Lifestyle medicine is not lifestyle “management”. It is a unique form of specialty medicine that uses evidence-based, therapeutic approaches to prevent, treat, and often reverse “lifestyle-related” chronic disease, as well as select autoimmune diseases. It is care that empowers the patient to take charge of their own health through “coaching and support” from their provider. In the times in which we live now, especially with the onset of COVID-19, where the social determinants of health impact disease, it is more important than ever to educate the patient on ways their daily behavioral choices contribute to their own health. It is helping the patient see through teaching they have control over that. Physician in Latin actually means “teacher.” In lifestyle medicine, the physician teaches the patient how to live their healthiest life.
The lifestyle medicine approach includes: a predominately whole-foods, plant-based (WFPB*) diet; regular physical activity; adequate sleep; stress management; avoidance of risky substance+ use; and use of other non-pharmacologic modalities to promote health and prevent chronic disease. It also provides positive psychology and connectedness as a part of this health care provision. it is a long-term solution that requires patient commitment.
*WFPB Diet consists of mostly food from plants (such as whole grains, vegetables, fruits, beans and legumes) with little or no animal products (such as dairy, meat, and eggs).
+Avoidance of risky substances means no smoking, illicit drugs and minimal to no alcohol consumption.
The patient is given ownership over their choices that determine health, being supported by the lifestyle medicine physician along the way. There are more frequent check-ins, as well as group activities such as meditation, yoga and/or cooking classes to encourage and promote healthy living.
“Conventional” medicine might not be the right phrase as lifestyle medicine dates back to Hippocrates, the Father of medicine, who said “Let food be they medicine and medicine be thy food.” Lifestyle medicine is truly conventional medicine. Evidence-based medications and interventions are used in lifestyle medicine healthcare model delivery, but only as a supplement to changes in the patient lifestyle. A provider acts both as a physician and a health coach, requiring patient engagement and responsibility for long-term health outcomes. It is a shared commitment.
Lifestyle medicine board certification involves years of study at the level of a generalist, specialist, or primary care provider doing the usual Internship and residency training required for primary board certification. Lifestyle medicine is not a specialty one can acquire without another board certification at this time. A unique aspect of the field is that the physician must actually “walk-the-walk” in order to be an effective advocate and provider of lifestyle medicine services.
By the year 2010, no state in the U.S. had an obesity prevalence less than 20 percent. These numbers have not improved over the last decade. We are facing a public health crisis of epidemic proportions, especially in light of COVID-19 affecting mostly obese and hypertensive patients. The field is growing out of necessity to address the conditions brought on by the social determinants of health.
The belief is that “your genes are not your destiny” and all medications have side-effects. All of these diseases are related, and they are all rooted in lifestyle:
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