Miss Giulia Bankov • October 14, 2019
Giulia is a graduate medical student at the University of Glasgow. She previously studied Neuroscience at King's College London and completed her Cognitive Neurobiology and Clinical Neurophysiology at the University of Amsterdam
Questions regarding topical issues related to the NHS are often asked at panel interviews and MMI circuits, as medical schools want to see that you have current knowledge on important topics regarding the country’s health system. Quizzing you on diseases of lifestyle and their impact on society and the NHS, as well as picking your brain about what can be done to solve these issues are common practice and a fair game at med school interviews and you want to be prepared if such a question were to come up.
We have summarised all the relevant information you would need to answer such a question in a structured format, so have a read below. Ultimately, don’t forget that preparation is key and having an interview question bank of topics that are likely to come up and that you are know how to answer will help you in your performance at your interview. For a list of current NHS hot topics, have a look at our NHS hot topics online course 1 and NHS hot topics online course 2.
Lifestyle diseases is an umbrella term that refers to non-communicable diseases linked to the way people live. They are often caused by lifestyle choices, such as excess alcohol consumption, smoking, lack of exercise and unhealthy eating. Common lifestyle diseases include obesity, type 2 diabetes, cardiovascular disease, and chronic obstructive pulmonary disease, among others. Now, let’s look at each of these separately and discuss how they are caused.
Let’s start with obesity, as that is a very common problem in the UK, with an estimated 1 in 4 adults and 1 in 5 children affected by it. While there are other pathophysiological risk factors that could lead to obesity, the most common cause is sedentary lifestyle and overconsumption of calories, particularly from fatty and sugary foods. Due to the lack of physical activity, that extra energy is stored in the body as excess fat.
It is important that you always consider the context, in which diseases of lifestyle occur. In the example of obesity, modern living often includes sedentary office jobs, which coupled with the easy access and affordable prices of fatty foods, increases the chance of becoming obese. Rates of obesity can also be linked to lower socioeconomic status, which suggests that an element of education about health and its lack thereof can be a factor, too.
Furthermore, it is important that you recognise that such diseases do not occur in isolation, but are often developed in clusters. Obesity often presents with other comorbidities, such as type 2 diabetes and coronary heart disease. That is logical when you think about it, as increased consumption of sugary foods also leads to insulin resistance and thus drives your blood sugar to be permanently high, resulting in type 2 diabetes. At the same time, if you consume too much fats which are not burned, they deposit not only as fat in the body’s soft tissues, but also begin to accumulate within blood vessels, restricting blood flow, and increasing the risk of heart attack.
Another important point to recognise is that the same diseases can be caused by different lifestyle factors. Cardiovascular disease, for example, can be the result of smoking too, as both nicotine and carbon monoxide cause the heart to work faster and increase the risk of developing blood clots. Smoking further causes 70% of all lung cancer and can lead to chronic obstructive pulmonary disease, which presents with inflammation of the airways (chronic bronchitis) and damage to the air sacs in the lungs (emphysema).
When you become a medical student, the course is designed so that one of the first practical skills you will be taught is taking patients’ medical history, and an important component of that is social history - does the patient smoke, drink, or take recreational drugs and how often, do they exercise, and what do their typical meal consist of. These are all incredibly important questions that you must always ask in a consultation. Having seen the vast majority of conditions they can cause and considering how widespread these are, you can see why this is such an important topic to be knowledgeable about at your medical school interview.
The first thing to consider when thinking about the impact of diseases of lifestyle is how prevalent they are, especially in the Western world, and especially in the UK. Naturally, if a disease is seen in a huge percentage of the population, it would have a much larger impact than if it was an extremely rare condition that only occurred once in a hundred million people.
Let’s take obesity for example. We discussed earlier that obesity is often linked to multiple comorbidities, as the underlying pathological mechanism can be common to all, but the reality is that it itself can further cause many more. Obesity is a common cause of joint problems and, in more severely affected individuals, can lead to osteoarthritis.
Psychologically, it has been discovered that obesity is correlated with depression, feelings of isolation and low confidence and self-esteem. You could imagine how the quality of life of someone who has troubles moving around, may be in frequent pain and has no self-motivation or is feeling depressed, can be affected. They might be unable to go to work anymore, isolate themselves from their social surroundings and further exacerbate their physical and mental health problems.
Now consider the statistics we already mentioned, that on average 1 in 4 adults in the UK is affected by obesity, which is a whopping 25%. If 25% of the UK’s adult population is unable to work or at least work effectively due obesity-related health problems, that will put the country’s economic stability under an incredible amount of strain. Imagine managing a huge factory and going to work one day only to find out that 25% of your employees have fallen sick indefinitely and there is no way for you to replace that lost workforce - you will soon fall behind on your orders and risk losing your business.
What’s more, if 25% of the adult population requires to be treated for muskuloskeletal, cardiovascular and mental health conditions all at once, among every other demand already placed on the NHS, that would impose an impossible burden on our health system that would affect the entire population.
There are multiple solutions that have been proposed, both on an individual and national level, when it comes to dealing with the impact lifestyle diseases have on our personal lives and on our economy. Taking preventative measures is ideally attempted in order to completely stop the development of the disease. In relation to lifestyle diseases, this can be achieved with educational programmes on the benefits of healthy eating and exercise, the dangers of smoking and excess alcohol consumption, as well as of drug abuse.
Catching the diseases early, before they have had a tremendous impact on the individual’s quality of life is another goal of the NHS, with various protocols of monitoring pre-diabetic and pre-hypertensive conditions in susceptible individuals. Government policies is another approach, with one of the most common examples is setting a higher tax on cigarettes, alcohol and sugary products. You can also have a look at key policies that the British Medical Association has proposed to tackle obesity.
An interesting initiative rolled out by the NHS to tackle obesity is the Couch to 5K, aiming to motivate people to learn how to run 5 km in the span of 9 weeks, which you could also talk about at your interview.
We hope that the above information has been helpful in structuring your answer. If you have any questions, don’t hesitate to contact us email@example.com.
Good luck at your interview!
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