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Everyone at ��������would firstly like to congratulate both Alex and Ellen on their new presidential roles here. We are looking forward to working together to grow ��������and the Lifestyle Medicine community, ensuring Lifestyle Medicine is represented across various health bodies and societies.

We have interviewed Alex and Ellen after their respective appointments, looking at everything they will bring to their new roles, as well as a little bit �������� their passions, aspirations and careers.

What do you hope to achieve/bring to the President role

I firstly want to say how delighted I am to accept the position of President of the British Society of Lifestyle Medicine and huge congratulations to Ellen for the much-deserved Vice-President role – I am very glad we get to work so closely together at such an exciting time for the ��������and indeed Lifestyle Medicine. These opportunities would not be possible without the foresight, diligence and dedication of Rob, Michael and Laurence creating the BSLM, the trustees and the incredible work the founders of Lifestyle Medicine have done over the years. Building on their efforts the now established core team, with mention to Fraser, Emma, and Andrew, have enhanced our professionalism and helped create the ��������as we now know it – supporting over 1500 members to effectively promote and apply Lifestyle Medicine throughout the UK and indeed the world so a huge thank-you to everyone involved.

I believe my role is mainly �������� representation with an element of leadership:

Representation – It is critical that the ��������is well represented in all areas – to Healthcare Professionals, the public, professional bodies, and abroad. My role will be to help ensure we are representing ourselves accurately and with absolute legitimacy as well as directly representing our mission statement myself when speaking on behalf of the ��������in a variety of contexts.

Leadership – I will contribute my voice, skills and understanding to helping guide the ��������in navigating the challenging landscape of health and social care in the UK. My core values of legitimacy, learning and optimism align very well with the BSLM’s of honesty, transparency and integrity and I am dedicated to listening to the expertise of our staff and members to help lead us to even greater achievements and position.

This is a 2-year tenure, and I am very aware this is not a long time! These are not personal goals as my position is entirely to serve the ��������and its members. Therefore, these are the top three I hope to achieve with the team in this time:

1. Establish the ��������and its Learning Academy as a world-leading, comprehensive, and high-quality Lifestyle Medicine educational resource for all academic levels – from public to professor.
2. Have over 50% (this is 19 or more I believe) of Medical Schools in the UK include specific Lifestyle Medicine education in their curricula.
3. Significantly increase the number of Nurse and Allied Healthcare Professional members to better represent their skills and experience.

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What do you hope to achieve/bring to the Vice President role

I’ve gone from disillusioned, burnt-out GP partner to re-energised clinician now running group clinics with a Lifestyle Medicine approach, teaching Lifestyle Medicine to GPs, trainees and clinical students as well as having advised the RCGP and Dept. Health and Social Care on obesity. I also take better care of my own health and am a better clinician for it. I want more clinicians to take this journey and deliver better care. A Vice-President, with Alex and the team lead by Fraser Quin, I can help the ��������support others to forge their own career in Lifestyle Medicine and deliver more effective healthcare. I am particularly aware of the immense workload in all areas of the NHS and want to make sure the ��������continues to include some often forgotten healthcare colleagues in this Lifestyle Medicine revolution; particularly those in primary care nursing who often hahave longer and better quality consultations than GPs and frequently see those with long term conditions that would really benefit from this approach.

I hope to build on the work of Dr Rob Lawson and Prof Fraser Birrell who first introduced me to Group Consultations (or Group Clinics). I would like to see group clinics become part of mainstream NHS practice and will support the ��������to continue its work to scale-up this consulting tool. In my experience, group clinics reduce stigma, connect people and help with problem solving and increase people’s confidence to manage their own health. Covid-19 has meant that particularly vulnerable groups have become very isolated and group clinics are one way to address this with no additional clinician time. More than anything however, group clinics allow clinicians to escape the trend towards transactional, ineffective micro-consultations; to slow down and work more collaboratively with patients with more authentic conversations.

The evidence is very clear that loneliness kills. Working in groups of those who have been shielding throughout Covid-19 really brought this home to me; we all need to talk �������� loneliness. The other Lifestyle Medicine pillars can dominate discussions and could benefit from some perspective; if having a drink or eating meat is something people do occasionally to connect with their friends and family, this may have effects that can’t be measured by nutrition science. There is no one-size fits all healthy lifestyle and as a pragmatic GP, I will support the ��������to keep its broad and all-inclusive but evidence-based take on Lifestyle Medicine.

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Tell us �������� yourselves – career/passions and what BSLM/LM has given you

I qualified as a GP in 2017. I had initially applied to GPST to be able to then enter Sports Medicine specialist training but fell in love with General Practice; its flexibility, opportunity and the ability to develop an incredible relationship with the people you care for and their community. In late 2017 had the opportunity to run some group consultations. I chose to run them with a lifestyle focus via the principles of nutrition, movement, destressing and sleep and underpinned by the psychology of health behaviour techniques I had been learning. The person supporting me, Alison Manson the UK training and implementation lead for groupconsultations.com, highlighted that these principles I was using overlapped very well with the pillars we all know and love (as well as the principles we have more recently outlined). Alison put me in touch with Dr Rob Lawson who has supported and mentored me ever since for which I am very grateful.

At around the same time I met a man called Brian Dickens, MBE. Brian is an incredible man and was heavily involved with community development – and still is. He was championing an emerging concept locally at the time called ‘Social Prescribing’ and we clicked immediately. We joined forces and I have been a passionate advocate and supporter of Social Prescribing ever since – both as a Clinical Director of the non-for-profit organisation ‘SocialP’ locally and on a regional and national basis. Social Prescribing can be a very effective tool to combat deprivation and inequality, two topics that I am dedicated to combatting as best I can with the positions and resources I have at my disposal.

I have actively pursued a varied career and as well as GP, Lifestyle Medicine and Social Prescribing am also heavily involved with School Medicine as the Doctor for Harrow School and Sports Medicine with my company – Meliora Medical Group (MMG). I am MMG’s Medical Director and registered CQC manager and have learnt a great number of applicable skills from my time in this position. Alongside these roles I am always looking to engage with teaching, and hopefully inspiring, my colleagues and junior colleagues �������� the areas I am passionate �������� so regularly teach in a variety of settings. Another particular interest is communication skills as they underpin everything we do and I regularly learn more �������� this amazing area through a few methods – not least through discussions with my now good friend, (Professor) Roger Neighbour, OBE!

The ��������and Lifestyle Medicine have utterly changed my career and the principles and pillars provide a foundation and framework that supports all areas of my personal and professional life. Completing the Lifestyle Medicine Diploma in 2019 provided a great opportunity to invest some quality time going into the many ‘rabbit warrens’ of the literature and further reinforced my passion. In particular, Lifestyle Medicine has helped emphasise just how important it is to prioritise one’s own health and wellbeing to enable one to be the best person and doctor one can be. I could not imagine my life without it and am incredibly grateful for the opportunities and support/education the ��������have provided.

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Tell us �������� yourselves – career/passions and what BSLM/LM has given you

I strongly believe we need to change the narrative around long-term conditions and start all our patient conversations with “what matters to you �������� your health right now?”. Then we need to explore socioeconomic issues and the pillars of lifestyle medicine before our traditional history taking. Attending ��������conferences and completing the diploma has given me the confidence to work more closely with patients and freed me up from rigidly following medication-based guidelines. I want clinicians to feel confident discuss all options with their patients; medications, surgery AND lifestyle. We need to help clinicians to overcome the unease that comes with allowing people the time to make these changes and highlight the evidence that people can make sustainable changes if given the right support.
Through ��������events I’ve met others passionate in the field; Professor Roy Taylor of the DiRECT Type-2 Diabetes remission trials, who boldly claims that “Type-2 Diabetes is chronic food poisoning” and Professor Felice Jacka from the Deakin Food and Mood Centre in Australia who was one of the first to use a randomised controlled trial to investigate a food intervention for depression. These inspirational people are challenging our current healthcare paradigm for the better. It is exhilarating to be part of this change. They embolden me to do the same and question how we are currently managing complex, long-term conditions in our deteriorating environment.

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Tell us �������� yourselves – light-hearted/outside medicine

It is always a bit strange talking �������� myself but here goes! I am very happily married to my absolute legend of a wife, Karen. We were married last year (28th May – I can remember!) after delaying things due to the pandemic and it was one of the top two days of my life! Talking �������� one best day, the other was on the 3rd of June this year when our son, George, was born. He is currently 5 weeks old and we are utterly in love although sleep is proving elusive – something all parents can empathise with I am sure.

I love music and performing – I play the ‘cello, piano and I sing and loved being in orchestras, choirs, musicals, and comedy shows in school and university. Any excuse to get on stage and perform or be silly and I am your man!

Sports and exercise also play a big part in my life – I have competed (pretty averagely!) at CrossFit and Athletics -the 400m – and now enjoy keeping moving with my aim having changed from performance to longevity, enjoyment and function. I love a walk as well as physically just mucking around and if you give me a ball (of most shapes or sizes) I will be happily entertained for hours.

I’m a big car fan as well so if you share that passion do bring it up when you see me as I’ll happily chat cars for a bit longer than necessary!

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Tell us �������� yourselves – light-hearted/outside medicine

I juggle motherhood and medicine and am beholden to so many who support and tolerate me doing both and failing regularly! It takes a metaphorical village to bring up children and many of us don’t have access to one. My two under 10-year-olds will tell you that I’m cruel because “everyone else eats MacDonald’s everyday Mummy!”. However, they suffer my terrible cooking skills, including creating the perfect “faux turd” whilst trying to make black bean patties (soft black lozenges pocked with sweetcorn) and trying to speed cook mash potato. Top tip: blending potatoes makes wallpaper paste.

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Why do you think clinicians should join the BSLM

I have yet to find such an incredibly positive, inspiring and changemaking (little nod to our excellent campaign there!) community than the members of the BSLM. With the very real challenges currently in the NHS and General Practice it is reassuring and uplifting to hear how people are caring for themselves and their patients using Lifestyle Medicine with profound benefits to all.

In addition to such a positive community and network the ��������provides incredible and ever-growing resources such as webinars, conferences, the journal, and the Learning Academy. The opportunity for professional development is huge and quite astonishing for an organisation of our size.

Being a member of the ��������allows one the ability to implement and embed Lifestyle Medicine into the very landscape of health and wellbeing in the UK which is incredibly exciting.

I am confident that anyone who attends our annual conference will profoundly experience their own reasons for joining the ��������– those who have will attest, those who have yet to – try it!

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Why do you think clinicians should join the BSLM

More than anything the ��������is one of the most energised, forward-thinking, and optimistic groups of healthcare professionals I’ve ever met. It is full of people who see a way out of the mess we are in with our current industrialised healthcare model. Lifestyle Medicine frees us from rigid medication flow-charts and allows us to go back to talking �������� what really matters to people; �������� what really goes on in people’s lives that drive us to ill health – poor sleep, stress, poor food, isolation etc. Opening the lid on these issues in a short consultation can feel overwhelming but Lifestyle Medicine teaches us how to manage this and equips us with tools to start to help people to change. I now feel excited and optimistic when looking after people with obesity, low mood, and Type-2 diabetes for example. Patients I used to feel depressed and hopeless ��������, I now have the tools to address some of the root causes rather than just making one blood test number better with a seventh medication.

The ��������supports clinicians to prioritise their own self-care to deliver better care to their patients. The NHS desperately needs clinicians of all backgrounds to keep going despite intolerable working conditions at times. I hear so many stories of clinicians, particularly GPs, being on the point of early retirement until they change their approach and join the ��������to forge a new career.

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What advice would you give to a clinician interested in LM?

Now this is a question I am lucky enough to be asked all the time! I give two tiers of advice that depend on how far along their journey the person is.

Tier One

• Join the BSLM! The best way to start your Lifestyle Medicine journey is to get aboard the good ship, BSLM. Once you have joined then get involved, reach out to us and we can connect you to people locally at various stages of their career who can support you and whom you can support
• Learn in greater depth �������� Lifestyle Medicine – there are many good quality resources out there and the ��������has collated or indeed created many of them for you. Of course, you can do this without joining, but I think it is a far easier process if you do join. From blogs, articles, the journal, webinars, and conferences – regional and national – there are a plethora of available options to help progress your knowledge and skills.

Tier Two

• Get involved and contribute – write blogs, give a talk in one of the webinars, join the special interest groups, spread the word �������� Lifestyle Medicine locally, organise conferences, or put yourself up for talking at regional or national events. There are so many ways you can help disseminate your expertise and add to the growing set of resources available to our members. We are always grateful for anyone supporting the endeavour.
• Influence – from inspiring and educating those around you, changing curricula and culture within or outside of your organisations and helping embed Lifestyle Medicine within local/regional and national policy you can be a powerful advocate for Lifestyle Medicine and change the landscape of healthcare around you.

Of course, your passions, skills and experience will influence how you approach getting involved. If you would like to talk �������� getting more involved with the ��������please do reach out to Emma Mulligan.

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What advice would you give to a clinician interested in LM?

Come to a conference, attend a webinar or do one of our courses! Take things further and do the diploma. Come and help us to make it even easier for others to access good quality information �������� Lifestyle Medicine and write for our Learning Academy; particularly if you are in nursing or allied health.

Remember, you don’t have to explore Lifestyle Medicine and every pillar with every patient. Relationships come first, address the patient’s concerns and simply introduce the idea that wider factors can contribute to people’s health – test the water, see if they are interested. If they are, I use a Lifestyle Medicine screening tool and invite people to come back if they appear ambivalent. Some people are enthusiastic straight away, so I sign-post or delve deeper. For others, it’s not the right time but showing interest in these conversations often means people return when the time is right for them; behaviour change needs to be on their own terms!

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What are the challenges facing LM

An important question! This really deserves an essay, but I will try to keep things brief…

I think a major challenge is that ‘Lifestyle Medicine’ is not a protected term. This then feeds into it being potentially open to interpretation on a personal/national and global perspective with the resulting vulnerability to its definition and impact. Without a globally understood and applied definition Lifestyle Medicine can be misused for the agenda of certain people and organisations, often for their own gain which can have disastrous impacts for its legitimacy. Without utterly impenetrable legitimacy the entire concept can be eroded and undermined inappropriately – either deliberately or inadvertently. Therefore, we have clearly defined it on the ��������website and are working to reinforce that message.

Another significant challenge to Lifestyle Medicine is just how burnt out, under-funded and demoralised many of our colleagues are. It is incredibly challenging to work as a healthcare provider in the UK currently and many of our incredible colleagues will naturally be focussing their attentions on what matters most clearly and obviously – ticking the QOF box, seeing the deluge of people ringing up at 0800hrs etc. It requires additional emotional energy and time to apply oneself to think ‘outside the box’ and I have talked to many people who just don’t have that luxury right now. The fact that targets and guidelines are created by people who do not necessarily have Lifestyle Medicine as a priority coupled with the fact that people are unaware of just how powerful and low risk Lifestyle Medicine can be means that its principles and pillars are often not considered or applied.

There are many other challenges but each of these does have a solution or way to mitigate and I am incredibly positive for our future – we have made significant and amazing steps and I am sure we will continue to do so! If you have any thoughts �������� how we can overcome the challenges Lifestyle Medicine must overcome, please do let us know.

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What are the challenges facing LM

Luckily, we are challenged in keeping up with the massive growth in interest in Lifestyle Medicine. This is despite no funding from “big food” or pharma; we need membership subscriptions and aligned organisation support. There are much larger players than us in healthcare who risk skewing the narrative around health with a focus on precision medicine, genes, and medications when we need to balance this with more whole-person, values-based and lifestyle approaches.

We need to keep up the momentum. This is a discipline that has grown from the ground up – I’m so proud of that. The desire for change from both patients and those working in healthcare is fabulous. However, we’re also exhausted from Covid/NHS underfunding and change is tiring and uncomfortable; I have had to come to terms with feeling that my previous medication focused approaches to some long-term illnesses may have caused more harm than good. Many people don’t have the support around their clinical teams to be able to do this.

Changing paradigms in healthcare is challenging and we will certainly make mistakes along the way. We must embrace our critics as well use critical thinking. This isn’t a “no medication approach”. Vaccines work and medicines save lives; we just need to redress the balance and provide an evidence-based voice for lifestyle approaches to sit alongside medications and surgery rather than in the small print.

We also need to make sure that Lifestyle Medicine isn’t reserved for the wealthy few and isn’t used as a policy tool to blame individuals for an environment that is making it harder and harder to lead healthy lives. We will need to work hard to convey a complex message that, whilst we need policy makers and government to act to improve the socioeconomic determinants of health, clinicians can still work at an individual level to explore lifestyle factors and provide personalised support for change.

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How do you see the future of ��������and LM in the UK.

I will keep this simple. My long-term future vision includes:

I want to see all health and allied professionals as well as the public aware of the ��������and Lifestyle Medicine.

With this exposure and understanding I would then hope that most interested and relevant professionals are current and active members.

Building on this membership I then hope that we have ��������and therefore Lifestyle Medicine representatives in all major arenas – Political, Educational, Health and Social care, and organisational within the UK.

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How do you see the future of ��������and LM in the UK.

I see a confident, grass roots charity rapidly growing and being embraced by the younger generation of health care professionals and practitioners who understand the critical role of this new approach. We have growing number of prestigious universities not just dabbling in Lifestyle Medicine now but seeing it as a core and critical part of the medical curriculum that benefits both patients and their clinicians. The future is bright!

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If you would like to connect to discuss your career in lifestyle medicine, how you could contribute to the ��������or any of the topics we have discussed above please do email Ellen or Alex.

Alex Maxwell and Ellen Fallows