Late last October, I arrived in sunny Orlando with a carry-on and a long cardboard tube. My ticket was not for Universal Studios, but a conference just 15 minutes away. In the air-conditioned exhibit hall, I felt my palms grow sweaty as a small audience gathered before my poster. One of them was a keynote speaker, who I had watched enthrall a packed ballroom earlier that morning with an electrifying opening talk.
My appreciation for the field of medicine — its ability to provide treatments for complex conditions, offer explanations for what we cannot see, and keep patients alive against all odds — has only grown over the course of my first year as a medical student. As I develop an understanding of how to care for patients, I realize that even treating symptoms is no easy task.
What drew me to lifestyle medicine (LM) was its mission of addressing the “root cause” of patients’ health conditions. LM adjusts the focus of medicine from the treatment of symptoms toward management and prevention through evidence-based lifestyle changes. At the American College of Lifestyle Medicine (ACLM) Conference, I was curious to learn from LM practitioners and researchers who had studied and seen its impact on patients’ lives.
Sessions shed light on how LM enhanced the care physicians were able to provide. There was a variety represented at the conference — from family medicine to oncology and orthopaedic surgery — because LM complements virtually any specialty, and any type of physician can become board-certified in LM. This universality appeals to trainees who are yet to decide on a specialty, as well as established physicians who want to add another layer of prevention and treatment to their practice.
It can be daunting to think about how to practice LM given that lifestyle encompasses many areas of a person’s life. LM is organized into six “pillars”: nutrition, physical activity, stress management, sleep, social connection, and avoidance of risky substances. Lifestyle change is already offered alongside many standard therapies and provided as a first-line recommendation for treating chronic diseases like diabetes and hypertension. Expertise in LM allows a physician to dive deeper into the details about which recommendations work best for their patients, and how they can be implemented into their lives given their unique circumstances.
While physicians are there to empower patients to make healthy choices, the level of lifestyle intervention is determined by their clinical scenario, personal goals, and motivation. Some patients are able to slow the progression of chronic disease; others can taper their dose of medication; a few can even go on to achieve remission or reversal, as in the case of Type 2 diabetics who lose their insulin resistance.
This approach to practicing medicine also leaves a positive impact on the providing physicians. According to them, moving toward prevention rather than crisis management was a pivotal paradigm shift that strengthened their relationship with their patients. Longer appointments that focused on proactive care gave space for collaboration; patients felt more engaged and empowered in their health decisions, while physicians felt their contribution was meaningful. Their deep satisfaction with the difference they were making in the lives of their patients felt like a bulwark against the tide of increasing physician burnout.
While learning about LM and its promising future in treating and preventing disease, I also came to appreciate the complexities and challenges of giving lifestyle advice. A keynote speech, led by a well-known nutrition researcher, acknowledged that some recommendations — particularly regarding diet — don’t come without a degree of controversy.
LM prides itself on being evidence-based, and its nutrition pillar recommends what the vast majority of research supports: a predominantly plant-based diet. However, evidence exists in favor of multiple dietary paradigms that prioritize vegetable intake, from Mediterranean to vegan to Atkins diets. As a result, there is disagreement on the finer details of plant-based diets and which one should be the "gold standard" clinical recommendation.
It was easy to see how health care professionals can get lost in the minutiae when trying to guide their patients toward the best possible options. The speaker pointed to studies comparing Mediterranean and vegan diets head-to-head, and smaller debates such as green tea versus coffee in the morning. He maintained that the pursuit of perfection may not be the goal, nor is it necessary for patient health. Instead, he concluded, striving for discussion and equipoise — balance in how we assess and apply lifestyle choices — may be the best way forward in a field filled with nuance.
I mulled over these insights later that day as I stood in the poster exhibit hall, and I was thrilled when the keynote speaker came by. As I explained my research on plant-based diets, another attendee approached my poster with strong disagreement, challenging dietary approaches that limit meat. The conversation could have become tense, but instead, I watched the keynote speaker steer it toward discussion. Rather than dismissing the attendee’s concerns, he invited dialogue: “Hey, that’s an interesting statement. Can you tell me more about what led you to that idea?” His openness transformed a potential debate into an exchange of perspectives.
That moment stayed with me. As I continue my training, I realize that evidence will evolve, guidelines will shift, and patients will bring their own perspectives, challenges, and values to the table. More than just a set of pillars, LM is a practice that strives for teamwork and conversation. It is an open dialogue that requires not only knowledge but the ability to listen, adapt, and build trust.
Sara Temelkova is a first-year medical student at Rush Medical College in Chicago, where she is involved in her school's lifestyle medicine student organization and Health Equity and Social Justice Leadership program. She is passionate about food justice, the gut microbiome, and the role of nutrition in health. She loves spending time in small bookstores, being on the badminton court, and admiring Lake Michigan. Sara is a 2024-2025 Doximity Op-Med Fellow.
Image by Dumitru Ochievschi / Getty Images
