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Advice to improve your movement, fitness, and overall health from the world #1 in orthopedics.

What Is Lifestyle Medicine?

In this Q&A, HSS expert Heidi Prather explains the benefits of the lifestyle medicine approach – and what to expect from a lifestyle medicine doctor’s visit.

Advice to improve your movement, fitness, and overall health from the world #1 in orthopedics.

Lifestyle medicine is a medical specialty that’s been getting a lot of buzz recently, with a new city-wide initiative taking off in New York City in 2022. HSS recently started a pilot lifestyle medicine program of its own to help people with musculoskeletal conditions and coexisting lifestyle-related diseases better manage pain, function, and overall health.

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We spoke with HSS lifestyle medicine program director, Heidi Prather, DO, to learn about the benefits of the lifestyle medicine approach.

What is lifestyle medicine?

Lifestyle medicine is a coordinated team-based approach to healthcare that integrates six vital “pillars” of good health to treat, reverse, and prevent chronic lifestyle-related diseases. Physicians, dietitians, physical therapists, mental health professionals, and other lifestyle medicine practitioners partner with motivated individuals to make meaningful and long-lasting changes that will benefit all aspects of a patient’s health for years to come.

Is lifestyle medicine new?

No, lifestyle medicine is not new. According to the American College of Lifestyle Medicine, it is actually the foundation of conventional medicine. Patient care guidelines for the initial treatment of the most common lifestyle-related chronic disorders — such as diabetes, obesity, hypertension, and heart disease — typically include lifestyle changes such as losing weight, eating a healthier diet, and getting more exercise, rather than starting treatment with medication.

What is new is the recognition of lifestyle medicine as a well-defined practice in today’s healthcare environment. The American College of Lifestyle Medicine began providing board certification in Lifestyle Medicine to qualified physicians in 2017. And the timing is critical: According to the U.S. Centers for Disease Control and Prevention, 37.3 million people in the United States have diabetes1. That’s about 1 in 10, but 1 in 5 of those individuals with diabetes don’t know they have it. Moreover, the overall number of Americans with diabetes is expected to rise to more than 54.9 million by 2030.2

What are examples of lifestyle-related diseases?

Lifestyle-related diseases are extremely serious. During the earliest months of the COVID-19 pandemic, for example, lifestyle-related diseases such as diabetes and obesity were implicated as factors that raised the risk of hospitalization and death from the infection. Obesity also increases the risk of musculoskeletal conditions, heart disease, stroke, and certain types of cancer. More than 42 percent of adults in America are obese, and among those 9.2% are severely obese.3

The situation is dire enough that New York City has made lifestyle medicine a priority. In February 2022, Mayor Eric Adams and New York City Health & Hospitals announced the expansion of lifestyle medicine services at six public healthcare sites, making it the most comprehensive lifestyle medicine program in the country. HSS is participating on the mayor’s council for this program, and we’re excited to have a seat at the table in the discussion to help improve the health of New Yorkers.

Is there a link between lifestyle-related diseased and musculoskeletal conditions?

People with musculoskeletal conditions such as arthritis commonly complain of knee, hip, and back pain. But many of them have co-existing lifestyle-related “comorbidities” — other health problems that contribute to their poor health.

These lifestyle-related diseases, as well as the musculoskeletal conditions, share a common root in inflammation. We're not just talking about swelling in an arthritic joint, but systemic inflammation throughout the whole body that is a hallmark of diabetes, heart disease, and cancer. Lifestyle medicine approaches can help treat all of these conditions by reducing inflammation.

What are some of the ways that lifestyle medicine can help people?

Lifestyle medicine encompasses six pillars, which focus on replacing unhealthy behaviors with positive behaviors. Each pillar is based on medical research findings, meaning that it is evidence based. The six pillars include:

  1. Nutrition, especially a diet rich in whole, predominantly plant-based foods such as vegetables, fruits, beans, nuts, and seeds.
  2. Physical activity, with regular exercise that you enjoy, can do daily, and maintain throughout your life.
  3. Stress management, with a focus on learning coping mechanisms and stress reduction methods to improve your well-being.
  4. Avoidance of risky substances, such as tobacco and addictive drugs, and limiting other substances such as alcohol.
  5. Restorative sleep, for the prevention of reduced immunity and other health issues. It’s not just about how many hours you are lying in bed, but the quality of the sleep you are getting.
  6. Social connectedness, for emotional health. Unfortunately, many of us became more isolated during the pandemic. But studies show that people with a strong network of social support have a better chance of succeeding in making and maintaining healthy lifestyle changes.

What are the benefits of lifestyle medicine for people with musculoskeletal conditions?

Taking an integrated lifestyle medicine approach to care may not only relieve arthritis symptoms, but can also improve overall health by lowering the dependence on diabetes medications, decreasing blood pressure, and reducing the risk of cancer. If you haven’t made much progress in managing your musculoskeletal condition, it may be because you have comorbidities that also require attention.

That’s where lifestyle medicine can help you. If you’ve been experiencing muscle, bone, or joint pain and you're ready to make some healthy changes, a meeting with a lifestyle medicine physician may be just what the doctor ordered. That nagging pain can become a catalyst to a new, more comfortable, healthier, and possibly longer life.

Pain is a signal that your body is not in balance. It is also an opportunity to make a positive change.

What can I expect from a lifestyle medicine consultation at HSS?

A lifestyle medicine consultation starts with a comprehensive evaluation by a lifestyle medicine physician that includes:

  • A conversation about your pain and other symptoms
  • An extensive health screening for all possible medical issues
  • Discussion of your personal goals
  • An assessment of your support network
  • Measurements such as your blood pressure, body mass index, and neck and waist circumference
  • Laboratory tests such as blood and urine analysis
  • Questionnaires that gauge how active you are in participating in your health care, and how likely or confident you are in making a lifestyle change

What happens after a consultation?

Based on the results of your evaluation and tests, we may refer you to other lifestyle medicine practitioners such as:

  • A dietitian, to discuss your eating habits and help put together a dietary plan to help you feel better.
  • A physical therapist or exercise physiologist, to assess your level of fitness and tailor an exercise plan that meets your needs and preferences.
  • A health coach, to help you establish your goals, identify stressors, and develop techniques to reduce stress and build or sustain relationships that are supportive of your health.
  • Community programs, to provide helpful information about lifestyle medicine behaviors and invite you to form social connections with other people in the program.

Your lifestyle medicine providers meet regularly as a team to discuss your progress and your ability to adhere to recommendations. We also ensure that you are receiving consistent messages that will increase your chance of success. That pain that brought you in to see us in the first place may become a barometer of what works for you — flaring up when you eat certain foods, for example, and abating when you are following the recommendations of your team.

Lifestyle medicine does not passively try to make a symptom feel better. The goal is to help you get better.

How do I get started?

If you are thinking about making a change, living with that change, and are motivated to take the responsibility for maintaining those changes, lifestyle medicine may be for you. Lifestyle medicine services at HSS are provided in person and through telehealth. Call 212-774-7653 for more information.

Over the next several months, we’ll be publishing additional articles about each pillar of lifestyle medicine and link you with resources. Stay tuned!

1. A Snapshot: Diabetes In The United States | Diabetes | CDC
2. Diabetes 2030: Insights from Yesterday, Today, and Future Trends - PMC (nih.gov)
3. Adult Obesity Facts | Overweight & Obesity | CDC

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