November 25, 2025
1 min watch
Key takeaways:
Lifestyle changes have been shown to prevent and reverse chronic diseases.
The practice of lifestyle medicine is gaining traction in the U.S.
DALLAS — Physicians attending the Lifestyle Medicine Conference waited patiently in a long line for Dean Ornish, MD, to sign a copy of his latest book.
Ornish was among the first to show through his research dating back to the 1970s that healthy lifestyle changes could not just prevent but even reverse chronic illness. His eponymous 9-week lifestyle program has demonstrated efficacy in randomized trials and is covered through Medicare. He has worked for decades to educate physicians and patients alike on the benefits of the practice of lifestyle medicine.
That work is gaining momentum: CMS has been warming to the idea of covering and reimbursing physicians who prescribe lifestyle interventions, and the number of members of the American College of Lifestyle Medicine (ACLM) is soon expected to exceed 20,000, according to the college’s president.
We caught up with Ornish after his book signing and asked about his perspective on the evolution of the field and his role in it. His answers have been edited for brevity and clarity.
Healio: Let’s talk about legacy. You’ve been referred to as the “founding father” of modern lifestyle medicine. How do you view your role in making lifestyle medicine mainstream?
Ornish: Well, thank you. I think lifestyle medicine is the most exciting and coolest field in medicine today — certainly the fastest growing. My contribution initially was to the science that so much of lifestyle medicine is based on. Part of the value of science is to help people sort out what’s true, what isn’t, for whom and under what circumstances, and nowhere is there as much confusion about what’s true as in diet and lifestyle medicine. Studies are hard to do. They’re hard to get funded, because pretty much all the studies that I’ve directed were thought to be impossible at the time.
In research that I directed, my colleagues and I showed — for the first time — that lifestyle changes could often reverse the progression of coronary heart disease. At the time, it was thought that nothing could reverse coronary heart disease. We also showed that these same lifestyle changes could often reverse the progression of type 2 diabetes, hypertension, and obesity.
In collaboration with the chairs of urology at UCSF and Memorial Sloan-Kettering Cancer center, we published the first randomized controlled trial showing that these lifestyle changes could often slow, stop and even reverse the progression of early-stage prostate cancer. We found that these lifestyle changes beneficially modified gene expression in over 500 genes in just 3 months in collaboration with Craig Venter. And we published the first research showing that any intervention — these same lifestyle changes — could often lengthen telomeres, which The Lancet referred to as “reversing aging on a cellular level.” This research was done in collaboration with Nobel laureate Elizabeth Blackburn, who received the ACLM Lifetime Achievement Award (at this year’s conference). Most recently, my colleagues and I published the first randomized controlled trial showing that any intervention — again, these same lifestyle changes — could often slow, stop and even reverse the progression of dementia due to early-stage Alzheimer’s disease.
These lifestyle changes include a whole-foods, plant-based diet low in fat, sugar and processed foods; moderate exercise; meditation and other stress-management techniques; and social support. In brief: eat well, move more, stress less, love more.
These studies are hard to get funded because it’s a catch-22: You’re trying to get funding from the NIH or other conventional sources, and they think it’s impossible. They say, “Why should we waste our money? Everybody knows it can’t be done.” And without the funding, you can’t find out if it might be accomplished. So, we had to raise the money as we went along, which is an insane way to do research, because you never know if you’re able to raise enough money to keep it going. Somehow, we did, and we were able to publish in most of the leading peer-reviewed medical journals. And I think that scientific basis is what has given lifestyle medicine much of its credibility.
If I’m the father of lifestyle medicine, then Susan Benigas is the mother of lifestyle medicine. She was able, through sheer force of will and brilliance, to create the American College of Lifestyle Medicine, with board certification, and is now partnering with the American Medical Association, and all the brilliant things that she’s done to create credibility in the field.
I was able to work with CMS for Medicare to cover my lifestyle medicine program for reversing heart disease. That took 16 years, but it was worth it, because if Medicare covers it, then many of the other insurance companies cover it, and if you change reimbursement, you change medical practice and, ultimately, medical education. And then there’s giving talks like this and writing books for the general public and so on, to make this more and more accessible and mainstream. Having seen what a powerful difference lifestyle medicine can make, I didn’t want this to be just concierge medicine — not that there’s anything wrong with that — but I wanted it to be available to everyone. It doesn’t cost anything to walk, meditate, love more and eat a third-world diet.
Healio: If the clinical integration of lifestyle medicine in U.S. practices was placed on a timeline, where are we? The beginning? The middle? The beginning of the end?
Ornish: I hadn’t thought about it like that. I guess I would say that it’s just now hitting its stride. It’s become much more mainstream.
It’s really interesting to see some of the people who I did my medical residency with at Mass General Hospital and my fellowship at Harvard Medical School who were in the more conventional tracks, who are now saying, “Gosh, you know, I used to think (lifestyle medicine) was so weird, but you know, it’s not.” We’re trained to think that it has to be something high-tech and expensive to be powerful. And I think our unique contribution has been using these very high-tech, expensive, state-of-the-art scientific measures to prove how powerful these very-low tech and low-cost interventions can be.
These same lifestyle changes can affect so many of the most common and costly chronic diseases because they share so many of the same underlying biological mechanisms. Now, we have a much more mechanistic understanding of why these lifestyle changes are so powerful and how dynamic they are. I described this unifying theory in my book, Undo It!
Dean Ornish, MD, the “founding father” of modern lifestyle medicine, discusses the evolution of the field.
Healio: I think about the super-busy front-line clinician, a primary care doctor, for example, or a physician assistant. They’re rushing from patient to patient, always moving, always busy. They may know some lifestyle medicine principles, and they may even apply those principles in practice to an extent. But they haven’t fully integrated lifestyle medicine into their practice. They want to do more, because they know that prevention is better and easier, and it makes more sense than reactive treatment of chronic diseases, but their bandwidth is significantly limited, and they may have concerns about reimbursement. What is your advice for them?
Ornish: Well, my initial plan was to do good science, and I thought if we just did good science, that’ll change medical practice. And I realized that was naive, in part because we don’t learn much about nutrition, much less lifestyle medicine. I co-authored a paper for the American College of Cardiology nutrition working group that showed that the average doctor gets 4 hours a year of nutrition training in medical school and gets none in 4 years of fellowship. We’re trained to use drugs and surgery. We get reimbursed to use drugs and surgery. Not surprisingly, that’s what we do. I realized that we needed to change reimbursement, not just do good science.
So, then I thought, if we could just work with CMS for Medicare to cover it, that would change everything. I had no idea that it would take 16 years, but ultimately, it was worth it, because, as I said, if you change reimbursement, you change medical practice and even medical education, and so then the primary care doctor that you’re talking about can get support for this. So that’s why I’ve been broadening my work to not only include doing good science but also trying to find ways to make this sustainable. And also by showing how much money it saves as we move more into value-based medical care.
Healio: You’re here at the Lifestyle Medicine conference signing your book, Undo It! What do you want readers to take away from it?
Ornish: Undo It! is a book about reversing chronic diseases. A book I wrote before that, called The Spectrum, was about preventing it. It doesn’t take so much change to prevent disease as it does to reverse it. But there’s also a synergy that comes when you make a lot of lifestyle changes at the same time… you feel so much better so quickly that it reframes the reason for making lifestyle changes from fear of dying to joy of living.
Fear is not really a sustainable motivator. But when you make big changes, you feel so much better so quickly because these biological mechanisms we’ve been talking about are so dynamic that it reframes the reason for changing lifestyle. Somebody who has bad angina and can’t walk across the street without getting chest pain, or make love with their spouse, or play with their kids, or go back to work without getting chest pain — usually within 2 or 3 weeks they’re angina free. They go, “Oh, OK, this isn’t just about living longer. It’s about living better. It’s not just about fear of dying. It’s about joy of living.”
Healio: Let’s focus on that for a moment. Advances in care can improve longevity, adding years to patients’ lives. But those extra years we’re hoping to give patients… what are they without meaning and purpose? How does lifestyle medicine address that?
Ornish: That’s an important part of my work — it’s the “love more” part of my program. People say, “I understand why it’s beneficial to eat well, move more, and stress less. What is this ‘love more’ part?” It’s about finding intimacy, community and meaning. I almost committed suicide when I was 19 because I could take all the meaning out of my life… I wrote about that in a couple of my earlier books, particularly the Love and Survival book. But then I later learned that I could imbue my life with meaning by doing acts of service, which is why I do what I do. Paradoxically, the most selfish thing I can do is to help other people.
People who are lonely and depressed and isolated and who don’t have much meaning in their lives are three to 10 times more likely to get sick and die prematurely when compared with those who have a sense of love and connection with community. There’s been a real breakdown in the social networks that used to give people that over the last 50 years, because many people don’t have an extended family, they don’t have a neighborhood where they grew up with two or three generations people. They don’t have a job that they’ve been at for 10 years where their co-workers are still there. They don’t have a church or synagogue or mosque or a club or anything that they go to regularly. Social (media) networks are not the same, because everyone looks like they have this perfect life but you.
But when you grow up in a neighborhood with two or three generations of people, it’s authentic. They know you. There’s just something really primal about that: “I see you — all of you — not just your biographical sketch or your Facebook profile, but I see all of you, and I’m still here for you.” And a lot of people don’t have that. And it’s worse for kids now.
We talk about lifestyle medicine, about treating the causes (of disease), but the cause isn’t just the behavior. It’s really these deeper issues that ultimately manifest in these behaviors. It’s not enough to focus on the behavior, but what’s underlying those behaviors. And that’s where a sense of community can be so powerful. And Vivek Murthy, the former Surgeon General, who is a good friend, to his great credit, spent a lot of his bully pulpit on educating people about the importance of social connections.
For more information:
Dean Ornish, MD, can be reached at [email protected].
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