This review article describes the challenges we face in the new era of weight loss drugs and the importance of avoiding an arms race between the pharmaceutical and food industries.

Out of frustration with our traditional pharmaceutically driven medical model, grass-roots clinicians have built a new vision for their role in this better integrated health system, with the discipline of lifestyle medicine. This article describes how lifestyle medicine can better support integration of care and help address some of the root causes of ill health in the consulting room. 

Nurses carry out the majority of chronic disease reviews in primary care and are best placed to lead the delivery of lifestyle medicine. Practicing lifestyle medicine offers the opportunity to support chronic disease remission; a conversation that changes consultations from disease labelling and prescribing to optimistic discussions around remission and recovery. 

Intermittent fasting has been used for centuries and only now are we starting to learn about the powerful effects it has on our physiology and longevity. This book chapter covers the different types of fasting, the evolutionarily conserved cellular pathways that are activated during fasting and the trials demonstrating health benefits from fasting in animal models and humans. 

Nutritional psychiatry (and now lifestyle psychiatry) are whole new fields of medicine that translate the knowledge of our gut microbiome and the gut brain axis into clinical practice. With rising rates of mental illness and food insecurity, clinicians and policy-makers urgently need accessible but evidence-based manuals on how best to teach about and use food to improve mental health. Nutritional Psychiatry is a well-written and hugely welcome start in a neglected arena.

When medical guidelines are viewed in totality, it is clear to me that we can’t see the wood for the trees, have forgotten the person behind the disease, and are failing to tackle the root causes of their symptoms.

I argue in this response that our current medical model is, however, based on a reductionist and deterministic view of health that stems from the era of gene discoveries. This has led to a belief that diseases exist in isolation and we are powerless without medicine and drugs.

I ask clinicians to step back from our relentless assessment, quantification, and labelling of disease and spend more time tackling its root causes so we can support people to reverse—or at least improve or delay—these conditions.