The chronic disease epidemic is one of the most pressing public health challenges of our time. However, I argue that we will not resolve this epidemic using the current system. Understanding the interconnected dynamics of the food industry, pharmaceutical industry, and consumer economy is integral to tackling this problem. The goal is to foster healthier living and better health outcomes for everyone, regardless of their social or economic status.


chronic disease epidemic


By Majd Isreb, MD, FACP, FASN, IFMCP

The dichotomy of wellness

When we take a closer look at who has access to a healthy lifestyle, a significant gap emerges. On one side, there are well-off individuals who have the means to eat healthily and live healthily. They are equipped with the knowledge and resources to maintain a balanced diet and engage in regular exercise. However, the choice to live healthily is an individual one. While some make this choice, others choose otherwise. The point here is not to lay blame but to highlight the fact that they have the freedom to make this choice.

The struggle of the disadvantaged

On the other side of the wellness dichotomy, we have the disadvantaged majority. These are the people living paycheck to paycheck, caught in the cyclical nature of financial insecurity and poor health outcomes. For them, it is often not a choice between healthy or unhealthy living. Rather, it’s about meeting basic needs within a constrained budget.


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Ultra-processed foods: A cheap but costly solution

Consider the affordability of ultra-processed foods. These foods are cheap, readily available, and filling. They are also addictive, leading to overconsumption. For those living on a tight budget, they may appear as a cost-effective solution. However, the long-term health implications of these foods present a different picture. The consumption of ultra-processed foods is linked to various chronic diseases, from diabetes to heart disease. Ultimately, the healthcare costs associated with these conditions far outweigh the initial savings.



The role of government and policies

In this context, the role of government is pivotal. Government policies can greatly influence health outcomes, especially for the disadvantaged. However, the current system often burdens the government with the consequences of poor health policies. Whether it’s paying for the healthcare costs associated with chronic diseases or subsidizing the very industries promoting unhealthy lifestyles, the government finds itself at the center of the chronic disease epidemic. It’s clear that a systemic change is needed. Some recommend an excise tax on sugary drinks, tobacco, and alcohol, but this issue is much bigger than that. It goes deep into the fundamentals of the food-pharma-economy complex.

The allure of consumerism

Another crucial aspect to consider is the role of the consumer economy. Various industries often target the disadvantaged to purchase the latest gadgets and engage in consumerist behaviors. This cycle of constant buying leaves little room for investment in health, such as buying healthier foods or gym memberships. This is not simply a matter of personal priorities; it’s a structural issue that requires systemic solutions.

Beyond conventional medicine: A systems approach

Addressing the chronic disease epidemic requires a shift away from our traditional medical paradigms. It is not enough to focus on lifestyle medicine, integrative medicine, functional medicine, or even conventional medicine in isolation. What we need is a comprehensive systems approach.

Rethinking the food industry

As a starting point, we need to transform our food industry. A paradigm shift is required to move away from the current model that prioritizes cheap, ultra-processed foods towards one that values and promotes nutritious, affordable foods.


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Pharmaceutical industry and health outcomes

The pharmaceutical industry also plays a key role in this systems approach. Instead of being driven by profit margins, the focus should be on real improvements in health outcomes. This can be achieved by investing in preventative measures and treatments for chronic diseases that are affordable and accessible to all.

Shift in government policies

The need for a paradigm shift in government policies cannot be overstated. The current pattern of subsidizing the pharmaceutical and ultra-processed food industries while maintaining a reactive approach towards health in the form of procedural and acute medicine is unsustainable and has yielded less than desirable health outcomes.

Instead, our government must direct efforts and funding toward promoting healthier foods, lifestyles, and preventative measures. This includes policies that incentivize the production and consumption of fresh, nutrient-rich foods, foster environments conducive to physical activity and advocate for healthcare services that prioritize disease prevention.

Such a transformation can create a culture that encourages and rewards healthy choices rather than perpetuating a cycle of chronic illness. While it’s true that these changes won’t happen overnight, it’s a crucial step we must take to stem the tide of the chronic disease epidemic that has taken hold in our society. With the right strategies, we can promote a system where wellness is attainable for all.

The Bottom Line

The path to better cost-effective health outcomes is not easy. It requires a complete overhaul of our current systems, from the food industry to the pharmaceutical industry and everything in between. Only then can we truly tackle the chronic disease epidemic and ensure a healthier future for everyone, regardless of their economic or social status.