American College of Lifestyle Medicine: Vision, Tenacity, Transformation

‘But the new research coming to light revealed that sufficiently intensive lifestyle changes could not only prevent disease but also reverse it.’

2019 marked the 15th anniversary of the founding of the American College of Lifestyle Medicine (ACLM). The history of the College is one that speaks to vision, courage, dedication, and perseverance, holding steadfast to the science that serves as the foundation of the field.

The vision was first cast by John Kelly, who from 1996 to 2004 was a courageous physician-in-training. He was impressed by the number of rigorous scientific studies published that showed the efficacy of intensive lifestyle interventions in treating and reversing disease. Physicians had long known that lifestyle habits were risk factors for chronic disease and had sought to educate the public about the need to make better choices in diet, physical activity, and so on to prevent disease. But the new research coming to light revealed that sufficiently intensive lifestyle changes could not only prevent disease but also reverse it.^1-8

Kelly saw that the published evidence and observation of successful lifestyle treatment programs indicated that a different skill set was required to successfully change lifestyle behaviors. It was evident that what was beginning to be referred to as “Lifestyle Medicine” was not simply prevention—it was, in fact, clinical treatment.

Recognizing that treating root causes of disease through evidence-based lifestyle behavior change was not represented by any field of medicine, Kelly concluded that this gaping void needed to be filled with a dedicated medical professional society—one that would represent disease treatment and reversal through therapeutic lifestyle intervention.

A founding committee was formed, and the first official in-person meeting took place on December 3, 2003. Bylaws were drawn in February 2004. The first General Meeting of the ACLM was held on March 9, 2004. The organization’s first elected directors were installed: Lee Berk, Wayne Dysinger, Franklin House, Jim Peters, Doug Plata, and Wes Youngberg. Officers included Secretary-Treasurer Ed Fujimoto, Vice-President Neil Nedley, and John Kelly elected as the founding president.

In his address to the group, President Kelly stressed 3 key points (which remain true today):

• “We cannot continue doing what we’ve been doing in medicine because we are failing miserably.

• Medicine must take an evidence-based approach to the practice of lifestyle medicine, and we little comprehend what the ramifications of doing this will be.

• We must understand when lifestyle-based prevention must be separated from treatment, and when they can be coupled.”

Kelly served as president until 2008, succeeded by Marc Braman, MD, MPH, FACLM (2008-2009); Wayne Dysinger, MD, MPH, FACLM (2009-2012); Liana Lianov, MD, MPH, FACLM (2012-2014); David Katz, MD, MPH, FACLM (2014-2016); and George Guthrie, MD, MPH, FACLM (2016-2018). Dexter Shurney, MD, MPH, FACLM, became president in October 2018, with Cate Collings, MD, FACC, president-elect, set to assume the presidency in November 2020, which will usher in the first cardiologist ever to serve at ACLM’s helm.

ACLM began as a volunteer-led medical professional society and remained as such for many years. Initially, membership included both physician members and non-physician doctoral-level clinical professionals. Over the years, ACLM’s membership has expanded, now including allied health professionals, health care executives, health coaches, medical students and trainees, as well as those in professions dedicated to advancing the field of lifestyle medicine.

There have been challenging years along the way, although tenacity and perseverance of ACLM’s foresighted leaders prevailed: They navigated through the tumultuous times, believing that the field that ACLM represented was worthy of the investment of time, talent, and treasure required to ensure that the vision of ACLM would come to fruition—where treating root causes of disease would become the default first treatment option across the United States and around the world.

Today, ACLM’s membership is nearing 4000 strong, having grown more than 600% in the past six years. With exceptional leadership provided by ACLM’s Board of Directors, working in collaboration with a staff of 20+ who manage not only the main operations of the College but also the special projects that operate as extensions, ACLM is positioned for exponential growth and impact.

Significant milestones since ACLM’s 2004 inception:

• Following Founding President John Kelly, MD, MPH as ACLM’s second president was Marc Braman, MD, MPH, who transitioned to the role of ACLM’s first executive director from 2009 through 2012.

• Wayne Dysinger, MD, MPH became the organization’s third president, during which time the seminal article, “Physician Competencies for Prescribing Lifestyle Medicine,” was published in JAMA⁹ in 2010, co-authored by Mark Johnson, MD, MPH, and Liana Lianov, MD, MPH.

• The American Journal of Lifestyle Medicine (AJLM) became a benefit of ACLM membership starting in 2011.

• Fellowship in the College was established in 2012.

• ACLM’s Standards were first published in 2012, the result of a Blue Ribbon panel.

• ACLM’s Professionals in Training was founded during Liana Lianov’s presidency, with Lifestyle Medicine Interest Groups (LMIGs) emerging on campuses across the country and internationally.

• Wayne Dysinger, then ACLM’s immediate past-president, recruited Susan Benigas as ACLM’s executive director; March 15, 2014, marked day one of a role she has now held for nearly 6 years.

• In 2016, the Lifestyle Medicine Corporate Roundtable (CRT) was established.

• The Lifetime Achievement and Trailblazer Awards were unveiled in 2015, with Drs Dean Ornish and John Kelly as the inaugural recipients.

• The Donald A. Pegg Student Leadership Award was established in 2016 by Beth Frates, MD, in honor of her late father.

• The True Health Initiative was birthed in 2015, a project of David Katz’ presidency.

• The Lifestyle Medicine Story Project began in 2016.

• To support the emerging network of lifestyle medicine medical professional associations around the globe, the Lifestyle Medicine Global Alliance (LMGA) was established in the fall of 2016.

• The American Board of Lifestyle Medicine (ABLM) was founded in 2016, hosting its inaugural exam in the fall of 2017: In the United States alone, nearly 1000 MD/DO physicians have received board certification, with well over 250 PhD/master’s clinicians and bachelor-level nurses receiving certification in lifestyle medicine through ACLM.

• The International Board of Lifestyle Medicine (IBLM), starting in 2018, now hosts lifestyle medicine certification exams around the world.

• The Lifestyle Medicine Core Competencies Program (LMCC) online course debuted in 2016, a partnership of ACLM and ACPM, made possible through seed funding from Cummins Inc, orchestrated by current ACLM President Dexter Shurney, at that time Cummins’ chief medical director.

• Drs John Kelly and Jeni Shull co-authored the Foundations of Lifestyle Medicine Board Review Course, which went live on ACLM’s learning management system in 2017, complete with a comprehensive 370-page manual.

• In early 2017, ACLM’s redetermination from 501(c)6 to 501(c)3 nonprofit status was approved by the IRS, enabling ACLM to accept tax-deductible donations in support of its mission.

• ACLM and Blue Shield of California announced a major partnership in 2017 focused on LM training for BSCA’s provider network.

• The Liana Lianov Fund for Happiness Medicine was established in 2017, resulting in the inaugural Summit on Happiness Medicine in Healthcare in April 2018, produced in partnership with University of Texas Dell Medical School.

• ACLM’s Monthly Webinar Series began in 2017.

• Through generous support of the Lifestyle Medicine Institute, the Lifestyle Medicine Economic Research Consortium (LMERC) was established in the fall of 2017.

• Downloaded more than 2000 times by educators in more than 80 countries, the Lifestyle Medicine Course Syllabus, authored by Beth Frates, MD, debuted in 2017.

• Through Greenbaum Foundation support, the Lifestyle Medicine Speakers Bureau was launched in 2018 to actively promote expert lifestyle medicine speakers to hospital grand rounds, medical schools and other forums.

• ACLM’s partnership with Wellcoaches, a CRT founding member, resulted in the Lifestyle Medicine for Coaches online course that debuted in 2018.

• Made possible by Ardmore Institute of Health grant funding, the Lifestyle Medicine Residency Curriculum launched its first pilot sites in 2018, with full roll-out set for 2020.

• During George Guthrie’s presidency, ACLM’s Member Interest Groups were heavily expanded, with 20 groups now joining a line-up of active committees and task forces.

• Accepting Dr Guthrie’s invitation to develop a new methodology and system for evaluating lifestyle medicine-related evidence, immediate past-president David Katz agreed to chair the task force that conducted a systematic review resulting in a white paper: Hierarchies of Evidence Applied to Lifestyle Medicine (HEaLM): Introduction of a Strength-of-Evidence Approach Based on a Methodological Systematic Review, published in 2019 the BMC Medical Research Methodology journal.

• In accepting the gavel as ACLM’s president in the fall of 2018, Dexter Shurney announced his “P” priorities of policy, payment, and partnerships, with ACLM’s advocacy efforts on Capitol Hill commencing in 2019.

• 2019 marked the launch of ACLM’s Taste of Lifestyle Medicine micro grants, available to medical and healthcare-related students and faculty.

• The inaugural Lifestyle Medicine Week debuted in 2019.

• Recognizing excellence in epidemiological research, Finnish physician, Professor Pekka Puska, MD, PhD, received the inaugural 2019 Ancel Keys Award.

• As a resource for those responsible for worksite well-being, the The Case for Lifestyle Medicine in the Workplace was published in 2019.

• The LM Reimbursement Roadmap was created as a valuable benefit to ACLM members.

• Building on the LM Course Syllabus, a comprehensive LM curriculum, Lifestyle Medicine 101, and companion teaching guide, debuted in 2019.

• 2019 marked the launch of the Lifestyle Medicine Provider Network (LMPN).

• The application process for ACLM’s LM Programs Certification went live late last year.

• Anticipated for early this year is the rollout of the new Reversing Type 2 Diabetes and Insulin Resistance with LM online course on ACLM’s learning management system.

ACLM has produced its own conference each year since 2011. Host cities have included Portland, OR; Denver, CO (2012); Washington, DC (2013); San Diego, CA (2014); Nashville, TN (2015); Naples, FL (2016); Tucson, AZ (2017); Indianapolis, IN (2018); Orlando, FL (2019); with November 1-4 already set for Carlsbad, CA, in 2020. Attendance has grown at a rapid rate—from 50 in 2011, to more than 1500 in 2019. This is testament to the rising tide of interest in the field.

With 80% or more of all health care dollars tied to the treatment of conditions rooted in poor lifestyle choices, the time is now for Lifestyle Medicine to become the foundation of a transformed and sustainable system of health care delivery. Identifying and eradicating the root cause of a disease as a first treatment option is vital. Patients have a right to know that a lifestyle medicine option exists, as opposed to accepting as inevitable that their only option is to become chronically ill and dependent on prescription medication to manage disease for a lifetime—an approach that is too often a disservice to both patient and provider.

We pause to reflect on the vision, perseverance, passion, and tenacity of those who have championed the field that many now consider to be the fastest growing in medicine.

Learn more at www.LifestyleMedicine.org. For information about the Lifestyle Medicine Global Alliance, visit www.LifestyleMedicineGlobal.org. Details about the Lifestyle Medicine Economic Research Consortium can be found at www.LMEconomicResearch.org. For information about ACLM’s annual conference, visit www.LMConference.org. Lifestyle Medicine expert speakers can be located through www.LMSpeakers.org.

Mission and Vision, Then and Now

ACLM’s original mission and vision statements were the following:

• Vision: The American College of Lifestyle Medicine provides leadership and assistance, facilitating lifestyle medicine clinicians’ pursuits of continuing medical education, practice knowledge, leadership skills, and research information needed to provide quality patient care and best counsel patients with respect to lifestyle-related diseases.

• Mission: The American College of Lifestyle Medicine serves its members by advancing the field of lifestyle medicine, promoting excellence in clinical practice and advocating on behalf of medical and public policy issues related to the practice and promotion of lifestyle medicine.

During a February 2018 meeting held in St. Louis, MO, ACLM staff and its Board of Directors developed a strategic plan and revised mission and vision statements:

• Vision: A world wherein Lifestyle Medicine is the foundation of a transformed, sustainable system of healthcare.

• Mission: Advancing evidenced-based Lifestyle Medicine as a value-based specialty that transforms, redefines and sustains health and healthcare by treating, reversing and preventing non-communicable, chronic disease.