In the United Kingdom, an increasing number of people seeking relief from chronic illnesses find themselves at the threshold of a healthcare system grappling with its own ailments. The National Health Service (NHS), once the beacon of public healthcare, is now perceived as beleaguered and dysfunctional, especially when it comes to managing long-term health conditions[1]. This gap in the healthcare system is gradually being bridged by private healthcare practitioners, notably those trained in the principles of the Institute of Functional Medicine (IFM).
These practitioners, including medical doctors and nutritional therapists, as well as others such as pharmacists, osteopaths, and others, are pioneering a shift towards a more holistic approach to healthcare. Their method, starkly different from the traditional symptom-focused paradigm, emphasises lifestyle changes, social and spiritual connections, informed food choices, and the judicious use of food supplements. These approaches are not just palliative but are reversing chronic ill-health and restoring function in many patients[2].
Chronic disease and root cause medicine
One of the most striking aspects of this functional medicine model is its emphasis on the root causes of illnesses rather than merely treating symptoms. Patients are often prescribed personalised lifestyle interventions, including dietary adjustments and nutritional supplementation, that target underlying imbalances and deficiencies. The results, often remarkable, are leading to a surge in demand for these services[3].
The burgeoning popularity of functional medicine in the UK reflects a growing disenchantment with the limitations of conventional healthcare, especially in managing chronic diseases. The NHS, with its stretched resources and a focus on acute care, often falls short in providing comprehensive and continuous care for chronic conditions, leading patients to seek alternative solutions[4].
The value proposition offered by IFM-trained practitioners is being increasingly recognised. Their success in reversing chronic conditions has begun to challenge long-held scepticism. Partnerships between primary care clinicians and nutritional therapists are emerging as centres of excellence, delivering integrated lifestyle medicine care that aligns with patients’ evolving health needs[5].
Media, politics and industry
The media, too, is undergoing a transformation in its coverage of health and wellness. What was once dismissed as unsubstantiated or alternative therapy is now gaining credence. This shift is driven by a combination of patient testimonies, emerging scientific evidence, and a growing awareness of the limitations of conventional medicine in managing chronic diseases.
This shift towards a more holistic approach in healthcare, while significant, is met with scepticism from certain quarters. Notably, some politicians and commentators, especially those with more right-wing liberal perspectives, tend to want to avoid utilising policy reforms and heightened awareness to change public health dynamics. However, there is an increasingly acknowledged fact that the food industry also bears a substantial responsibility in exacerbating health issues. This acknowledgement reflects a deeper understanding of the complex interplay between industry practices and public health.
The production of cheap, nutritionally inadequate but calorie-dense processed foods, coupled with agricultural policies that have undermined local food supply chains, has had a profound impact on public health. These policies, often influenced by food industry lobbyists, contribute to a cycle of poor nutrition and chronic illness, necessitating a re-evaluation of food production and distribution systems. Firms are earning £52.7bn a year from UK sales of tobacco, junk food and excessive alcohol, and their consumption is contributing to Britain’s rising tide of illness, by transferring the related health costs onto the taxpayer and NHS[6].
A paper published in Nature Food on the 20th Nov 2023, identified that even a modest change of food selection and intake, buy following sustained recommendations from the government’s public health orientated Eatwell Guide dietary plan, is associated with 8.9 and 8.6 years gain in life expectancy for 40-year-old males and females, respectively. In the same population, sustained dietary change from unhealthy to longevity-associated dietary patterns is associated with 10.8 and 10.4 years gain in life expectancy in males and females, respectively[7].
Summary
The rise of functional medicine in the UK, amidst the challenges faced by the NHS, signals a critical juncture in healthcare. It represents a shift towards a more holistic, preventative approach to health, emphasising the role of lifestyle and nutrition. As this approach gains traction, it challenges entrenched interests and compels a broader rethinking of health policies and practices. The success of these functional medicine practitioners is not just a testament to their skill but also a call to action for a more integrated, sustainable, and patient-centred healthcare system.
References
[1] https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/an-nhs-under-pressure
[2] Beidelschies M, Alejandro-Rodriguez M, Ji X, Lapin B, Hanaway P, Rothberg MB. Association of the Functional Medicine Model of Care With Patient-Reported Health-Related Quality-of-Life Outcomes. JAMA Netw Open. 2019 Oct 2;2(10):e1914017.
[3] Beidelschies M, Alejandro-Rodriguez M, Ji X, Lapin B, Hanaway P, Rothberg MB. Association of the Functional Medicine Model of Care With Patient-Reported Health-Related Quality-of-Life Outcomes. JAMA Netw Open. 2019 Oct 2;2(10):e1914017
[4] Chapter 6: Public health, prevention and patient responsibility
[5] Shurney D. The Evolution of Lifestyle Medicine. American Journal of Health Promotion. 2023;37(7):1013-1017.
[6] Holding us back: tobacco, alcohol and unhealthy food and drink. Nov 2023
[7] Fadnes, L.T., Celis-Morales, C., Økland, JM. et al. Life expectancy can increase by up to 10 years following sustained shifts towards healthier diets in the United Kingdom. Nat Food 4, 961–965 (2023).