Public Health and Nutrition Coach combines digital platforms with behavioral psychology to deliver prevention programs associated with an average weight loss of 7 kg and a sustained reduction in diabetes risk
Chronic diseases are no longer just a public health problem – they now represent one of the costliest systemic failures of modern economies. According to the World Health Organization, noncommunicable diseases are responsible for around 1.8 million preventable deaths annually in Europe alone and cost the economy over $500 billion each year, with most cases attributed to modifiable lifestyle factors – diet, physical activity and persistent behavioral patterns. In other words, a significant portion of health spending goes not to unavoidable diseases, but to consequences that could have been delayed, reduced, or prevented altogether.
As this economic reality becomes clearer, public institutions and private providers are being forced to rethink what effective medicine actually means. Prevention is increasingly viewed less as a set of general recommendations or information campaigns and more as a structured, evidence-based process that requires specialized expertise. In this way, a new class of professionals is emerging at the intersection of public health, nutrition, psychology and digital solutions – specialists who work not on treating diseases but on changing the behaviors that cause them. Today, modern prevention programs are being designed, tested and scaled in this evolving space.
In practice, this model is already being implemented in government and digital chronic disease prevention initiatives in the UK. Barbara Mkhitarian – a public health and nutrition specialist with an academic background at Oxford and a master’s degree in Global Public Health Nutrition – works at the intersection of research, public programs and digital platforms, focusing on diabetes prevention, weight management and sustainable behavior change. Her experience includes field research on child malnutrition in East Africa and participation in scalable chronic disease prevention programs in the UK health system, where prevention is gradually moving from a complementary measure to a strategic priority. It is precisely the combination of research, practice, digital tools and understanding of how people make health decisions that creates their unique perspective on translating prevention into real behavior change.
When humanistic thinking becomes a medical tool
Transitioning from the humanities to public health rarely seems like an obvious career move. For Barbara, however, this path became the foundation of her professional methodology. By studying languages, literature and culture at the University of Oxford, she developed skills in analysis, communication and contextual thinking – qualities that later proved crucial when working with human behavior.
Her decision to change fields was not abstract, but rather rooted in personal experiences with the healthcare system. Faced with limited support and a superficial approach to the causes of health problems, she began researching the effects of diet and lifestyle on the body. This experience served as a starting point for her academic focus on Global Public Health Nutrition and her subsequent professional practice.
“I was frustrated with the ‘Band-Aid’ approach that was being offered to me,” Barbara recalls. “Instead of dealing with the causes, the system focused on the symptoms. When I managed to change the situation myself through diet and lifestyle, I realized that this was exactly the area in which I wanted to work.”
Today, she believes her humanistic background helps not only in writing and communicating complex ideas in simple words, but also in building collaborative relationships with clients. This is particularly important in prevention, where a directive approach often produces resistance rather than change.
Why prevention is subject to treatment – and where the system fails
Despite clear economic and social benefits, prevention still receives less attention and investment than treatment. Barbara sees the reasons not only in the medical system, but also in the larger social context.
Effective prevention requires changes in lifestyle, nutritional environment, educational approaches and even urban infrastructure. This requires long-term investment and cross-sector collaboration – tasks that are difficult to fit into short-term political and financial cycles.
“Prevention requires a complete change in mindset,” explains Mkhitarian. “And not just in medicine, but also in education, in the way our food systems and workplace cultures are organized. We live in an environment that encourages harmful habits, and changing them is far more difficult than prescribing treatment.”
Further challenges arise from social realities: the availability of highly processed foods, addiction to sugar and alcohol, chronic stress and lack of time. Under such conditions, it is simply unrealistic to expect people to follow recommendations without structural support.
Behavior change instead of instructions
A key differentiator of Barbara’s approach is that the focus is not on information but on behavior change. Unlike traditional recommendations, which often sound like instructions, behavioral models are based on motivation, psychological barriers and each person’s individual context.
In her practice, Mkhitarian applies health psychology theories and motivational interviewing methods that enable clients to become active participants rather than passive recipients of advice: “Behavior change is not about criticism or pressure. It’s about partnership. We identify sources of motivation and help people feel autonomy, competence and support. This is what makes change sustainable.”
This approach is particularly important in the prevention of chronic diseases, including type 2 diabetes, where one-time interventions fail. Behavioral barriers—from cognitive biases to guilt and all-or-nothing thinking—require systematic, long-term work, not isolated consultations.
Digital prevention as a scalable model
A practical implementation of these principles is Barbara’s work in digital diabetes prevention programs, including collaboration with Liva Healthcare. As part of government initiatives, she works directly with patients at increased risk and uses digital tools to help them change their lifestyle habits.
The results are measurable: from weight loss to the complete elimination of pre-diabetic diseases, confirmed by blood tests. Liva’s studies show that participants who stayed in the program for over nine months experienced an average weight loss of almost 7kg and online coaching led to lasting changes compared to standard care.
“Digital platforms allow us to scale personalized support without dramatically increasing costs,” notes Mkhitarian. “They provide long-term guidance for those who cannot regularly attend medical facilities and remove many logistical hurdles.”
Beyond economic efficiency, the digital model increases engagement through ongoing contact, reminders and the ability to receive support in familiar environments. This is particularly important for people with reduced mobility or those living in remote areas.
From field research to a systemic view of health
Mkhitarian’s professional perspective was largely shaped by fieldwork in Ethiopia, where she studied acute malnutrition in children under five. Working in remote villages gave her practical insight into the impact of environment, culture and access to resources on health.
This experience was a reminder that there are no one-size-fits-all solutions and that prevention must take into account socio-economic and cultural factors – from food deserts in London to climate and gender conditions in other countries.
“Working in Ethiopia taught me that health care is not just about diet and physical activity,” says Barbara. “It’s about culture, living conditions, family roles, access to information and basic resources. Without understanding this, prevention doesn’t work.”
Today, Mkhitarian applies this systemic perspective in UK programs, emphasizing the role of health coaches and nutritionists as a bridge between medical recommendations and people’s real lives.
Prevention as an economic and social strategy
According to the World Health Organization, noncommunicable diseases account for up to 80% of healthcare expenditure in high-income countries, making them the most important cost driver for modern healthcare systems. Even a small delay in the outbreak of the disease has a significant economic impact. But as Barbara emphasizes, prevention brings not only financial but also social benefits.
“When we invest in prevention, people stay healthier and independent for longer,” notes Mkhitarian. “That means a more productive workforce, less strain on families and less inequality, especially if we start early.”
Behavior change specialists in particular are becoming key figures in this change by translating abstract prevention strategies into functional, scalable models. In overburdened healthcare systems, this change is truly essential today.
