Doctors Fail at Lifestyle Change, and That's (Unfortunately) Logical

People go to the doctor with a simple question: “I don’t feel well.”

And what do they often get back? “Eat healthier, exercise more, rest a bit, sleep enough.”

That sounds logical. It just rarely works. Not because you “lack discipline”, but because the system is almost built to fail at this.

1. You Ask for Coaching, But You Get Triage

A doctor’s consultation is designed for assessing risks, ruling out disease, treating and referring. Great for acute problems. Less suitable if you want to change long-term.

Lifestyle change is something else: behavior, habits, context and relapse. You can’t fix that in 10 minutes.

A 10-minute consultation cannot replace a year of behavior change.

2. “Exercise More” Is Not a Plan

Lifestyle rarely fails on knowledge. It fails on execution.

If you’re tired, stressed, sleep poorly, or your day is just too full, then “being healthy” isn’t an inspiring choice but an extra task. Without a concrete plan, follow-up and adjustment, advice remains mostly: a slogan.

What does work? Making things concrete. Not “exercise more”, but “every Tuesday at 7pm a walk”. Not “eat healthier”, but “this week I’ll try lentils instead of meat twice” or “I’ll follow my healthy eating week plan from this blog for a day”. And then: someone who thinks along, adjusts and asks how it went. That makes the difference between good intentions and real change.

3. The Healthcare System Rewards Quick Fixes, Not Prevention

Adjusting medication, monitoring blood values, ordering tests: that fits perfectly into the system.

But real lifestyle guidance requires repetition, structure, coaching and above all a lot of time. And there’s no room and no budget for that.

The system is set up for treatment, not prevention. While prevention has the greatest impact on your long-term health.

4. Your Environment Actively Works Against You

“Living unhealthy” is often not a choice, but a consequence of stress, burnout and sleep deprivation, and of a commercial environment that constantly pushes you towards ultra-processed, cheap temptation.

The Lancet family describes this as commercial determinants of health: how commercial systems and strategies actively promote health damage.

“Young people are especially at risk of being influenced by advertisements and celebrity promotion. For example, fast-food advertising to youth activates highly sensitive and still-developing pathways in teens’ brains.” (The Lancet, Commercial Determinants of Health)

You’re not weaker than others. You’re up against a system that’s deliberately designed to make healthy choices difficult.

5. Individualization: You Have to “Carry It All Yourself”

We increasingly live alongside each other instead of with each other. Less village feeling, less safety net, less practical help. And then comes the implicit message: figure it out yourself, including your health.

Only: lifestyle change works better with support, doing things together, and feeling less alone in the process.

People go through different phases in behavior change and relapse is part of the process (Prochaska & DiClemente, 1983). In the action phase, which is often stressful, social support (“helping relationships”) becomes extra important (Prochaska, DiClemente, & Norcross, 1992).

The Lancet explicitly names social connection (and the lack of it, such as loneliness) as a health issue, not as “a private problem”.

6. One GP Can’t “Do This on the Side”

Lifestyle change usually only really works with teamwork: medical follow-up with the doctor, plus guidance that is designed for behavior (dietitian, physiotherapist, coach, group approach, psychological support where needed).

A GP cannot be everything: diagnostician, medication manager, therapist, and life coach at the same time. And that’s not necessary.

Bottom Line

Doctors fail at lifestyle change because we have them do something that is almost impossible within the current system: coaching on behavior, without time and structure, in a society that both pushes you unhealthy and makes you feel you have to do it alone.

The solution?
Not trying harder. But recognizing that lifestyle change requires a multidisciplinary approach, with sufficient time, structure and social support.

And a system that sees prevention not as a side issue, but as core care.

References

The Lancet Series on Commercial Determinants of Health (2023). Describes how commercial strategies actively promote health damage.

Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7(7), e1000316. Shows that social isolation has comparable health risks to smoking.

Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390–395. Investigates why behavior change fails without structure and follow-up.

World Health Organization (2021). Social Determinants of Health. Emphasizes that health is determined by social and economic factors, not just individual choices.