December 17, 2022
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Lifestyle medicine – a medical specialty that emphasizes behavioral changes as the primary treatment for chronic illnesses like type 2 diabetes, heart disease and obesity – is gaining attention in the health care industry.
Chances are growing that your doctor may soon talk to you more extensively about your diet, physical activity, sleep habits and even your social life.
This increasing possibility stems from a recent announcement from health insurer Humana and the American College of Lifestyle Medicine. Under a partnership between the two organizations, Humana will offer free lifestyle medicine training to its in-network medical professionals. The initiative will boost ACLM's pledge to provide continuing education to 100,000 clinicians nationwide.
It is a significant step for all who share my advocacy for healthy behaviors among people of all ages and genders. Humana is no doubt attracted by any opportunity to prevent disease and develop lower-cost treatments. But the insurance industry acknowledging the health benefits of scientifically-proven, behavior-based interventions is a sure sign that there is something to this healthy lifestyle thing that I am constantly preaching.
That said, how might this impact your life? What value does this action bring to the average Joe trudging through life? And what role do patients play in lifestyle medicine? Let us start with a definition of lifestyle medicine.
According to ACLM, lifestyle medicine is a specialty that leverages the patient's own behaviors (i.e., their lifestyle) to treat chronic conditions like cardiovascular diseases, type 2 diabetes and obesity.
Often referred to as "whole-person care," ACLM organizes these behavioral modifications into six pillars – a whole-food, plant-dominant eating pattern, physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connections.
Highlighting the scientific evidence behind lifestyle medicine, proponents stress that the adoption and sustainment of healthy habits can add years to one's life, improve the quality of life, and help prevent and reverse chronic disease. Since 2017, the American Board of Lifestyle Medicine has offered an exam-based certification in lifestyle medicine for physicians.
Between the ACLM and the International Board of Lifestyle Medicine, which grants physician certifications outside of the U.S., there are nearly 2,500 physicians certified worldwide. The Humana-ACLM venture is designed to add to this number, but before you get too excited, according to Statista there were just over 1 million professionally active physicians in the U.S. alone in 2021.
As for the impact on the average Joe, one example comes from the Physical Medicine and Rehabilitation Clinics of North America, which characterizes lifestyle medicine as "coaching" patients to help them maintain healthy habits, like smoking cessation or better eating.
The organization sees lifestyle medicine and physical medicine as "complementary" and "synergistic" with treatment of the "whole patient" in their social setting. Translated, lifestyle medicine gives your doctor additional tools, albeit tools they may have always had, in addition to medication and surgery, and a new perspective on their traditional approach to delivering care.
The journal Medical Science Educator offers an interesting take from Dr. Hanno Pijl, an internist-endocrinologist in the Netherlands, on the need for lifestyle. Pijl says today's health care system has not adapted to "chronic 'age-associated' non-communicable disease," and still very much reflects a model centered on infectious disease and fractures, treated by antibiotics and anesthesia-enabled surgeries.
His argument suggests that there is no scientific basis for the notion that sickness is inevitable in old age, pointing to behavior- and environmentally-based noxious stimuli as a culprit for disease. Pijl specifically cites "wrong food, prolonged stress, lack of physical exercise, bad sleep and smoking" among the most prevalent self-imposed causes. He points to these behaviors as the "root causes" of chronic disease and asserts that lifestyle modifications, not drugs, is the answer.
His prescription? A model in which patients share responsibility for their health, rather than placing 100% of the burden on their physicians, coupled with a diagnostic process that includes "the socio-economic, mental, spiritual and behavioral aspects of a patient's life in addition to biological markers of health and disease."
Though there has been a movement to teach techniques such as motivational interviewing in our medical schools, it is clear from the thoughts of Pijl, that lifestyle medicine pushes medical training squarely in the direction of exploring social, cultural and religious dimensions of a patient's life and a good dose of motivational communication training.
A final example of the slow creep of behavior-based interventions into contemporary medicine comes from the Harvard Medical School, which recommends the adoption of the core principles of lifestyle medicine to build resiliency and avoid burnout among surgeons.
Dr. Beth Frates, a lifestyle medicine educator at Harvard, recommends that surgeons who want to advance into leadership roles be conscious of their own health. She asserts that it will give them a competitive edge and enable them to serve as role models for their patents.
Like many examples I have seen in men's health, Frates' entry into the field was prompted by her father's heart attack, which was the result of a poor diet, insufficient exercise and extensive stress. Nonetheless, her application of lifestyle medicine as a self-help tool within the medical community itself offers further evidence to its acceptance.
Having researched and written extensively on the benefits of healthy behavior through the lens of 50-plus men, the value of lifestyle medicine comes as no surprise. Still, behavior change is a challenging and difficult proposition, and clearly, based on the number of physicians certified in lifestyle medicine, we have a long way to go.
Nonetheless, the movement of behavior-based care models into the mainstream of American medicine as represented by the Humana-ACLM partnership is encouraging. The model advocated by the ACLM is scientifically evidenced-based and offers the opportunity to stem and treat chronic diseases that impact the quality of our lives as we age — and that impact is affecting people at younger and younger ages.
So, next time you see your doctor, do not hesitate to offer him or her insights into your lifestyle. See how your doctor responds. Be a proactive patient and glean whatever motivation you can from the conversation. The evidence keeps mounting that lifestyle is the pathway to health and happiness. Jump on the bandwagon.
Louis Bezich, senior vice president and chief administrative officer at Cooper University Health Care, is author of "Crack The Code: 10 Proven Secrets that Motivate Healthy Behavior and Inspire Fulfillment in Men Over 50." Read more from Louis on his website.
