Doctors who treat chronic diseases with lifestyle changes

Dr. Wayne Dysinger, right, says he tries to treat chronic diseases through lifestyle changes.
Dr. Wayne Dysinger, right, says he tries to treat chronic diseases through lifestyle changes.
Rebecca Plevin/KPCC

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About six years ago, Sharon Fields made a doctor's appointment. Her husband had just died of esophageal cancer. She wanted to know if there was anything wrong with her.

"Lo and behold," she says, "I had high blood pressure, high cholesterol and psoriasis."

But her physician didn't immediately prescribe medication. Rather, she says, he wrote a prescription for "beans and greens."

And, Fields says, it's worked. Her blood pressure and cholesterol have returned to healthy levels. The skin condition went away and hasn't returned.

'Lifestyle choices'

Fields sees Dr. Wayne Dysinger, a primary care physician in Riverside.

He practices an approach called lifestyle medicine. It's based on the concept that chronic diseases and conditions such as obesity, diabetes, high blood pressure and high cholesterol are caused in large part by lifestyle choices: What people eat, how often they exercise, how much they sleep and how they deal with stress.

So, Dysinger says, "we believe that if the disease came because of lifestyle choices, then the treatment ought to be related to lifestyle choices as well."

This is not radical medical advice. Many doctors advise their patients to eat better and exercise more. What's different is the way that lifestyle medicine doctors do it.

They're likely to recommend behavioral changes before thinking about medication. Their goal is to address the root causes of a health problem, instead of just treating its symptoms. So along with prescribing beans and greens, they might recommend meditation for people with sleep problems, and exercise for depression.

Some situations, though, call for a more intensive approach.

When patients have acute conditions, such as uncontrolled diabetes, Dysinger says he will prescribe medication to get their blood sugar under control. But at the same time, he says, he would also learn "about the health risks they had because of certain lifestyle choices, and I would be trying to work with them."

Another advantage of lifestyle medicine is that it’s cheaper, Dysinger says, noting, "it doesn't cost a lot of money to eat differently. It doesn't cost a lot of money to sleep a little better."

'An incredibly important component'

The concepts of lifestyle medicine – diet, exercise and sleep - are pretty back-to-basics. But lifestyle medicine as a practice is still quite young.

Its trade group – the American College of Lifestyle Medicine – has only been around for about 10 years. It claims just under 1,000 members nationwide.

Meanwhile, the head of the California Medical Association, which represents more than 40,000 health care providers, says he doesn't have a problem with lifestyle medicine.

"If physicians want to specialize in that area, and work closely with patients to affect lifestyle change, that's a good thing," says Medical Association President Dr. Steven Larson.

He even agrees with Dysinger's assertion that in some instances lifestyle medicine can "actually reverse, or actually get rid of ... diseases."

There is "good evidence that a significant change in diet can reverse the need for medication for diabetes and hypertension," says Larson. "As the saying goes, we are what we eat."

Larson says more doctors would incorporate discussions about lifestyle and habits into their practice, but they're dealing with patients with multiple health concerns and don't have enough time for these valuable conversations.

Lifestyle medicine is also catching on in medical schools. More and more are incorporating it into their curricula, says Dr. John Prescott, chief academic officer for the Association of American Medical Colleges.

Lifestyle medicine "cannot exist by itself, but it's an incredibly important component," Prescott says.

"There are other things that we'll need – there are medications that need to be taken. But behavioral changes, this emphasis on wellness, are critically important as we go about helping to change the health of the nation."

'Plenty of energy'

Back in Riverside, Sharon Fields says she's become a fan of lifestyle medicine, too. Along with eating better, she faithfully follows her doctor's advice to get regular exercise.

"I have plenty of energy, I have a wonderful life, I go to church, I work five days a week," Fields says.

And that's pretty good, considering that next month, Fields turns 80.