Not officially recognized as a medical specialty by health authorities, functional medicine nevertheless generates considerable attention. What does it involve? Why is this practice not officially recognized?
What is functional medicine?
According to its proponents, functional medicine aims to heal the body by addressing the root causes of a disease, rather than merely masking symptoms with medications. A familiar analogy is often used: conventional medicine acts like a firefighter who puts out the fire (symptoms), while functional medicine seeks to understand why the fire started. On the website of the Institute for Functional Medicine (IFM) in the United States, functional medicine is defined notably by the inclusion of ingestive therapies. Here, the idea is to bring together Western medical science – drugs, surgery, etc. – and complementary therapies.
However, functional medicine is not officially recognized as a medical specialty by health authorities, particularly in France where neither the Medical Board nor universities grant official diplomas in this discipline. But why this lack of recognition?
What complementary therapies?
The central therapy of functional medicine revolves around therapeutic nutrition and micronutrition. There may be temporary removal of certain foods from daily life, for instance gluten, dairy products, or items containing short-chain carbohydrates (FODMAPs). It can also involve taking supplements such as amino acids and omega-3 fatty acids, or even plant extracts like berberine.
Other complementary therapies fall within the framework of functional medicine. For example, body-mind therapies such as medical hypnosis or mindfulness meditation, as well as manual and physical therapies like osteopathy, chiropractic care and other therapeutic massages. There is also mention of environmental medicine and detoxification, for instance through hepatic-support protocols and coaching.
These various therapies have multiple objectives, including reviving cellular or mitochondrial function, reducing intestinal inflammation, boosting immunity, lowering cortisol (the stress hormone) or regulating blood glucose. They may also aim to regulate the autonomic nervous system, ease digestive pain associated with irritable bowel syndrome, or restore tissue mobility and optimize the flow of bodily fluids.
What criticisms are leveled at this discipline?
The Institute for Functional Medicine (IFM) offers a certification program involving more than a hundred hours of continuing medical education. It should be noted, however, that this credential comes in two versions: medical and professional – without prescribing medications. The medical version targets physicians, licensed naturopaths (NDs), nurse practitioners and physician assistants, while the professional version is aimed at nurses, pharmacists, dentists, psychologists, nutritionists (and dietitians), physiotherapists, chiropractors and other licensed health professionals.
Conventional medicine relies on the scientific method known as Evidence-Based Medicine, i.e., based on evidence. Yet functional medicine lacks robust randomized controlled trials to validate the overall effectiveness of its protocols. There is also concern about over-diagnosis and overtreatment – particularly through the widespread use of biologically based tests not academically validated – which can lead to false positives and thus overconsumption of dietary supplements.
Finally, the IFM and its private, non-degree trainings allow various professionals to claim to practice functional medicine. This entirely falls within a regulatory gray area, potentially exposing patients to financial abuses or to guidance that runs counter to science.
Source: Has “functional medicine” proven its effectiveness? No (scientifique-en-chef.gouv.qc.ca)
Article prepared with the help of AI · Our method
