Lifestyle Medicine is no Trojan Horse: it is an Inclusive, Evidence-based & Patient-focused Movement

We welcome positive aspects of Nunan et al’s article and the opportunity to briefly discuss their analysis. However, likening Lifestyle Medicine to a Trojan Horse implies deception and malice; and is both unworthy and unjustified.

There are important positive messages conveyed: for example, articulating many of Lifestyle Medicine’s key drivers (Box 1), plus individual and public health level interventions (Box 2).

However, there are important fallacies too and we seek to correct these:

Lifestyle Medicine is inclusive, evidence-based, patient-focused and is not a movement needing to attack other health delivery approaches. We hope that scientific debate can be more dignified and constructive going forwards. We absolutely agree primary care and public health colleagues should work together and practise what we preach.

Given rapid BSLM growth, plus the success and popularity of progressive curricula like Imperial College’s ‘Lifestyle Medicine and Prevention’ undergraduate medicine modules, that are evidence-based and rooted in population health and inequalities, Lifestyle Medicine is becoming mainstream. We suspect future generations will term Lifestyle Medicine, as simply ‘Medicine’.

Author Affiliations

Fraser Birrell
Occupation: Director of Science & Research, Consultant & Senior Lecturer in Rheumatology
Affiliation: British Society of Lifestyle Medicine
Competing interests: Director of Science & Research for the British Society of Lifestyle Medicine and Editor-in-Chief of Lifestyle Medicine, the official journal of the British Society of Lifestyle Medicine, Australasian Society of Lifestyle Medicine, the European Lifestyle Medicine Council and the Korean College of Lifestyle Medicine. Research grants for engagement through, plus spread and evaluation of group consultations (which create the time and space for effective delivery of Lifestyle Medicine) from Sir Jules Thorn Trust, National Institute for Health Research, Medical Research Council.

Richard J Pinder
Consultant Public Health Physician
Imperial College London
Competing Interests: Director of Undergraduate Public Health Education and module lead for Imperial College London’s undergraduate medicine modules on Lifestyle Medicine and Prevention.
No direct or indirect other financial conflicts of interest to declare in relation to Lifestyle Medicine.

Rob Lawson
Lifestyle Medicine doctor & retired GP
British Society of Lifestyle Medicine
Competing interests: Chairman of British Society of Lifestyle, Medicine President of European Lifestyle Medicine Council, Chair of World Lifestyle Medicine Council (formerly known as the Lifestyle Medicine Global Alliance).

1) Nunan D, Blane DN, McCartney M. Exemplary medical care or Trojan horse? An analysis of the ‘lifestyle medicine’ movement. Br J Gen Pract. 2021 Apr 29;71(706):229-232. doi: 10.3399/bjgp21X715721. PMID: 33926883.