Lifestyle medicines

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Abstract
Sildenafil and orlistat, prescribed for erectile dysfunction and obesity respectively, have been labelled as “lifestyle drugs” in the popular imagination. Although this description may trivialise serious medical conditions for which the drugs are indicated, it encapsulates concerns that some indications for these drugs might be regarded as issues of personal choice rather than illness. It is difficult to define what we mean by the term lifestyle drug since the perception of what is illness and what is within the sphere of personal responsibility rather than health care may depend on whether one is a potential patient or a potential “payer.” The perception may depend on social and cultural norms too,1 and it is also a function of how a medicine is used. For instance, most people would agree that the prescription of sildenafil for a healthy man unhappy with his sexual performance is a lifestyle use, but would consider differently the case of a diabetic man with neuropathy. A working definition for this paper might be that a lifestyle drug is one used for “non-health” problems or for problems that lie at the margins of health and wellbeing (see table). A wider definition would include drugs that are used for health problems that might be better treated by a change in lifestyle; this definition might include drugs such as lipid lowering agents or proton pump inhibitors. #### Summary points Lifestyle drugs are drugs used for non-health problems or for conditions that lie at the boundary between a health need and a lifestyle wish These drugs threaten the financial sustainability of current health systems Traditional approaches to regulating medicines are not effective for lifestyle drugs; coordinated action is needed to manage pharmaceutical policy nationally and locally Greater public involvement is essential in establishing priorities Lifestyle drugs may promote debate about appropriate directions of …