In the latest video from PROMiXX we talk to Doctor Omar Iqbal MBChB RCGP NHS General Practitioner and Welsh Muscular Physique Champion.

We wanted to know;

• Is modern medicine killing the healthy lifestyle?
• Do patients seek prescription drugs over diet and exercise?
• How can a GP / Doctor help patients understand the benefits a healthy lifestyle brings. 
• Who's to blame?

As a bodybuilder and Doctor, Omar has a unique view on the benefits of a healthy lifestyle and on overall health and wellbeing. 

Below is the transcript of the full interview. 

[transcript]

My name is Dr Omar Iqbal. I'm a local general practitioner which means that I'm not affiliated to one practice and I work all over the south of the country and I have a keen interest in bodybuilding. That interest stemmed from an injury I sustained about 12 years ago.

Q. How much did you learn about nutrition while studying for your degree? 

I would say not a great deal through the medical course. I mean there are a few lectures, possibly a few tutorials centred around nutrition but I wouldn't say it was weighted at all to that really, and even now in general practice, I don't think we spend enough time with our patients talking about nutrition.

Q. What's your opinion on the uptake of prescription drugs?

It's just the repetitive nature of what I see and, what I see is that prescription seeking behaviour, gives me something that's going to help me lose weight, the easy option. The reality of this is that it's difficult, I always say that to my patients, losing weight dieting is difficult.

The more enjoyable we can make it, the easier it's going to be but it's still going to be difficult because if the patient can help themselves to find that sort of motivation to make make sure that their diet is clean and balanced and healthy, that they're doing regular exercise then that's where it's going to come. No drug is ever going to beat that.

Q. Are patients aware that nutrition can help them lose weight, rather than a prescription?

In my experience, the majority of the time, the patient wants something that's going to do this for them they want you to do this for them.

I can almost liken it to one of the most common things we see in general practice which is an upper respiratory tract infection or a common cold or sore throat or something like that. The amount of patients I have coming in wanting antibiotics, they're not seeing the the bigger picture in the fact that they can help themselves with conservative measures. Let your body fight it off. It's similar with nutrition and diet. Exercise helps you to do these simple things. You don't need a GP to give you something and you're going to see the results. 

I think with the time pressures and the other pressures GPs are under are probably partly to blame for that as well. Just giving a prescription, getting the patient out the door so they can move on. Sitting and talking to a patient about their diet, their lifestyle the exercise levels takes time and time is something we don't have.

Q. How would you want to help patients improve their nutrition and weight loss?

In the ideal scenario, you know, if we had more time, had that extra five minutes just to have a chat about the patient and their lifestyle - what's their diet like, were there sort of physical activities like day to day and what is their energy expenditure. Sit down and make a little bit of a plan with them I think that would be of tremendous benefit.

Q. What do you see most frequently with patients?

Absolutely anxiety & depression. I would probably say, they are two of most common things I see. So out of 18 patients, I would hazard a guess that at least four or five will be due to mental health concerns. There's a common feature in all my clinics and that's why I think it's so important about lifestyle, medicine, diet and exercise and the beneficial effects they can have on on mental health.

That brings me on to something else with regards to mental health, giving patients a prescription 'here's an antidepressant, take this, go away and you'll get better '. Does it help? Evidence suggests, yes, but I certainly think we need adjuncts with that and those are, addressing your lifestyle and your diet, your hobbies and exercise. Those are things that always sort of take a back seat.

Q. What questions do patients ask you the most?

The most common is, 'how do I lose weight?', 'I want to lose weight'.

"Tell me how to do it',  and unfortunately patients just want something easy, they want something that they can go and do and this is going to happen overnight and unfortunately, that's just not the case.

I think that's why we struggle as GPs, to engage patients in doing regular physical activity, dieting to lose weight and it's the failure to establish those healthy relationships with with food and exercise which is a big factor.

I think that's why we struggle to to get our patients to lose weight

Q. How do your colleagues react to you being a bodybuilder?

It's always a question of how'd you have the time to do that, how'd you have the time to go and train and focus on how you look and your diet when you're in such a stressful and demanding job that takes up so much of your time?

I get asked that so much by my colleagues, by patients, by staff at the GP surgeries, and my answer is usually always the same, that the training is my hobby and I enjoy it. If I didn't enjoy it, I don't think I'd be in this position and that's why it's so important to try and make exercise enjoyable for patients and in any way we can, because if it's seen as a chore, which I think it often is, it's not going to be done. It's going to possibly be done for a short period of time, and then the joy is going to fizzle out and it's not going to be sustainable.

We have to find a way to make it enjoyable for the patient and to develop a healthy relationship with exercise and exactly the same with diet.

Q. Where do you see yourself in the next couple of years?

For the time being, I'm going to stay in South Wales as a local GP. The stability of the NHS is a little bit of a problem at the moment so I can't see myself committing to any sort of long term practices which I do want to do eventually and go into a partnership, so that would mean I'm essentially a business partner in a GP practice and I'll be able to develop that continuity of care with patients, follow them up and encourage that sort of lifestyle. That side of medicine will become much easier, I'll be able to almost track my patients.

That's the dream but, you know, as I say short-term I can't see it happening with how things are in the NHS. But that's what I ultimately like to do.