

Empowerment Through Education: Dr Lucy discusses the empowering impact of education and coaching programs in enabling individuals to take control of their health and well-being. She explains that these programs provide practical guidance, resources, and support to facilitate sustainable lifestyle changes. Dr Lucy underscores the importance of equipping individuals with knowledge and skills to overcome barriers, set achievable goals, and maintain long-term health habits.

Synergy Between Lifestyle Changes and Medications: Dr Lucy and Dr Mary explore the synergistic relationship between lifestyle changes and medications in managing chronic conditions and enhancing health outcomes. They emphasise that while medications may be necessary to control symptoms or prevent complications, lifestyle modifications address underlying risk factors and augment treatment effectiveness. The doctors advocate for integrating both approaches to achieve a comprehensive and personalised approach to healthcare.

Reducing Medication Dependency: Dr Lucy examines how lifestyle modifications can potentially reduce the need for medications or lower their dosages in some cases. She discusses addressing lifestyle factors such as unhealthy diet, sedentary behaviour, and chronic stress to improve health outcomes. Dr Lucy underscores the importance of adopting a holistic approach to health, which may lead to reduced reliance on pharmacological interventions and improved quality of life.

Mindset and Psychology: Dr Mary explores the pivotal role of mindset and psychology in overcoming barriers to adopting healthy behaviours. She explains that individuals may encounter internal challenges such as self-doubt, fear of failure, or resistance to change, which can impede their ability to make sustainable lifestyle changes. Dr Mary emphasises the significance of coaching and education programs that focus on mindset and behaviour change strategies to empower individuals to pursue healthier lifestyles.

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Episode 205: 


Dr Mary Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson.

Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.

Both (0:16) And this is the Real Health and Weight Loss podcast!

Dr Lucy Burns (0:23) Good morning gorgeous listeners. It is me Dr Lucy this morning and guess what? I have my gorgeous friend Dr Mary with So, we have a fantastic topic coming up this morning. Gorgeous Mary, how are you, lovely?

Dr Mary Barson (0:36)  Pretty good today all things considered. It's winter, oh well it's not, it feels like it's getting wintry and I've got my wood fire going and I'm out there carrying wood and enjoying that cosiness. I quite like I've quite liked a southern Victorian winter. I know that I differ from you in this regard, but I'm kind of loving it, to be honest.  

Dr Lucy Burns (0:59)  Oh good.  Do you know the one thing I, look, as you know, I don't like the cold and I don't like clouds. I like sunshine. That makes me kind of happy. But I agree with you. I do like warm snuggly food. So last week, I cooked on the cooking show our chicken laksa, which is beautiful. Like it's warming, it's creamy. It's, you know, we call it a winter warmer. So yeah, there are components of it. I think what I would just like for Victoria, is the length of time of winter to actually just be the three months it's supposed to be not the six months that it seems to drag on.

Dr Mary Barson (1:39)   Yeah, absolutely. I love the shorter days as well. Possibly the minority here. I love stargazing and I love that you know, you can go and enjoy the stars and look at all you know that beautiful space and Cosmos earlier in the day, when there aren't clouds, of course. So, yes, yeah, you know, it's good. I like having summer too. But I'm well, I'm well. And I'm excited about today's topic, as a doctor who loves lifestyle medicine. Today's topic is very close to my heart.

Dr Lucy Burns (2:11)   Indeed, indeed. And look, it follows our theme, I think of being you know, air quotes, “boring middle-of-the-roaders”, because we're not about extremism and, you know, I've seen this and lots of you will have seen this meme or picture on various social media and it's two queues. So there are people in two windows, like a bank window. On one window is, you know, 500 people lined up and on the other window is no people lined up. You know, there are various iterations of this, but on the people lining up in, you know, in the hundreds, it's got, you know, pills and medicine window. And then on the other side, it's got lifestyle, and there are zero people lining up, and people get on and basically slam people slam, so are so many people here. But in social media, you know, of course, everyone's got a voice and everyone's got an opinion, but people will get on and slam people for taking medications. So they're very judgmental, very critical and will say things like, Well, if you just improved your lifestyle, you wouldn't need medications. So I thought that is really today's topic. Is it this or that? Is it lifestyle or medicine or could it be actually a bit of both? Let's dive in.

Dr Mary Barson (3:36 )  Oh, you boring middle-of-the-roader, are you suggesting that we can have both? No, I completely agree. Let's dive in. So I'd like to maybe first we could define lifestyle medicine a little bit that might be helpful. You're a board-certified lifestyle medicine physician, which is very cool. I don't quite have those qualifications. But I've got training in functional medicine and nutrition, and all of these lifestyle things. What is lifestyle medicine? What do we mean by that? Dr Lucy? 

Dr Lucy Burns (4:04)   Yeah, so it's taking aspects of the way we live our life. So things that we can do in our everyday, middle-of-the-road boring lives, that we can use to not only prevent disease but also treat it. So, I think there's always again, another thing to think about in medicine and one is disease prevention and the other one is disease treatment and they can be different. And look, it's interesting. I mean, some people use medications to prevent certain diseases. But I think at the heart of it, there are lots and lots of things that we can do to treat the disease before we head to the medication route or route depending on which part of the world you're from. So yeah, so that's it is at its heart and for me what it means is that as a doctor I'd spent a lot of time in my clinic, deprescribing. So when I first was a junior doctor, we learned to prescribe medications and I was slightly excited about the idea that I could write a magic pill for somebody and it would help them. And I honestly thought that was the way to go. Like, it was a good thing to do and it's not a bad thing to do.

Dr Mary Barson (5:21 )  I can remember the first medication chart that I wrote in the hospital. It was for paracetamol. But I could remember the excitement that I had that suddenly now, I am allowed to do this. I can write something on the medicine chart and then that person's gonna get it. I wrote paracetamol when someone had a headache in the hospital, it was a big moment for me. 

Dr Lucy Burns (5:44)   Yeah, absolutely and me, too. And I, you know, when I wrote scripts for high blood pressure, you know, again, I did all of that with good intent to prevent further complications for people, nothing that you know, of course, there are always exceptions. But in general, the majority of doctors have their patient's best interests at heart, they honestly do.

Dr Mary Barson (6:07)   I've never met a doctor who didn't care about their patients, ever. Like I haven't. Sometimes I've definitely met lots of patients who felt like their doctors didn't care about them. Who felt like they were just treated as, you know, a body part or a brain, or just a number, or an annoyance Like, I certainly think that there can be problems with communication and the patient experience absolutely. But at the heart, I've never met a doctor who didn't actually care. I truly have not. 

Dr Lucy Burns (6:40)   Indeed, indeed, and I think there are lots of reasons why patients sometimes don't feel heard by their doctors and I thought a couple of things, we could just go through a few of those now. The number one thing I would say, in the way medicine is delivered, and when I mean medicine, I mean the kind of health care by medical doctors in particular GPs, is time constraint. So, you know, the time constraint is enormous, it's so hard. 

Dr Mary Barson (7:11)  There are time constraints for factors that are beyond the control of the doctor and the clinic, like, there are real-world reasons why they can't spend an hour with every patient or half an hour with every patient, it'd be great if they could, and some can, but the only way that can work is with you know, an increase in charges for the patient, which is not ideal, either so that the time constraints are real.

Dr Lucy Burns (7:39)   Absolutely. The second thing, I think that you know, results in patients not feeling heard or believed or listened to by their doctor, is actually sometimes doctors don't know everything, they honestly don't. It is the knowledge that you need. And particularly this as a general practitioner, is huge. It's massive and when I was a junior doctor, and when I was studying for my GP exams, which were a long, long time ago, now, there were about four medications for diabetes, as an example, there were maybe five or six different medications for hypertension, and, you know, one medication for osteoporosis. These days, there's over 20, different medications, classes, and rules on prescribing, not prescribing, is it on the PBS? Is it not on the PBS, all of those things? Now, there are rules on the rules all over the place.

Dr Mary Barson (8:39)   And it changes constantly. 

Dr Lucy Burns (8:42)   It does, it does and innovations come and all sorts of things. So it is sometimes that the doctor hasn't, you know, it's not across the breadth of every single topic or healthcare issue with the same depth, so they may have a lot of knowledge might be very experienced, maybe they see a lot of knee injuries, for example, or sports medicine stuff, which may mean they're not as across hormone replacement therapy for menopausal women. Or there may be across hormone replacement therapy, but don't know the nuances of the rules around you know, weight loss medications, or all of those things like this so much coming and it's really, really tricky. 

Dr Mary Barson (9:27 )  And then I'd say another thing is, is different communication styles. I'm sure when you go and see the doctor, especially if you're unwell or you need something, you're feeling vulnerable, you are patient to varying degrees or putting yourself in the hands of the health care professional. And sometimes there can be an expectation mismatch or a feeling that people's needs aren't met. And I think there are lots of ways that we could improve this as a profession. But this doesn't mean that the person ratio is bad. And it definitely doesn't mean that all medications are bad and that if people are on medications, there's something wrong with them. Or there's something wrong with a doctor who is prescribing medications they have a place they really, really do. Health, like real health, I would argue is not something that can happen in the doctor's office. Real health is something that happens in your life, as you're saying Lucy with lifestyle medicine, it's the aspects of the way that you live your life that either promote good health, or could harm good health, the way in which you live your life that can help prevent or treat illnesses, that you've got illnesses that you don't yet have, and hopefully never will, or can make them worse. That's health and then on top of that, you've got allopathic medicine, where you can have medications to better improve your blood sugar control with diabetes to improve your blood pressure, your blood sugars simply have your blood pressure, you know, there are medications you can have for everything, it's so powerful autoimmune illnesses, there are so many things out there. And now you if you break your leg, you're gonna want some of those stronger painkillers. It's powerful, and it has a place. And that's what happens in the doctor's office. And that is a wonderful adjunct, I think, to what you do day to day, but knowing what to do day to day, knowing how to improve your lifestyle. You know, that's where lifestyle medicine comes in.

Dr Lucy Burns (11:30)  Absolutely and unfortunately, lifestyle medicine takes some time to explain, people need encouragement to develop consistency around it. And with the constraints of the way the current health system happens. In general, most doctors don't have time to go through that. So they just don't they then go right, well, what's the bit that I can do in my very short time, I can prescribe something that seems quite good. So they'll either do that, or sometimes what they'll do is go— well, go away, and come back in three months, and we'll see how it is and there's often a bit of lip service to, you know, see if you can lose, lose some weight, or see if you can do some exercise, but get it it's that is not lifestyle medicine. So if you can lose some weight and see if you can do some exercise, it's really getting down to the bones of how to do it. Okay, so again, what we are is to talk about is the map and the compass. So what to do, and then how to actually do it and put it into your life and how to do it when life you know, throws you curveballs, which, you know, I would actually argue that life doesn't throw curveballs that it just is a curveball, it's all the time a curveball.

Dr Mary Barson (12:38) I agree, right.

Dr Lucy Burns (12:42)   And so we need to come up with a way that we can do all of this, most of the time, again, doesn't have to be perfect, but it has to be consistent. 

Dr Mary Barson (12:50)   Yeah. And that's why you and I started online coaching and online courses, because it was a way to, to reach lots of people in a beautiful group setting, which is in itself, very empowering. And so that people can make those lifestyle changes, fit them into your life, not delivered, you know, ineffectually, you know, every three to six months in a doctor's office, because it takes time to implement the changes. It takes time to develop your mindset skills and to change your mindset and to make your lifestyle work for you.

Dr Lucy Burns (13:24)   Absolutely, yes. So yeah, to quote the old Pantene ad for those of you who are of my generation, it won't happen overnight, but it will happen. And it's truly is that and that's it's trusting the process continuing on building. And again, you know, this is why I mean, this is why it's so exciting for us because we get to see lots of our people making these changes. And then it's a bit like compound interest, you start to add a little bit more then those two things add a bit more. And then another little thing adds on top, and all of a sudden, your health, has grown just like wealth. So it is it's amazing. It's fantastic. It's inspiring, and small changes can yield huge results.

Dr Mary Barson (14:13)  It's it's doable, everyone can do it. And if you're also taking medication, for whatever reason, that's okay, too. But the wonderful thing is that lifestyle changes and medicine can work synergistically, you know, it's not like you have to just do lifestyle changes or have Ozempic or just do lifestyle changes or have a Metformin. You can do both, and both can be very powerful.

Dr Lucy Burns (14:41)  Yes, absolutely. And, you know, I would say that if everybody could spend time working on their lifestyle factors, then the things that will happen are either they won't need the medication anymore, huzzah! Or two, they may well be able to reduce the dose and our favourite thing at Real Life Medicine, we've got lots of favourites. But one of our favourite favourite things is that you know, if you can use the lowest effective dose of a medication, then that is good for you. Reduce the side effects, it's cheaper for you, it's just all around better. So the lowest effective dose, the way to get the lowest effective dose is to enhance the lifestyle component of medicine. Which again, is what we do all the time, day in, day out.

Dr Mary Barson (15:29)   It’s what we live and breathe.

Dr Lucy Burns (15:31)   Indeed. So lovelies, it's not this or that it is this and that. And we want to I guess, just reassure people, there is no shame in needing medication or surgery, no shame at all. They are incredibly powerful tools. What we think is that everybody should have the opportunity to improve their lifestyle. And I know it's harder for some people than others. But often, the reason for that is a skill shortage. It's not that you can't do it, that you're weak, hopeless, undisciplined, lazy, none of that. It is a skill shortage around what we like to call mindset or cognition or psychology, whatever word you like to use. But that's, again, it's so powerful to recognise the things that your brain says to you, that stop you from doing the things that you at the back of your mind know you could or want or should do. 

Dr Mary Barson (16:27)   That's it. be empowered, beautiful people this and that. I love it. 

Dr Lucy Burns (16:33)   Indeed. Alright lovelies, we'll catch you all next week. Have a beautiful week. Think about your lifestyle. Work out one little thing that you can do for this week, and we'll see you next week.

Dr Mary Barson (16:41)  Bye now.

Dr Lucy Burns (30:22)  The information shared on the Real Health and Weight Loss podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.

DISCLAIMER: This Podcast and any information, advice, opinions or statements within it do not constitute medical, health care or other professional advice, and are provided for general information purposes only. All care is taken in the preparation of the information in this Podcast.  Real Life Medicine does not make any representations or give any warranties about its accuracy, reliability, completeness or suitability for any particular purpose. This Podcast and any information, advice, opinions or statements within it are not to be used as a substitute for professional medical, psychology, psychiatric or other mental health care. Real Life Medicine recommends you seek  the advice of your doctor or other qualified health providers with any questions you may have regarding a medical condition. Inform your doctor of any changes you may make to your lifestyle and discuss these with your doctor. Do not disregard medical advice or delay visiting a medical professional because of something you hear in this Podcast. To the extent permissible by law Real Life Medicine will not be liable for any expenses, losses, damages (including indirect or consequential damages) or costs which might be incurred as a result of the information being inaccurate or incomplete in any way and for any reason. No part of this Podcast can be reproduced, redistributed, published, copied or duplicated in any form without the prior permission of Real Life Medicine.