A Milestone: 2024 Marks the 20th Anniversary of the Founding of the American College of Lifestyle Medicine

More than a medical professional association, the American College of Lifestyle Medicine (ACLM) represents a galvanized force for change, a magnet for purpose-, passion-driven medical professionals who want to help lead and be part of the change they know is desperately needed to transform health and redefine healthcare. Since its inception in 2004, ACLM has been a transformation catalyst—a disruptor of the status quo disease and disability care system.

No other medical professional association has advocated that the field it represents become healthcare’s foundation; yet, this is express in ACLM’s vision statement: A nation and world wherein lifestyle medicine is the foundation of health and all healthcare.

While it’s imperative that lifestyle medicine be integrated as the first treatment approach into primary care, ACLM’s leaders are a microcosm of how lifestyle medicine’s focus on treating the root cause of disease is needed in ALL fields of medicine. The composition of ACLM’s current and immediate-past Boards of Directors reflects this: 2 cardiologists, an endocrinologist, an oncologist, an OBGyn, a pediatrician, a physiatrist, a psychiatrist, internal medicine primary care physicians, family medicine docs, a physician associate, a nurse practitioner, a PhD in behavioral health, and an RD with a PhD in nutrition. Moreover, ACLM’s 11,000 members are representative of the interdisciplinary clinical practice team that enables lifestyle medicine’s scalability, supporting the behavior change that’s at the heart of the field.

It was the foresighted leaders 20 years ago who saw the need, cast a vision, and boldly took action to infuse health back into healthcare. Passion and dedication on the part of so many have been required over the past two decades to catapult ACLM and the field of lifestyle medicine to where they are today, including induction in June 2024 into the American Medical Association (AMA) House of Delegates.

We asked Founding President John Kelly, MD, FACLM, DipABLM, Intensivist, recognized in 2015 as ACLM’s inaugural Trailblazer Award recipient, to reflect on the impetus for establishing ACLM:

“The driving force in my professional life, after completing medical school and much of residency in preventive medicine with a degree in epidemiology, was the blinding flash of the obvious that our medical system was doing things backwards in many ways and needed a medical specialty focused on treating causes instead of symptoms—a specialty that could reverse disease with lifestyle changes. The fact that intensive lifestyle change could reverse disease had been demonstrated in multiple rigorous trials by 2003.

Working with a small group of medical professionals as advisors, I worked to establish a new medical specialty dedicated to using lifestyle change to reverse disease—the American College of Lifestyle Medicine. I was surprised and very thankful to receive an AMA Foundation Excellence in Medicine Award as a Young Physician for my leadership in establishing ACLM because it gave credibility to the organization.

After much dialog back and forth, the ‘founding group’ came to the consensus that what was needed was a new specialty and not just an interest group for all specialties. The knowledge base and practice setting for intensive lifestyle medicine was unlike any existing specialty; there was an unfilled niche. We called it Lifestyle Medicine. Others had coined the term, but we adopted it and, I believe, made it ‘the brand.’ One of our goals was to coalesce the rising field of lifestyle medicine around evidence-based methods and research evidence.

Because many of us in the founding group were affiliated with Loma Linda University, a faith-based institution, we knew it was vital to ensure that ACLM was established as a secular professional specialty—a non-sectarian, evidence-based, professional, specialty society. Another goal was to embrace divergent methods that were evidence-based, and exclude dogmatic and unscientific methods. Our founding group agreed we would follow the best evidence, no matter where it should lead. Twenty years later, this remains ACLM’s staunch commitment.”

Dr Kelly expresses his gratitude for what ultimately became the 100 founding members of the College and its founding Advisory Board members, which included his friends and colleagues Drs. Walter Willett, David Jenkins, James Prochaska, Hans Diehl, John McDougall, Brenda Rea, Wayne Dysinger, T. Colin Campbell, Marc Braman, Joel Fuhrman, Caldwell Esselstyn, Sylvia Cramer, George Guthrie, Michael Greger, John Westerdahl, Ron Stout and many others who were early champions of the field.

A number of these individuals and other lifestyle medicine pioneers have been recognized as ACLM award recipients. The Lifetime Achievement and Trailblazer Awards debuted in 2015, with ACLM unveiling other awards over the years, including the President’s Award, Ancel Keys Award and the Donald A. Pegg Student Leadership Award. Special Recognition Awards were established in 2022.

Milestone anniversaries are important times to revisit history: It was the unsustainable chronic disease trends and their associated costs that were a driving force in ACLM’s birth—with the urgency that the founders felt then being even more magnified today.

ACLM’s bold, courageous, visionary presidents deserve high praise for their leadership and dedication. They and their board colleagues have been the driving force throughout the past two decades:

John Kelly, MD, MPH, FACLM, DipABLM, Intensivist (2004-2008)

Marc Braman, MD, MPH, FACLM, DipABLM (2008-2009)

Wayne Dysinger, MD, MPH, FACLM, DipABLM, Intensivist (2009-2012)

Liana Lianov, MD, MPH, FACLM, DipABLM (2012-2014)

David Katz, MD, MPH, FACLM (2014-2016)

George Guthrie, MD, MPH, FACLM, DipABLM (2016-2018)

Dexter Shurney, MD, MBA, MPH, FACLM, DipABLM (2018-2020)

Cate Collings, MD, FACLM, DipABLM (2020-2022)

Beth Frates, MD, FACLM, DipABLM (2022-present)

For many years, ACLM remained a volunteer, physician-led organization, with founding member Dr Marc Braman stepping in from 2009-2012 as ACLM’s first executive director. Susan Benigas accepted the reins as executive director 10 years ago, in March 2014, with this year marking her 10-year ACLM anniversary. During her tenure, the College has grown from one part-time event coordinator to a staff of 40 spread across 22 states, and a membership of 380 in the spring of 2014 to what is now 11,000 strong and growing.

In 2019, in celebration of ACLM’s 15 ^th anniversary, the article, American College of Lifestyle Medicine: Vision, Tenacity, Transformation, appeared in AJLM chronicling the College’s history and seminal accomplishments, including the 2010 publication in JAMA of Physician Competencies for Prescribing Lifestyle Medicine and the establishment in 2016 of the American Board of Lifestyle Medicine (ABLM) and, in 2017, the International Board of Lifestyle Medicine (IBLM).

Since the inaugural ABLM and IBLM exams in 2017, 6688 physicians and other health professionals, representing 75 countries, have earned certification in lifestyle medicine. This number includes 3075 physicians and 1263 other health professionals in the United States—with U.S.- and Canadian-certified clinicians featured in ACLM’s LMPros.org—a patient-facing, searchable directory.

It’s these nearly 7000 physicians and medical professionals—and others who will be certified in lifestyle medicine this year—who, starting in 2025, will have the exclusive opportunity to vie for certification as a Blue Zones Physician or Blue Zones Healthcare Professional, an opportunity created through a partnership announced earlier this year between ACLM and Blue Zones, LLC. Blue Zones recognized the vital need to marry lifestyle IN medicine with lifestyle AS medicine, with the clinicians already certified in lifestyle medicine—those having demonstrated clinical proficiency—being uniquely equipped to support Blue Zones’ community health transformation goal: to make the healthy choice the easy choice.

The accomplishments of ACLM’s first 15 years were impressive; yet, the growth in size, reach and scope has accelerated over these past five years:

• ACLM’s annual conference has seen record-breaking attendance each of the past 10+ years: With a sell-out attendance of 2000 in person and more than 1000 virtual in 2023, the LM2024 event, set for October 27-30 at the Rosen Shingle Creek Resort and Spa in Orlando, FL, will cap at 2500 in person attendees, recognizing Lore Health as the featured presenting sponsor.

• ACLM’s Corporate Roundtable has evolved into ACLM’s showcased Platinum Partners and the Institutional Innovators Council.

• Membership has increased from just under 4000 five years ago to what is now 11,000, nearly 60% of whom are physicians, with expansion of ACLM member benefits and engagement opportunities.

• ACLM Member Interest Groups (MIGs) have grown from the first three, established in 2015, to what are now 30, with some having upwards of 1000 members.

• ACLM’s Health Equity Achieved through Lifestyle Medicine (HEAL) Initiative was established in 2020 to address lifestyle-related chronic disease health disparities.

• Collaboration with other members of the Lifestyle Medicine Global Alliance (LMGA), facilitated by IBLM, on the Lifestyle Medicine Core Competencies: 2022 Update.

ACLM’s Student/Trainees are a thriving segment of ACLM’s membership, representing medicine’s future leaders:

• The first Lifestyle Medicine Interest Group (LMIG), established at Harvard Medical School by current ACLM President Beth Frates, was the seed planted that has now grown to over 140 LMIGs on campuses across the U.S.; these include 90 medical schools through which students are educated about the six pillars of lifestyle medicine.

Clinical practice guidelines for chronic disease treatment and prevention frequently list lifestyle intervention as part of the standard of care. Even so, the vast majority of physicians and healthcare professionals have not received this training as part of their formal medical education. Filling the gaping void of lifestyle medicine in medical education, across the medical education continuum, is one of ACLM’s highest priorities. In 2022, ACLM became an AMA Ed Hub content provider. And, throughout the course of the past five years, ACLM’s CME/CE offering rollouts have included:

• 3^rd and 4^th editions of the Foundations of Lifestyle Medicine Board Review Course

• Lifestyle Medicine Question Bank

• Unveiling of the Remission of Type 2 Diabetes and Reversal of Insulin Resistance Certificate course and Type 2 Diabetes Remission Certificate

• Debut of the Physician and Health Professional Well-being course (PWB)

• Re-launch, in partnership with ACPM, of the Lifestyle Medicine Core Competencies Program (LMCC)

• The multi-module Food as Medicine (FAM) for medical professionals course, including:

o Nutrition for Prevention and Longevity

o Nutrition for Treatment and Risk Reduction

o Calorie Density: A Simple Powerful Approach

o Nutrition: Preconception, Pregnancy and Postpartum

o …with additional modules in development

• In coordination with the American Journal of Lifestyle Medicine (AJLM), launched CME/CE articles, with six selected each year

• Expansion of solely offering AMA PRA Category 1 credits^TM for physicians to offering joint accreditation through Rush University to provide AMA PRA Category 1 Credit(s)™, CNE, CPE, CPEU, ABIM MOC, ABLM MOC, AAFP Prescribed Credits, NBC-HWC, and continuing education credits for psychologists, social workers, physical therapists, and occupational therapists

ACLM made a major stride in advancing lifestyle medicine continuing medical education (CME) when showcased by the White House in late 2022 for its $24.1 M commitment in support of the White House Conference on Hunger, Nutrition and Health. This pledge represented the equivalent of 100,000 complimentary registrations for ACLM’s $220, 5.5-hour CME/CE-accredited Lifestyle Medicine and Food as Medicine Essentials online course. Coupled with this was ACLM and ABLM’s commitment to provide a 50% scholarship for lifestyle medicine training and the opportunity for certification for one primary care provider (PCP) in each of our nation’s ∼1400 federally qualified health centers (FQHC’s) as means of educating and equipping clinicians on the front lines of delivering care to our most under-served populations.

To date, more than 40,000 clinicians have registered for the Essentials course, with the 5.5 CME hours comprised of ACLM’s one-hour Introduction to Lifestyle Medicine, coupled with the first two modules of the FAM course. In 2023, ACLM increased its initial commitment to 200,000 complimentary course registrations and extended the deadline to September 2025.

With the goal of ACLM and ABLM’s 50% FQHC PCP scholarships becoming full ride, in late-2023, ACLM unveiled its National Training Initiative (NTI), announcing ACE as its inaugural NTI Impact Partner, with Impact Partners’ tax-deductible donations to ACLM serving to match ACLM and ABLM’s pledge.

Other ACLM scholarships that have launched over the past five years include:

• Health Equity Achieved through Lifestyle Medicine (HEAL) Scholarship Program, providing training and the opportunity for certification in the field to underrepresented in medicine (UIM) clinicians

• Dr Stephen Turner Residency Director and Faculty Scholarship, available to residency directors, associate directors, and faculty interested in adopting the Lifestyle Medicine Residency Curriculum

In addition to a focus on CME, ACLM’s graduate medical education (GME), undergraduate medical education (UME) and pre-professional curricula offerings are empowering educators across the country and internationally to integrate lifestyle medicine into their training.

• The Lifestyle Medicine Residency Curriculum (LMRC) is now licensed into more than 300 residency programs across the nation, over half of which are family medicine residencies.

• ACLM President Beth Frates, MD, FACLM, DipABLM, prior to her election as president, while serving on the ACLM Board of Directors, generously gifted to ACLM the LM101 Curriculum and Syllabus she developed for the highly sought-after course she has taught for many years at the Harvard’s Extension School. The complimentary curriculum is serving to ignite transformation in countless settings across the country and around the world.

• Former ACLM Board Member Michelle Hauser, MD, MS, MPA, FACP, FACLM, DipABLM, Chef, and Stanford associate professor, bequeathed her comprehensive Culinary Medicine Curriculum and companion syllabus to ACLM, now having been provided for complimentary download from ACLM’s website over 10,000 times.

• The Lifestyle Medicine UME Question Bank was launched in cooperation with the National Board of Medical Examiners and the American Board of Lifestyle Medicine to support medical school faculty with lifestyle medicine related questions to use in Categorical Assessment Tests.

• ACLM entered into a strategic partnership with the University of South Carolina, Greenville to support the LMEd open access to a collection of evidence-based curricular resources offered through the University of South Carolina School of Medicine Greenville to train future clinicians in prevention and treatment of lifestyle-related diseases.

ACLM’s Practice Advancement Department, launched in January 2024, began in 2022 as a focus area supported by ACLM’s Clinical Practice and Quality Committee (CPQC). Accomplishments include:

• Hosting the first Lifestyle Medicine Reimbursement Summit

• Submission of a response to a request for information on the Medicare Physician Fee Schedule of which the Centers for Medicare and Medicaid Services (CMS) signaled their consideration

• Review by ACLM leaders of the National Quality Forum’s (NQF) more than 1000 endorsed measures to identify those that incent and reward lifestyle medicine intervention; the result: few if any

• CPQC leadership meetings with representatives of CMS, CMMI, National Committee for Quality Assurance (NCQA), NQF, and the American Academy of Family Practitioners (AAFP) government relations team to advocate for lifestyle medicine payment and quality measure alignment

• In collaboration with ACLM’s Member Interest Groups, facilitated the development of a wide array of clinical practice tools and patient-facing educational resources, all available through ACLM Connect, ACLM’s member engagement platform. Select resources include:

o Revised LM Reimbursement Road Map

o Lifestyle Medicine Shared Medical Appointment (LMSMA) Toolkit

o LM for Cancer: Risk Reduction and Survivor Toolkit

o Women’s Health During the Reproductive Years Toolkit

o Beyond the Numbers: Pediatric Obesity Toolkit

o Independent LM Primary Care Practice Toolkit

o FQHC/CHC Toolkit

o Validated LM assessment tools

o Lifestyle medicine electronic medical record template with standard LM data elements—being built and published within Epic

o A wide array of patient-facing educational resources

ACLM’s Health Systems Council (HSC) was established in 2022 as a collaborative learning community that has quickly grown to 108 integrated health systems across the U.S., with a keen focus to build a repository of lifestyle medicine implementation models including video, PDF and research abstract resources showcasing successful integration across a variety of settings and practices. These include an array of specialized lifestyle medicine implementation briefs, toolkits, and practice resources spanning integration within various specialties, payment, and reimbursement modalities.

While research was identified in 2004 as an ACLM priority, the necessary resources weren’t in place until the Lifestyle Medicine Economic Research Consortium, launched in late-2017, evolved to become ACLM’s Research Department, established in 2020 along with ACLM’s Research Committee. The department will now be showcased as the Lifestyle Medicine Research Institute, recognizing Blue Zones as the exclusive founding partner.

ACLM Research Department accomplishments include:

• Publication of four expert consensus statements

• Development of ACLM’s first clinical practice guideline, “Lifestyle Interventions for Treatment of Type 2 Diabetes and Prediabetes,” with targeted completion by year-end 2024

• Editing and sponsorship of a special issue in Frontiers in Nutrition on food as medicine

• Three-year growth of Lifestyle Medicine Conference Abstracts from <30 to >180 submissions

• Unveiling in 2020 of ACLM’s Lifestyle Medicine Program Certification, a vetting and recognition of structured LM programs that have demonstrated significant outcomes presented in peer-reviewed publications; a total of seven programs have met the criteria for ACLM Program Certification as either a treatment or education program

• Novel, original research projects on topics that include implementation of lifestyle medicine in health systems, global dietary guidelines, reduced burnout among lifestyle medicine practitioners, diabetes remission, medication deprescribing, and others

A full list of organization-sponsored publications are featured on ACLM’s website, including:

• ACLM’s position statement on type 2 diabetes remission, introducing the novel idea that remission should “be held as the primary clinical goal and that lifestyle medicine interventions that produce changes leading to remission should therefore become the standard of care”

• ACLM’s expert consensus statement: Dietary Interventions to Treat Type 2 Diabetes in Adults with a Goal of Remission; endorsed by the American Association of Clinical Endocrinology, supported by the Academy of Nutrition and Dietetics, and co-sponsored by the Endocrine Society

• Qualitative case series, with the methods paper recently published, on the implementation of lifestyle medicine in health systems, covering the impact of leadership, workplace culture, and workforce training on the growth and implementation of LM across eight diverse health systems

• Positive benefits for employee well-being, as our analysis of a cross-sectional survey of 482 respondents interested in LM found that those who practiced more LM as compared to less had a 43% decrease in the odds of experiencing burnout: Top-reported reasons among this sample for the positive benefit of LM included professional satisfaction, sense of accomplishment, and meaningfulness (44%); improved patient outcomes and satisfaction (26%) and enjoyment of teaching/coaching or engaging in relationships (22%)

As ACLM continues to deepen research efforts, we will address more directly the five components of the Quintuple Aim—population health, patient experience, healthcare costs, clinician well-being, and health equity.

The past five years included a global pandemic: COVID-19 shone a bright light on the urgent need to address the underlying conditions that exacerbated the virus’ most harmful effects and the disproportionate impact on our underserved communities. These underlying conditions, by and large, were lifestyle-related chronic conditions, serving to heighten awareness about and interest in ACLM and the field of lifestyle medicine, which includes prescribing food as medicine.

Food “in, as, is” medicine is now in vogue, with ACLM having been advocating for intensive therapeutic lifestyle change (ITLC), including using food as medicine, since its inception. While much of the food is medicine (FIM) discussion is now focused on food insecurity and the need to address its with more healthful calories, rather than just any calories, lifestyle medicine’s food as medicine (FAM) Rx is highly prescriptive, with a focus on ITLC intervention that evidence shows as efficacious in treating already existing disease, with the goal of health restoration. All pillars of lifestyle medicine—a whole food, plant-predominant eating pattern, regular physical activity, restorative sleep, stress management, positive social connection, and the avoidance of risky substances—work synergistically to support sustainable behavior change.

• ACLM launched FoodAsMed.org as a curated repository of FAM CME and other educational and research-related resources. ACLM’s unique FIM role is to educate and equip physicians and medical professionals about using FAM for disease treatment—as part of LM’s evidence-based six pillars.

Amplified acknowledgment of the importance of lifestyle medicine’s root cause treatment approach—resulting from COVID-19, combined with ACLM’s advocacy efforts on Capitol Hill—has led to a growing number of significant media placements, including the featured March 2020 Newsweek article titled “For Extra Protection Against COVID’s Worst Effects, Look to Lifestyle Medicine.” Other high-visibility outlets ACLM has appeared in are Wall Street Journal, New York Tines, Becker’s Hospital Review, Consumer Affairs, Medscape, and Healio. Made possible by the generous support of the Ardmore Institute of Health, ACLM was also pleased to publish in 2022 a 22-article supplement in the Journal of Family Practice: A Family Physician’s Introduction to Lifestyle Medicine.

ACLM had begun bipartisan advocacy efforts in support of its members in 2019 by introducing the College and the field it represents to key Members of Congress and leaders in regulatory agencies such as the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS). COVID-19 served as a wake-up call: Receptivity to our message began to resonate unlike ever before, as the vulnerability of our population health had been laid bare—the result of epidemic levels of chronic disease.

Since the 2022 White House Conference on Hunger, Nutrition and Health, ACLM has had “a seat at the table” at major convenings and events on food is medicine and medical education, and we have introduced Congressional members and staff to our members’ work. Our priority areas of focus continue to be: lifestyle medicine in medical education; reimbursement and quality measures; health equity as it relates to lifestyle-related chronic disease health disparities; and military health for recruits and active-duty personnel.

ACLM represents the future of a transformed and sustainable system of healthcare delivery. Achieving the Quintuple Aim is ONLY possible with a lifestyle medicine-first approach. Lifestyle medicine delivers superior patient outcomes and dramatically improved levels of both patient and clinician satisfaction, while reining in healthcare costs. It also directly addresses lifestyle-related chronic disease health disparities. Lifestyle medicine also addresses a sixth aim of global sustainability, with science showing the inextricable connectedness of our lifestyle behaviors on both human and planetary health.

ACLM’s Global Sustainability Committee, over the past two years, has published the following about the intersection of human and planetary heath:

• Pathak N, McKinney A. Planetary Health, Climate Change, and Lifestyle Medicine: Threats and Opportunities. Am J Lifestyle Med. 2021

• Pathak N, Pollard KJ, McKinney A. Lifestyle Medicine Interventions for Personal and Planetary Health: The Urgent Need for Action. Am J Lifestyle Med. 2022

• And, finally, a paper pending publication in the Annals of Medicine special issue: From Sustainability to Health: Role of Plant-Based Diets: Health Disparities and Climate Change in the Marshall Islands

Lifestyle medicine-trained clinicians are dedicated to “treating the cause”—striving to identify and eradicate the root cause of disease, with a goal of medication de-escalation. Lifestyle medicine clinicians get to the heart of the matter by listening to patients, using motivational interviewing, and co-creating inspiring SMART goals that empower people to reach their vision for themselves and fulfill their purpose. The clinical outcome goal of lifestyle medicine treatment is disease remission and reversal, resulting in health restoration.

There’s a call today in healthcare to deliver high-quality, patient-centered care—care that’s shifting from fee-for-service to value-based care (VBC). Optimization of VBC is only possible with a lifestyle medicine-first approach; recognizing, too, that lifestyle medicine clinical care is at the heart of whole-person health, with behavior change as the foundation.

Addressing the epidemic of chronic disease, now afflicting adults and teens alike, is one of the most urgent issues of our time. Lifestyle medicine delivers the healing and restoration our nation and world, including our planet, so desperately need. Moreover, lifestyle medicine reignites the passion for why most physicians and medical professionals went into medicine: to become true healers.

While ACLM, over the past 10 years, has developed multiple revenue streams—from CME course offerings and membership to Platinum Partners and our Innovators Council, ACLM’s mission-advance to disrupt the status quo and usher in a sustainable system of healthcare delivery is possible only through philanthropic investment on the part of many. Special thanks to the Ardmore Institute of Health for its on-going support and to those listed on ACLM’s Wall of Champions—individuals and organizations who partner with ACLM on an annual basis to bring to ALL people the hope, healing and health that lifestyle medicine enables.

Transformative impact happens when we come together as a galvanized force for change. Here’s to the 20 years of impact ACLM is celebrating in 2024—and the exponential impact to come!

“People are much happier when they have a worthwhile purpose—a purpose that helps make the world a better place. Lifestyle medicine is, at its core, about helping people make the best, evidence-based choices for living.”

• – ACLM Founding President John Kelly, MD, MPH, FACLM, DipABLM, Intensivist

In honor of ACLM’s 20^th anniversary, and the years to come….

Let’s celebrate, engage, and ignite!

Disclosure: Susan Benigas is the paid Executive Director of the American College of Medicine.