“I’ve been living with type 2 diabetes for about four years. Every time I visit the clinic once every three months to see the doctor, the doctor will tell me that my blood sugar level is high, that I need to control my diet and do some exercise,” reflects Sathis, a patient at the clinic. “I will nod away but when I return home, nothing changes.”
Sathis's experience highlights the common struggle faced by many individuals living with chronic diseases such as type 2 diabetes where the gap between medical advice and actual lifestyle changes often proves challenging to bridge. This struggle not only impacts the individuals personally but also places a significant burden on the healthcare system. Healthcare providers have witnessed these challenges firsthand, recognizing that when type 2 diabetes remains uncontrolled, it can lead to various health complications and increase the overall cost of treatment.
The challenge of making lifestyle changes became less daunting when Sathis participated in a Lifestyle Medicine program at a primary care clinic in the Negeri Sembilan state of Malaysia. The program aimed to empower patients with type 2 diabetes to adopt healthier lifestyles and actively participate in the management of their condition.
Lifestyle medicine offers a comprehensive and holistic approach that addresses the key underlying causes of most chronic diseases, including lifestyle factors such as diet, physical activity, stress management, sleep, social connectivity, and use of tobacco and alcohol. Through behavioural interventions focused on these six key lifestyle pillars, this evidence-based approach seeks to prevent, manage, and treat chronic diseases, to ultimately improve overall health and well-being.
Patient getting his Body Mass Index measurements at the health facility. Credit: WHO/Izarra Azuddin
Empowering Patients to Make Positive Lifestyle Changes
“The benefits are plentiful. From not knowing anything, to being able to change our way of life. Now I feel healthier, lighter and have a lot more energy. Sometimes I do not feel like I’m 50 years old,” commented Nurzela, a participant of the Lifestyle Medicine program. The program consisted of interactive group sessions supplemented by virtual support led by a multidisciplinary team of healthcare professionals at the clinic. Participants not only gained knowledge about adopting a healthy lifestyle but also found themselves motivated to make positive changes. “After following this program, I disciplined myself. Now, in terms of my eating habits and exercise, everything has changed. I used to take the elevator at work, but now I don't. I take the stairs instead. I’ve managed to lose some weight, and my blood sugar and blood pressure are better controlled now,” shared Sathis.
The program incorporated behaviour change techniques that empowered participants to overcome barriers and embrace healthier habits. This personalized approach provided individuals with the tools and strategies needed to navigate the challenges of implementing lasting lifestyle modifications. The interactive group sessions and virtual support created a supportive and collaborative environment, allowing participants to share their experiences, challenges, and successes. This sense of community and mutual encouragement played a pivotal role in sustaining motivation and fostering positive changes. “When I discover that I have peers who share the same fate and have the same problem (disease) as me, I don't feel pressured during the program because we can meet with friends and exchange views,” commented Zainah, a participant.
Patient reading a Lifestyle Medicine pamphlet. Credit: WHO/Izarra Azuddin
A Multidisciplinary Approach
One of the key strengths of the Lifestyle Medicine program is the involvement of a multidisciplinary team at the primary care clinic. The multidisciplinary team, including clinicians, dieticians, counselling psychologists, physiotherapists, occupational therapists and medical social workers underwent training in lifestyle medicine to equip them in delivering an integrated health service. These trained healthcare providers who delivered the program spoke of how it was rewarding to understand and collectively address the interrelationships between the various aspects of patients’ health, including diet, exercise and mental well-being. The three-month program was piloted with 30 patients with type 2 diabetes and an evaluation of its feasibility is underway.
“The use of multidisciplinary teams to advocate for lifestyle changes in patients affected by diabetes has successfully demonstrated that patients with diabetes can be motivated and engaged in undertaking lifestyle changes to improve self-management of their disease and treatment compliance. We look forward to the expansion and mainstreaming of these efforts within an integrated noncommunicable disease (NCD) management strategy,” said Dr Rabindra Abeyasinghe, WHO Representative to Malaysia, Brunei Darussalam and Singapore.
"As a public health advocate, I firmly believe that lifestyle medicine clinics are the cornerstone of a healthier Malaysia. By addressing the root causes of diseases through personalized lifestyle interventions, we can witness a remarkable shift towards vitality, longevity, and a higher quality of life for all Malaysians," added Dr Sivarajan Ramasamy, public health specialist at the Negeri Sembilan State Health Department.
The voices of patients and healthcare providers involved in the program echo the value of lifestyle medicine to empower individuals to make healthier lifestyle choices. By integrating lifestyle medicine into primary care settings and empowering healthcare providers with the necessary skills and knowledge, this program could serve as a foundation for a comprehensive and patient-centered approach to combat the growing burden of type 2 diabetes in Malaysia.
The program was part of a wider Lifestyle Medicine project that aimed to build the capacity of a multidisciplinary team of healthcare providers at the primary care level to deliver a lifestyle medicine service. The project implementation was overseen by the Malaysia Ministry of Health, supported by the WHO Representative Office for Malaysia, Brunei Darussalam and Singapore, with funding support from Denmark.
Watch a video about the Lifestyle Medicine Program: