ACLM calls for lifestyle medicine to serve as a framework from high-value, whole-person care

The American College of Lifestyle Medicine (ACLM) is calling for lifestyle medicine to be adopted as a foundation for delivering high-value, whole-person care across the U.S. health care system. In a position paper, published November 12 in the American Journal of Lifestyle Medicine, ACLM leaders outline how evidence-based lifestyle interventions can address the nation’s chronic disease crisis, reduce spending and improve outcomes for both patients and clinicians.

“ACLM’s High-Value Care Framework redefines what quality care means in modern medicine, translating lifestyle medicine into a model that fulfills the Quintuple Aim,” said ACLM President Padmaja Patel, M.D., DipABLM, FACLM, CPE, a co-author on the paper. “It aligns seamlessly with the full continuum of care — from prevention to treatment to remission — demonstrating that lifestyle medicine is not confined to one stage but is integral to them all. Lifestyle medicine is high-value care delivery. It offers a unifying framework that mobilizes people, teams and systems to prevent disease and restore health.”

The paper includes five key positions outlining how lifestyle medicine — a specialty focused on addressing the root causes of chronic conditions through evidence-based lifestyle interventions — can help reform U.S. health care delivery.

Chronic disease costs and fragmentation are driving reform efforts

The position paper notes that chronic disease now drives the majority of U.S. health care spending, mortality and disability, with $4.9 trillion spent annually on health care. Rising rates of obesity, diabetes, cardiovascular disease and other chronic conditions have contributed to higher utilization and worse outcomes, despite U.S. spending exceeding comparable nations.

Traditional care models, the authors argue, are often reactive and fragmented. Fee-for-service reimbursement can incentivize volume over outcomes, preventing clinicians from addressing root causes of illness.

As a result, patients experience more hospitalizations, emergency department visits and poorer long-term health trajectories.

The paper positions lifestyle medicine as an essential component of value-based care delivery, including alignment with prevention efforts, treatment protocols, remission models and social drivers of health.

Five position points for implementation

The paper asserts that lifestyle medicine should be recognized and implemented as:

1. A care delivery model that addresses the escalating chronic disease burden.
2. A catalyst for health care transformation that delivers the Quintuple Aim.
3. Whole-person care applied across populations, settings, intensities and modalities.
4. A model delivered by trained, interdisciplinary experts across the care continuum.
5. A framework rooted in nine core elements: accessible, comprehensive, high quality, integrated, whole-person, accountable, cost-effective, equitable and achievable.

Lead author Samrina Marshall, M.D., M.P.H., DipABLM, emphasized the system-level implications.

“This framework demonstrates how lifestyle medicine may be implemented at all points of care across the health system that makes high-value, whole-person care a reality,” Marshall said.“By empowering patients and supporting clinicians with training, certification and practical tools, we can advance the Quintuple Aim and transform the health of our communities.”

Training and certification

The paper also highlights ACLM’s ongoing efforts to expand training, certification and practice support resources across medical specialties, academic pathways and health systems.

The organization has provided more than 1.2 million hours of lifestyle medicine education since 2004. Its training programs, board certification pathways, practice toolkits and shared medical visit models are cited as core components needed to support clinical adoption.

With lifestyle medicine now practiced in primary care, endocrinology, oncology, pediatrics, hospital medicine and other fields, the authors call for greater alignment of reimbursement models, regulatory frameworks and clinical program design.

Evidence base and clinical applications

The paper highlights the effectiveness of controllable factors like diet, physical activity, sleep optimization, stress reduction, social support and avoidance of risky substances in treating and preventing chronic disease. These six pillars are used as core treatment modalities in lifestyle medicine practice.

According to research published in the American Journal of Health Promotion, up to 80% of chronic diseases and premature deaths could be prevented through sustained lifestyle behavior change.

The authors note that many clinical guidelines already recommend lifestyle intervention as first-line therapy, although reimbursement and practice infrastructure remain barriers.

They continue, calling for lifestyle medicine to be incorporated into medical education, benefit design, reimbursement structures and care delivery. The paper emphasizes aligning stakeholders — that is, payers, health systems, clinicians, communities and patients — to expand access and implementation.

Increasing the availability of nutrition resources, shared medical visits, community supports and culturally responsive care can help reduce disparities and advance equity. The framework outlined in the ACLM paper highlights measurement of lifestyle behaviors, patient‑reported outcomes and clinician well‑being as key indicators to assess impact and guide improvement.