A Comprehensive Clinical Lifestyle Medicine Specialty Fellowship Program: What Intensive Lifestyle Treatment Can Do

Abstract

Lifestyle medicine (LM) is recognized as an essential component of evidence-based medical treatment, particularly for chronic diseases. Multiple studies have shown that intensive therapeutic lifestyle change can arrest and reverse disease, including heart disease, type 2 diabetes, essential hypertension, metabolic syndrome, and autoimmune and inflammatory conditions. While more modest lifestyle changes can slow the onset or prevent disease, studies reveal that intensive therapeutic changes are required to arrest and reverse disease. As increasing numbers of clinicians have learned about the powerful treatment effects of intensive lifestyle interventions, interest in LM has greatly increased. This, in turn, has led to the need for evidence-based clinical LM training in how to effectively provide intensive LM interventions that can arrest and reverse disease. As with all clinical training, such training must include actual patient care guided by knowledgeable expert LM clinicians. The purpose of this article is to (1) describe the need for and function of clinical LM specialists, (2) describe the key components in the training of clinical LM specialists to treat and reverse chronic disease, and (3) describe the steps/components in establishing and implementing a clinical LM specialty-training program.

Keywords: clinical lifestyle medicine education; intensive lifestyle interventions; lifestyle medicine curriculum design; lifestyle medicine training.

Figure 1.

Lifestyle medicine and acute care versus public health/preventive medicine.

Figure 2.

Threshold effect for lifestyle intervention dosing (Dansinger et al). (Notice the nonlinear relationship between adherence on the x-axis and change on the y-axis. Changes only begin to occur with adherence above ~4-5).