- Healthcare costs are skyrocketing. In 2019, the annual "disease management" approach to medicine cost Americans $3.8 trillion.
- "Lifestyle medicine" aims to optimize well-being and prevent—or reverse—disease via intensive therapeutic lifestyle change (ITLC).
- ITLC lowers people's medical bills, saves them money, and may reduce burnout rates among over-burdened healthcare providers.
Motivating people to eat healthier and exercise more is challenging. Almost everyone knows that eating less junk food and spending less time sitting has been shown to increase one's odds of living a longer and healthier life. Yet having this evidence-based knowledge often isn't inspiring enough to boost people's motivation to make lifestyle changes.
For example, a 2018 study found that 80 percent of Americans don't get enough exercise for optimal health based on recommended physical activity guidelines.
As a public health advocate, until now, I've missed the opportunity to encourage people to make lifestyle changes by discussing personal finances and the cost savings associated with healthier living. However, a new case study series (Livingston et al., 2021) on "Lifestyle Medicine and Economics" opened my eyes to the possibility that saving money on healthcare costs might be a strong motivator for those who are otherwise resistant to making healthy lifestyle changes.
The findings of this American College of Lifestyle Medicine case study series were recently published in the International Journal of Environmental Research and Public Health. For this paper, first author Kara Livingston and colleagues examined how intensive, therapeutic lifestyle intervention change (ITLC) can reverse disease and reduce healthcare costs based on four individual case studies.
Lifestyle Changes Can Reduce Food Costs and Medical Expenses
As one example, "Case #3" was an overweight pre-diabetes male in his 50s with high blood pressure, low potassium, sleep apnea, edema, fatty liver, and arthritis.
After being hospitalized for severe abdominal pain in October 2016, he realized that he was dissatisfied with his constant need for medical care and unhealthy eating habits. He committed to making a major lifestyle change by eliminating meat and eating a whole-food, plant-based (WFPB) diet. Not only did he save money on groceries by eating a WFPB diet, but he also reduced his comorbidity and medical bills.
In three months, the man lost 80 pounds, lowered his blood pressure, eliminated hypokalemia, and wasn't edematous. After radically changing his dietary habits, he no longer had sleep apnea, nor was he pre-diabetic.
"[Case 3] reports that his grocery bill is half of what it used to be and notes that eating beans, rice, and produce, particularly from local farms and grocers, is less expensive than his previous diet that incorporated foods, such as meats and cheeses," the authors explain. "Specifically, he currently spends about USD 350–400/month on groceries, in comparison to the USD 700/month that he previously spent. In addition, his overall spending has decreased because he eats out very rarely."
Over the course of 20 months, "Case #3" lost 168 pounds and went from a starting weight of 348 lbs down to 180 lbs. He also experienced significant disease reversal and lower healthcare costs. Livingston et al. estimate a potential savings of $92,031 (USD) for this case study based on avoided medical costs following his intensive lifestyle changes.
According to the authors, making intensive lifestyle changes "reversed all medical conditions with the exception of his arthritis." Case #3 also experienced a "major improvement in his level of happiness and quality of life." Notably, this disease reversal created an upward spiral of physical and psychological well-being by facilitating the ability to spend more time doing outdoor activities he loves (e.g., kayaking, biking).
Lifestyle Medicine Can Help Reduce Skyrocketing Healthcare Costs
In 2019, U.S. healthcare spending reached $3.8 trillion or $11,582 per person; this is 17.7 percent of the nation's Gross Domestic Product. Chronic mental and physical health conditions account for about 90 percent of the four-trillion USD spent annually on healthcare in the United States.
When integrative medicine focuses on daily habits and lifestyle changes that often make people sick over time, it has a prophylactic effect of preventing disease. The current "disease management approach" of primarily treating people who are already sick has caused healthcare costs to skyrocket and perpetuates burnout among over-worked healthcare providers, stretched thin by the Covid-19 pandemic.
"We know that chronic disease places an enormous burden on both individuals and our healthcare system," co-author Padmaja Patel said in a news release. "The current healthcare quality measures, performance measures, and incentive models are tied to a disease management model. They do not serve well for lifestyle medicine providers who focus on disease reversal and remission."
"We believe this case study provides the justification for these research priorities and hope it will lead to other study designs that further explore the full benefits and value of lifestyle medicine," she concluded.
Kara A. Livingston, Kelly J. Freeman, Susan M. Friedman, Ron W. Stout, Liana S. Lianov, David Drozek, Jamie Shallow, Dexter Shurney, Padmaja M. Patel, Thomas M. Campbell, Kaitlyn R. Pauly, Kathryn J. Pollard, and Micaela C. Karlsen. "Lifestyle Medicine and Economics: A Proposal for Research Priorities Informed by a Case Series of Disease Reversal." International Journal of Environmental and Public Health (First published: October 29, 2021) DOI: 10.3390/ijerph182111364
This paper is part of a special issue: "The Lifestyle Medicine Movement: An Extension of Public Health into Medicine."