How to succeed in lifestyle medicine

May 22, 2026

By Meagan L. Grega, MD, FACLM, DipABLM, DipABFM

The increasing burden of chronic disease is a challenge all primary care doctors face. Conditions including type 2 diabetes, cardiovascular disease, obesity, chronic kidney disease, depression and cognitive decline are no longer the exception; instead, they make up the majority of our daily workload while affecting younger and younger patients.

According to the CDC, three out of four U.S. adults live with at least one chronic condition and 50% live with two or more, placing an enormous burden on individuals, families and communities. Health care spending now exceeds $5.3 trillion annually, costing approximately $15,474 per person and devouring nearly 18% of our GDP. Yet our outcomes lag behind those of nations that spend far less. And though our medical toolkit has never been more advanced, many of the conditions driving morbidity, mortality and health care costs are still rooted in modifiable lifestyle factors.

Lifestyle medicine as a payment model

Lifestyle medicine offers a powerful, evidence-based path forward, one that addresses root causes rather than simply treating symptoms while also offering a framework for addressing the upstream drivers of disease in a way that aligns with both scientific evidence and the realities of patients’ lives. The new Center for Medicare and Medicaid Innovation MAHA ELEVATE model signals a clear commitment from HHS to shift toward preventing and treating chronic disease through whole-person care, with an emphasis on lifestyle medicine.

Though the deadline for the first-round application period has passed, this is a moment worth paying attention to. Practices that are already integrating lifestyle medicine principles, including whole-food, plant-predominant nutrition, regular physical activity, restorative sleep, healthy stress management strategies, nurturing social connection and avoidance of risky substances, will be best positioned to lead, adapt and thrive.

Getting started in lifestyle medicine

I didn’t set out to build a career in lifestyle medicine. I was trying to solve a problem I kept encountering in exam rooms. As a family physician, I saw the same patterns over and over again: patients struggling with worsening diabetes, hypertension and heart disease despite receiving appropriate, evidence-based medical care. I could prescribe medications effectively, follow guidelines precisely and still feel like I wasn’t addressing the root causes of what was making people sick. Patients’ vitality continued to decline—not because they weren’t trying, but because the system wasn’t designed to support meaningful change in their lifestyle choices and medications alone were not sufficient to restore them to a state of good health.

It became increasingly clear that I wasn’t getting to the root cause of what was driving their health challenges. That realization pushed me to look beyond procedures and pharmaceuticals, instead focusing on the daily environments, habits and barriers shaping my patients’ lives. Lifestyle medicine offered an approach that finally made sense by connecting the underlying mechanism of chronic disease with the lived reality of my patients.

That shift in perspective didn’t stay confined to the clinic. In 2007, it led to the creation of the Kellyn Foundation, a 501(c)3 non-profit organization with a focus on making healthy choices easier and more accessible in my community. What started as a response to individual patient needs evolved into a broader Healthy Neighborhood Immersion strategy that integrated healthy lifestyle education in schools, food access in under-resourced areas, culinary medicine education and clinical lifestyle medicine interventions into a cohesive strategy.

Programs like hands-on cooking classes, Garden as a Classroom programs, and the Eat Real Food Mobile Market became essential tools for addressing upstream drivers of disease. Over time, it became clear that sustainable behavior change requires more than information. Successful implementation of health-promoting change requires shifts in the choice architecture of the surrounding environment, nurturing longitudinal supportive relationships and redesigning systems to make the healthy choice the default choice.

Perhaps the most meaningful lesson along the way has been the power of relationship and continuity. Through long-term engagement with patients, students and community members, I’ve experienced how consistent exposure to healthier norms can shift behaviors across the lifespan while providing hope for people struggling with chronic disease.

For me, lifestyle medicine is not just a clinical approach; it’s a way of reimagining how we partner with individuals and communities to create lasting health. It has also brought medicine back into alignment with why many of us chose this career in the first place.

What lifestyle (and functional) medicine looks like in practice

For family physicians, lifestyle medicine doesn’t require abandoning what we already do; instead, it enhances it by providing more tools in our armamentarium.

In practice, it looks like:

• Standardizing periodic assessment of dietary patterns, physical activity, sleep quality, stress levels, supportive social connection and exposure to risky substances.
• Creating SMART goals (specific, measurable, achievable, relevant and time-bound) for health behavior change through motivational interviewing and shared-decision making.
• Using team-based care, including health coaches, dietitians, behavioral health specialists, chefs and fitness professionals to support sustainable change.
• Collaborating with aligned community partners to extend your reach into the places where your patients live, work and play.
• Prescribing the correct “therapeutic dose” of lifestyle interventions based on whether the goal is prevention, treatment or reversal of disease.
• Scheduling consistent, longitudinal follow-up appointments to provide support and accountability throughout the behavior change journey.
• Consideration for inclusion of shared-medical appointments that allow physicians to deliver education more efficiently, answer common questions for the group rather than repeatedly for individuals, and explore behavior change strategies while providing more time for interaction and enhancing social connection for patients navigating similar challenges.

Some practices also incorporate elements of functional medicine. Though the terminology may differ, the overlap is clear and both approaches focus on upstream drivers of health. In practice, this means placing as much emphasis on building workflows that support sustainable lifestyle change as we do on prescribing medications. It also means designing systems that extend care beyond the exam room. When we help patients see that small, consistent shifts can lead to meaningful outcomes, it can truly change the trajectory of their health.

How patients benefit from lifestyle medicine

The benefits for patients go far beyond improvements in A1c, blood pressure, weight and lipid profiles. One of the first things patients often tell me when they start making healthy lifestyle changes is that they have more energy to engage in the activities that are meaningful for them. They often mention that they are sleeping better and that they no longer have episodes of constipation that previously caused uncomfortable bloating. They talk about their pleasant surprise when they find out their children, spouse or friends are not only supportive of their new habits, but would even like to try some of the new foods or join them for a walk on the weekend.

I also see something less easily quantified: a sense of agency and a feeling of hope that they are not destined to just become sicker over time. Patients begin to understand that their daily choices matter, not in a punitive way, but in an empowering one. They start to connect how they feel with how they live. And over time, many experience not just disease management, but true health restoration.

What lifestyle medicine has meant for me and my team

Integrating lifestyle medicine has changed more than patient outcomes; it’s changed the experience of practicing medicine for our care team. For clinicians, it can reduce the sense of futility that sometimes accompanies chronic disease management. It is incredibly inspiring to see patients improve their health in meaningful ways. Lifestyle medicine also creates opportunities for collaboration. Health coaches, nurses, behavioral health specialists, fitness professionals, dietitians, chefs and community-based organizations can all play a critical role. Care becomes less siloed, allowing patients to access insights and support across a broad spectrum of expertise through an aligned multidisciplinary team.

And perhaps most importantly, it fosters sustainability. Clinician burnout often stems from misalignment between what we know matters and what we’re able to deliver. Lifestyle medicine helps close that gap.

What I hope MAHA ELEVATE will change

The MAHA ELEVATE model has the potential to accelerate many of these shifts towards adoption of lifestyle medicine principles in practice. At its core, it recognizes that long-term health outcomes are driven by more than clinical interventions alone. It creates incentives for practices to invest in prevention, behavior change, team-based care and community collaboration. At the same time, the selected pilot programs will function as evidence-generating clinical trials aimed to produce data that will inform Medicare coverage determinations in the future.

For family physicians, I hope it will:

• Validate the importance of lifestyle interventions as a foundational component of care.
• Support infrastructure for team-based, longitudinal care.
• Reduce reliance on volume-driven, fee-for-service models that limit opportunities for meaningful patient engagement in supportive behavior change programs.
• Encourage innovation in how we deliver and measure care.

Even for practices that don’t participate directly, models like MAHA ELEVATE influence the broader ecosystem. They shape expectations, reimbursement strategies, and ultimately, the standard of care.

A call to action

Moments when policy, care delivery and patient needs begin to align are opportunities to meaningfully transform how we practice medicine. The MAHA ELEVATE model is one signal among many that health care is evolving. The question is not whether lifestyle medicine will play a role in that future, it’s how prepared we are to integrate it.

You don’t need to overhaul your entire practice overnight. You don’t need perfect workflows or complete certainty. But you do need to start. Explore the resources. Connect with colleagues. Reach out to community-based organizations and look for ways to collaborate. Lean into the areas that resonate most with your patients and your practice. The shift toward lifestyle medicine as a foundation of health care is accelerating. Family physicians are a powerful force! Working together, we can create the future of health care through leveraging the power of lifestyle choices.