Public Health and Nutrition Coach combines digital platforms with behavioural psychology to deliver prevention programs linked to an average 7 kg weight loss and sustained reductions in diabetes risk

Chronic diseases have long ceased to be just a public health issue — today, they represent one of the most costly systemic failures of modern economies. According to the World Health Organisation, non-communicable diseases account for roughly 1.8 million preventable deaths annually in Europe alone and cost the economy over $500 billion each year, with the majority of cases linked to modifiable lifestyle factors — diet, physical activity, and persistent behavioural patterns. In other words, a significant portion of healthcare spending goes not toward inevitable illnesses but toward consequences that could have been delayed, reduced, or entirely prevented.

As this economic reality becomes increasingly clear, public institutions and private providers are forced to rethink what effective medicine actually means. Prevention is less and less seen as a set of general recommendations or informational campaigns and increasingly as a structured, evidence-based process requiring specialised expertise. This is how a new class of professionals emerges at the intersection of public health, nutrition, psychology, and digital solutions — specialists who work not on treating disease but on changing the behaviours that cause it. It is in this evolving space that modern prevention programs are designed, tested, and scaled today.

In practice, this model is already being implemented in governmental and digital chronic disease prevention initiatives in the United Kingdom. Barbara Mkhitarian — a public health and nutrition specialist with an Oxford academic background and a master’s degree in Global Public Health Nutrition — operates at the intersection of research, public programs, and digital platforms, focusing on diabetes prevention, weight management, and sustainable behavioural change. Her experience spans field research on childhood malnutrition in East Africa as well as participation in scalable chronic disease prevention programs within the UK healthcare system, where prevention is gradually shifting from a complementary measure to a strategic priority. It is precisely the combination of research, practice, digital tools, and understanding how people make health decisions that forms her unique perspective on turning prevention into real behavioural change.

When Humanistic Thinking Becomes a Medical Tool

The transition from the humanities to public health rarely appears as an obvious career move. For Barbara, however, this path became the foundation of her professional methodology. Studying languages, literature, and culture at Oxford University developed her skills in analysis, communication, and contextual thinking — qualities that later proved critical in working with human behaviour.

Her decision to shift fields was not abstract but rooted in personal experience with the healthcare system. Faced with limited support and a superficial approach to the causes of health problems, she began to explore the impact of nutrition and lifestyle on the body. This experience served as the starting point for her academic pivot toward Global Public Health Nutrition and for her subsequent professional practice.

“I was frustrated by the ‘band-aid’ approach I was being offered,” Barbara recalls. “Instead of addressing root causes, the system focused on symptoms. When I managed to change the situation myself through diet and lifestyle, it became clear that this was exactly the area I wanted to work in.”

Today, according to her, her humanistic background helps not only in writing and communicating complex ideas in simple terms but also in building collaborative relationships with clients. This is especially important in prevention, where a directive approach often provokes resistance rather than change.

Why Prevention Loses to Treatment — and Where the System Fails

Despite clear economic and social benefits, prevention still receives less attention and investment than treatment. Barbara believes the reasons lie not only in the medical system but also in the broader social context.

Effective prevention requires changes in lifestyle, food environments, educational approaches, and even urban infrastructure. This demands long-term investment and cross-sector collaboration — tasks difficult to fit into short-term political and financial cycles.

“Prevention requires a complete mindset shift,” Mkhitarian explains. “And not just in medicine, but in education, in how our food systems and workplace cultures are organized. We live in an environment that encourages harmful habits, and changing it is far harder than prescribing treatment.”

Additional challenges come from social realities: the availability of ultra-processed foods, dependence on sugar and alcohol, chronic stress, and lack of time. In such conditions, expecting people to follow recommendations without structural support is simply unrealistic.

Behavioural Change Instead of Instructions

A key distinction of Barbara’s approach is the focus not on informing but on changing behaviour. Unlike traditional recommendations, which often sound like directives, behavioral models are built around motivation, psychological barriers, and the individual context of each person.

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: “Behavioral change isn’t about criticism or pressure. It’s about partnership. We identify sources of motivation and help people feel autonomy, competence, and support. That’s what makes change sustainable.”

This approach is particularly crucial in preventing chronic diseases, including type 2 diabetes, where one-off interventions fail. Behavioral barriers — from cognitive biases to guilt and all-or-nothing thinking — require systematic, long-term work rather than isolated consultations.

Digital Prevention as a Scalable Model

A practical embodiment of these principles is Barbara’s work in digital diabetes prevention programs, including collaboration with Liva Healthcare. Within government initiatives, she works directly with patients at elevated risk, helping them change lifestyle habits through digital tools.

The results are measurable: from weight loss to full reversal of prediabetic conditions confirmed by blood tests. Liva’s studies show that participants remaining in the program for over nine months experienced an average weight loss of nearly 7 kg, and online coaching led to sustained changes compared to standard care.

“Digital platforms allow us to scale personalized support without drastically increasing costs,” Mkhitarian notes. “They provide long-term guidance for those who cannot regularly visit medical facilities and remove many logistical barriers.”

Beyond economic efficiency, the digital model enhances engagement through continuous contact, reminders, and the ability to receive support in familiar environments. This is particularly important for people with limited mobility or living in remote areas.

From Field Research to a Systemic View on Health

Mkhitarian’s professional perspective was shaped significantly by field research in Ethiopia, where she studied acute malnutrition in children under five. Working in remote villages gave her practical insight into how health is shaped by environment, culture, and access to resources.

This experience served as a reminder that universal solutions do not exist and that prevention must account for socioeconomic and cultural factors — from food deserts in London to climate and gender-specific conditions in other countries.

“Working in Ethiopia taught me that healthcare is not just about nutrition and physical activity,” Barbara says. “It’s 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, emphasising the role of health coaches and nutrition specialists as the bridge between medical recommendations and people’s real lives.

Prevention as an Economic and Social Strategy

According to the World Health Organisation, non-communicable diseases account for up to 80% of healthcare expenditure in high-income countries, making them the dominant cost driver for modern health systems. Even a small delay in disease onset yields a significant economic impact. However, as Barbara emphasises, prevention provides not only financial but also social dividends.

“If we invest in prevention, people stay healthier and independent longer,” Mkhitarian notes. “This means a more productive workforce, reduced family burden, and lower inequality, especially if we start early.”

It is precisely behaviour change specialists who become the key figures in this transition — translating abstract prevention strategies into functional, scalable models. In overloaded healthcare systems, this shift is truly essential today.

Read more:
Chronic Disease Prevention Remained Abstract for Too Long — Barbara Mkhitarian Made It Measurable