insights

Embracing change can be challenging. Anyone who has tried to alter their diet, break a bad habit, or add more exercise to their day can attest to this. Yet for many patients with chronic illness, lifestyle modifications are an important element on the path to wellness that may have huge impacts on clinical outcomes. Some estimates suggest that up to 40% of patients do not adhere adequately to clinician instructions, with the rate rising to 70% or more when significant lifestyle modification or complex behavior changes are recommended.¹ Concern for health, social support, and intervention delivery and design are just a few components that may play into patient engagement and the sustainability of these health interventions.² How can clinicians help their patients fully embrace lifestyle change?

A 2020 prospective cohort study suggests that adherence to a healthy lifestyle at mid-life is associated with a longer life expectancy free of major chronic diseases like cancer, diabetes, and cardiovascular diseases.³ The life expectancy free of diabetes, cardiovascular diseases, and cancer at age 50 was 23.7 years for women who adopted no low-risk lifestyle factors, in contrast to 34.4 years for women who adopted four or five low-risk factors. For men, the life expectancy free of any of these chronic diseases at age 50 was 23.5 years for those who adopted no low-risk lifestyle factors and 31.1 years for those who adopted four or five low-risk lifestyle factors. The low-risk lifestyle factors included: never smoking, body mass index 18.5-24.9, moderate to vigorous physical activity (≥30 minutes/day), moderate alcohol intake (women: 5-15 g/day; men 5-30 g/day), and a higher diet quality score (upper 40%).³ 

Collaborative Therapeutic Partnership

Establishing and maintaining a strong, empathic relationship with patients is one crucial factor for the sustainability of long-term lifestyle changes such as tobacco cessation, healthy weight management, and increasing physical activity levels.^4,5 Some questions clinicians may want to consider prior to developing a plan for lifestyle change include:

• Is your patient ready to consider this change?
• What might your patient need to give up in order to embrace change?
• What barriers might your patient face that might discourage lifestyle change?
• How has your patient successfully changed behavior in the past?¹

A health provider can play a critical role in this process by increasing patient awareness through a collaborative approach to sharing information, education, and personal feedback. The functional medicine model was developed, in part, to do just this. Functional medicine is grounded in a strong patient/provider relationship. Specific tools—like IFM’s Functional Medicine Matrix and Timeline—help the practitioner understand the course of the patient’s life as seen through the lens of health and disease. Often, disease occurs when fundamental lifestyle factors like diet, movement, rest, and/or sleep are lacking or imbalanced in an individual’s life.

Personalized Treatment Strategies

Patients with chronic conditions may already be overwhelmed by burdensome illnesses and treatments and have a difficult time incorporating behavioral modifications into their daily routine. A patient-centered therapeutic approach may help to promote patient engagement and empowerment.⁶ Lifestyle goals and targets can be tailored to patients’ preferences and progress while building confidence in small steps.⁷

Behavioral change may occur gradually over time. Patients who are mindful of their decision-making when it comes to lifestyle change, and who are more conscious of the benefits of changing an unhealthy behavior, may find it easier to adhere to clinician-prescribed behavior modification.^1,8 IFM offers a range of tools, from therapeutic food plans to exercise resources to stress management techniques, to guide the practitioner in designing a personalized treatment plan that may help the patient achieve their optimal outcome.

Conclusion

Integrating the strategies of modifiable lifestyle factors and monitoring progress in a healthcare plan may help improve patient engagement and increase overall health and well-being. At IFM’s Applying Functional Medicine in Clinical Practice (AFMCP)^TM, functional medicine experts use case-based and interactive presentations to engage attendees in real-world situations and demonstrate proper use of a suite of clinical tools that help support a patient’s treatment strategy and health outcomes. For more information about AFMCP and other research on the importance of lifestyle change, please visit the following pages:

Related Content

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References

1. Stonerock GL, Blumenthal JA. Role of counseling to promote adherence in healthy lifestyle medicine: strategies to improve exercise adherence and enhance physical activity. Prog Cardiovasc Dis. 2017;59(5):455-462. doi:10.1016/j.pcad.2016.09.003
2. Deslippe AL, Soanes A, Bouchaud CC, et al. Barriers and facilitators to diet, physical activity and lifestyle behavior intervention adherence: a qualitative systematic review of the literature. Int J Behav Nutr Phys Act. 2023;20(1):14. doi:1186/s12966-023-01424-2
3. Li Y, Schoufour J, Wang DD, et al. Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study. BMJ. 2020;368:l6669. doi:10.1136/bmj.l6669
4. Brandt CJ, Søgaard GI, Clemensen J, Søndergaard J, Nielsen JB. Determinants of successful eHealth coaching for consumer lifestyle changes: qualitative interview study among health care professionals. J Med Internet Res. 2018;20(7):e237. doi:10.2196/jmir.9791
5. Brandt CJ, Clemensen J, Nielsen JB, Søndergaard J. Drivers for successful long-term lifestyle change, the role of e-health: a qualitative interview study. BMJ Open. 2018;8(3):e017466. doi:10.1136/bmjopen-2017-017466
6. Adam LM, Jarman M, Barker M, Manca DP, Lawrence W, Bell RC. Use of healthy conversation skills to promote healthy diets, physical activity and gestational weight gain: results from a pilot randomised controlled trial. Patient Educ Couns. 2020;103(6):1134-1142. doi:1016/j.pec.2020.01.001
7. Koenigsberg MR, Corliss J. Diabetes self-management: facilitating lifestyle change. Am Fam Physician. 2017;96(6):362-370.
8. Barkmeijer A, Molder HT, Janssen M, Jager-Wittenaar H. Towards effective dietary counseling: a scoping review. Patient Educ Couns. 2022;105(7):1801-1817. doi:10.1016/j.pec.2021.12.011