Why I chose lifestyle medicine

In November, 2017, I was board certified in lifestyle medicine.  I am in the first wave of doctors and clinicians worldwide, and Delaware's only board certified lifestyle medicine doc.

What is Lifestyle Medicine?

Lifestyle medicine seeks to treat and reverse the underlying cause of our most deadly and expensive diseases, whereas internal medicine seeks to manage these diseases using exclusively drugs or procedures.

As an internist and lifestyle medicine doctor, I seek to use whichever is the most effective treatment according to scientific evidence.  Definitely in many cases, especially when you are sick with illness, drugs are really warranted.  But for our most common and most expensive diseases, research is clear that drugs have a limited benefit, whereas lifestyle change can be more impactful to long term health.

There are some diseases, such as congestive heart failure or atrial fibrillation, that truly benefit from drugs.  But for the majority of our chronic diseases, like hypertension, high cholesterol, and type 2 diabetes, heart disease, and many others, lifestyle change is more beneficial than drugs.

So lifestyle medicine offers great news to patients.  The vast majority of people I meet are aware: drugs have many risks and limited benefit.  Ask most patients and they will tell you they would far rather be rid of disease than to remain a multidrug patient the rest of their lives.  Lifestyle medicine offers a way to be healthy and drug free.

Lifestyle Medicine vs. Internal Medicine

On 1 hand, lifestyle medicine & internal medicine are not very different. They both honor the same scientific body of evidence. They both state that our many costly chronic diseases (like diabetes, obesity, hypertension, heart disease) should first and foremost be managed with diet and exercise.  

They differ on what to do about disease. Internal medicine assumes it is someone else’s job to facilitate healthy lifestyle changes, so it rarely happens. Internal medicine (like most all of conventional medicine in the US) moves on to its real order of business, to administer drugs. That would be swell except we know from copious research that drugs for these chronic western diseases offer only incremental improvements and a host of side effects.  

By contrast, lifestyle medicine puts the change to a healthy lifestyle front and center.  Philosophically, lifestyle medicine sees the body as naturally healing if we just get out of the way.  We lifestyle medicine practitioners learn the skills to make those changes happen. In the end, most patients find the lifestyle changes fun, delicious, and rewarding. Far more doable than what conventional medicine offers: all those pills and all those tests and procedures and doctor visits you need for the rest of your life.


BE WELL, PHODDavid Donohue