Can you become board-certified in lifestyle medicine? Yes!

If you don’t know a physician who practices lifestyle medicine (LM) already, chances are you will. Founded in 2004, the American College of Lifestyle Medicine (ACLM) created a new board certification program and currently has more than 6,000 practicing members representing every continent.^[]

LM offers an alternative for physicians and other HCPs who’ve felt frustrated with the current healthcare system, according to two LM physicians who spoke to MDLinx.

According to the physicians interviewed for this article, the results achieved for patients and their practices speak for themselves.

What is lifestyle medicine?

LM relies on lifestyle modification as the frontline intervention for chronic diseases such as CVD, obesity, and type 2 diabetes. It’s not a standalone board certification, but a supplemental one for PCPs and specialists.

“(LM) treats the underlying cause of disease rather than its symptoms that are too often addressed with ever-increasing quantities of pills and procedures,” the ACLM wrote. “Because it treats causes and not just symptoms, only through lifestyle medicine can we alter the course of spiraling health care costs.”

LM is based on six pillars:

• Nutrition—LM practitioners recommend plant-based diets including seeds, nuts, whole grains, vegetables, fruit, beans, and lentils.

• Exercise—To do daily and consistently through all stages of life.

• Stress—A double-edged sword, stress can help us achieve our goals, or it can contribute to negative mental health conditions, obesity, and a dysregulated immune system. LM practitioners equip patients with stress coping mechanisms so they can achieve the right stress balance.

• Substance abuse—Specifically, tobacco cessation and reducing alcohol consumption.

• Sleep—Improving sleep with coping mechanisms, optimal environmental conditions, and diet to avoid immune system strain.

• Relationships—Assessing how a patient’s home life and interactions with (or isolation from) others contribute to their overall health.

The two LM physicians who spoke to MDLinx said this approach closes knowledge gaps left by conventional medical training, and empowers patients to take control of their health.

Beyond the prescription

Sandra Sobel, MD, an endocrinologist practicing in Pittsburgh, PA, said that while research supports pharmaceutical interventions for metabolic health, many of her patients wanted other evidence-based options.

“If we only focus on using medicines to treat disease without talking about the lifestyle component, we're also limiting the efficacy of the medicine, and we're also missing a huge opportunity of engaging patients in their own care,” Sobel said.

Of course, many patients know that diet, exercise, stress reduction, and better sleep are conducive to better health. What many don’t know is how to achieve these health goals sustainably.

Sobel said that earlier in her career, a patient asked her for specifics on these lifestyle modifications—and she didn’t have any. LM certification equipped her to have patient-specific conversations about stress, exercise, sleep, and other personalized health topics.

“I can’t tell you how many times in those conversations that the proverbial light bulb goes off and a patient says, ‘Nobody ever explained that to me,’” Sobel said.

"This is what happens as a result of having more time," she continued, "and of focusing on the lifestyle component—not just the prescriptive component.”

Education and evidence

For John Sosa, MD, discovering LM was a convergence of his personal and professional values and ambitions. By the time he brought LM into his Tampa, Florida-based family medicine practice, his LM certification had closed knowledge gaps that had persisted since his medical school and residency years.

“We were taught to manage various conditions―manage people’s diabetes, manage their heart disease and high blood pressure, and put them on medicine,” Sosa recalled.

That knowledge, he said, translates directly into patient education. He described a recent conversation with a female patient who had diabetes, in which he took the time to explain the “why” of the condition. Her reaction, Sosa said, was surprising.

“‘Wow, nobody’s ever told me that. You know, everybody in my family’s diabetic, and all everyone talks about is low carb, and don’t eat fruit and don’t eat sugar,’” Sosa recalled her saying. “That’s all the stuff I got taught in med school. That’s how we managed diabetes—but we never reversed it. We never got anybody off their medicine.”

For Sosa, the other attractor to LM was evidence. A daily review of the headlines reveals more studies that support lifestyle-based interventions for better health, he said. This trend is unlikely to change.

Putting LM into practice

If you’re considering picking up LM certification, Sobel and Sosa said the process isn’t onerous. After passing an initial exam, ACLM offers a CME model that most physicians will find familiar.

This maintenance of certification approach typically involves reading a few journal articles and answering questions based on them. ACLM also offers an exam every 10 years for doctors who prefer a more traditional process. Of course, doctors will still need to maintain certification in their primary specialties.

The effort, according to Sobel and Sosa, is well worth it. For Sosa, his pursuit of LM clarified his mission as a physician and his personal health philosophy. He doesn’t just preach the six pillars of LM—he lives by them.

“My journey got me here. I was already on that path and then I stumbled on lifestyle medicine. I became board certified, and that’s when I really shifted into high gear and became 100% plant-based,” Sosa said. “I feel better doing it. I recover better. I work out better.”

The LM journey has been equally beneficial for Sobel.

“Being able to provide that personal anecdote to patients I think is also really powerful,” she added.