It is often said of major political parties that to be successful they must be coalitions or ‘broadly secular’. In democracies, parties interested in winning power bring together those with a shared set of values and principles - but they allow for differences of opinion and emphasis. In the UK, this meant the Labour Party for decades could be the party of Tony Blair and Jeremy Corbyn. And the Conservative Party seemed able to accommodate both Ken Clarke and Boris Johnson.
But all coalitions come under stresses and strains. Disagreements can often become the main focus, and coalition members can often forget the things which brought them together in the first place. And in extreme cases coalitions fall apart.
When the BSLM was founded in 2016 I was aware we were putting together a coalition. While I knew there would be broad agreement on general principles, I knew also there would be argument and debate about some of the detail. When conducted respectfully and constructively that debate has been positive.
Crucially, there were a set of fundamentals we agreed when we were founded. These haven’t changed. Indeed, membership of the BSLM requires not only that these fundamentals resonate with new members but that they sign up to them.
So what are those fundamentals? Firstly, we are independent. That means we have no direct links whatsoever with any religious or political groups or organisations nor indeed any commercial entities. Are our members drawn from a wide variety of backgrounds and beliefs? Yes, absolutely. Do we ask prospective members what their religious or political beliefs, or any other beliefs, are when they apply to join? No, of course not. We are not a belief-led organisation.
We are also clear: a clinician’s political or religious beliefs should not be brought into the clinical decision-making process or interactions with patients.
But there is another element to the independence question which needs restating in my view. And that is that no one group or organisation, whether religious or political, can ‘claim’ Lifestyle Medicine as its own. That is as important to BSLM as being independent of such groups or organisations. And we must continue to make that point with our partners in the Lifestyle Medicine Global Alliance and elsewhere. If we are to have a shared global ‘coalition’ committed to Lifestyle Medicine, and I believe we do, then this will be addressed in appropriate fora around the world.
In addition to independence there are other elements of our mission statement that all members sign up to. So, we are non-profit making. We are evidence informed: the science and evidence to support Lifestyle Medicine interventions is critical. We will operate at all times with honesty, transparency and integrity. So, as a charitable organisation our accounts are made publicly available from our Charities Regulator and are published on our website.
It’s very clear where our money comes from and how it is spent. Membership subscriptions will always be our mainstay - if we don’t have members we don’t exist. Income from educational activities, most often provided by volunteer members, is another. International Certification also brings in revenue one third of which is spent on a licensing agreement with the International Board of lifestyle Medicine. Home-grown certification is also being developed in collaboration with several UK academic institutions.
Our members who sign up to these principles are drawn from a range of clinical backgrounds and disciplines. A multidisciplinary, multi-system approach to tackling the chronic disease problem demands such diversity and is very much a LM approach.
But that doesn’t mean we always agree on everything. Our coalition of members shares a belief that lifestyle factors are key contributory factors in the growing problem of non-communicable disease which threatens to overwhelm societies and healthcare systems. And that lifestyle interventions through Lifestyle Medicine are a critical part of the solution. Key elements include exercise and physical activity, sleep, stress management, substance misuse and of course diet and nutrition.
If we are ignoring upstream ‘causes’ of our ills we are missing the point. Social isolation, unhealthy environments, deprivation, socio-economic stressors or ‘rotten life syndrome’, mentioned by Sir Michael Marmot recently, are extremely important and must be addressed. The arguments over dietary macronutrients between some vociferous ‘camps’ are distracting from the very real problems faced by very real people.
Beyond broad agreement on the harmful effects of almost all processed foods and the benefits of real foods, the BSLM does not advocate one single dietary or nutritional approach. We rely on widely accepted scientific research to guide us when dealing with the beliefs of the patient in front of us. Again, this is a core principle (science-led) upon which we were founded.
Indeed, we wish for the BSLM to provide a forum for those with an interest in Lifestyle Medicine, including diet and nutrition, to come together and discuss the evidence base and merits of different approaches. In spite of challenges, we will continue our work to facilitate this especially at the BSLM conference in London in June 24-26th 2020 at Twickenham Stadium. We must respect nuanced views and listen and learn with humility. No one person or organisation holds possession of the absolute truth.
In keeping with this there is no priority for BSLM to formally align ourselves with any one nutritional or dietary group or organisation unless it is wholly science-based. It’s not always an easy tightrope to walk. But I maintain as BSLM chairman that the only thing with which we want to align ourselves is robust evidence. That applies to nutrition as it does with anything else for that matter.
I’m confident that our growing movement can sustain itself as a diverse coalition - whether at the UK level or indeed internationally. If the objective of a political party is to win power, then ours is to make Lifestyle Medicine mainstream. In that I think we are well on the way to achieving our objective. We are not fringe, we are not niche, we are not alternative: we are essential to effective healthcare.
So let’s agree our core principles, discuss and debate the detail respectfully, and keep our main focus on what matters: improving people’s health and wellbeing through Lifestyle Medicine. BSLM can be a catalyst for #1Change!
BSc MBChB MRCGP FRCGP Dip BSLM/IBLM
BSLM Trustee & Founder
Having qualified in Medicine in 1975, Rob has gained extensive experience as a GP in Scotland. His principal interests have been primary and secondary prevention of disease and the specialty of Lifestyle Medicine. As well as leading his NHS team to the highest awards for quality (2003-2013) he founded a charity in 1991 providing weekly activity and support in venues around East Lothian for sufferers of long term conditions including heart disease, Type 2 diabetes, stroke, lung disease and frailty. He has retired from NHS practice to concentrate on the applications of Lifestyle Medicine to healthcare. In 2016 he co-founded BSLM, a registered charity, to promote the principles of Lifestyle Medicine to healthcare professionals and the public. On a personal note he is a cancer ‘survivor’. He can be contacted at email@example.com.