Inspiring lifestyle change and physical activity

We all know that therapeutic lifestyle change (TLC) — a diet rich in fruits and vegetables and low in saturated fat combined with routine physical activity — can improve health and well-being while drastically reducing health care costs. Many of the diseases of modern living are due to human beings having a stone age physiology but living in a sedentary, high caloric-intake world.

Yet despite our understanding, how often have you succeeded in inspiring your patients to do what it takes?

How often have you recommended lifestyle change but have had the patient ask: “Can’t you just give me a pill instead?” Then, at the next visit, you politely listened to an earful of complaints about the side effects, costs, etc of the medication.

The phrase “lifestyle change” suggests that change has or is about to occur. We all know that wishful thinking and continuing the unhealthy lifestyle habits that originally led to the development of type 2 diabetes, obesity, hypertension, dyslipidemia, atherosclerosis, etc will never result in improvement. A number of my new patients assure me that they have “diet-controlled” diabetes when a more accurate description would be “diet uncontrolled.”

I have been in these situations more times than I can recall. I don’t have any secrets on how to inspire my patients. If you have any, please share with us. I have had a handful of success stories, but these are a depressingly small minority.

One way we can inspire is to practice what we preach. Physicians frequently do not follow our own recommendations. Just look at the long line at the industry-sponsored dinners at any major medical meeting and you will understand what I am talking about. I know you know. It was me who was standing in the line beside you.

By making positive changes in our lives, we become more understanding listeners and better clinicians. My patients explain to me that given the work, family and other commitments, it is hard to find the time to exercise. I understand. I am a proponent of routine physical activity; I run ultramarathons of 50 miles and more. Sometimes it is difficult to find the time.

I ask my patients: “Why don’t you try doing something that you will be able to do such as walking 20 minutes three days a week? Or you could park your car at the far end of the parking lot and take the stairs instead of the elevator."

“I’m sorry, walking back and forth between the couch and the refrigerator doesn’t count.”

It may be challenging, sometimes impossible, to motivate our patients. One place we can begin is to start following our own advice.