Your doctor may soon become your fitness coach.
You’ve spent the last half hour with your doctor as he poked and prodded during your annual physical. He goes over your blood work and the numbers are mostly good, but your cholesterol is a bit high. Your doc reminds you of the risks if it gets out of control.
At the end of your physical, he hands you your usual prescriptions — and one more. This one is for exercise. This scenario is playing out more and more in doctors’ offices, and there is a movement in the medical community to make assessing physical activity levels and prescribing exercise part of routine examinations.
The Exercise Is Medicine (EIM) program is one of the effort’s main drivers. EIM encourages primary care doctors and other healthcare providers to include physical activity in patient treatment plans. It’s no secret that physical activity is integral to the prevention and treatment of many diseases; the EIM philosophy is that physical activity should be regularly assessed and treated as part of a holistic approach to medical care.
The Centers for Disease Control and Prevention (CDC) recommends adults 18 to 64 years old get at least 2.5 hours of moderate intensity aerobic activity every week, or 1.25 hours of vigorous aerobic activity combined with at least 2 days of weight training. Yet, according to the CDC, fewer than half of us meet those guidelines.
With obesity, type 2 diabetes, and heart disease reaching epidemic proportions — and all having a variety of unpleasant complications — doctors and public health officials are embracing new measures to encourage people to get moving.
Urologist Neil Baum has been prescribing exercise for several years as a way to help his patients improve chronic health conditions and reduce their medications. When he sees an overweight patient he asks: “Would you like to get off of all of these medicines? Would you like to start feeling better? There’s no pill for this, you’ve got to start exercising.” Baum gives patients an exercise regimen and dietary guidelines, and gets them to make a commitment to the program. They set a weight-loss goal and schedule a follow-up appointment in one month. For those who buy in, the results have been phenomenal, Baum says.
In particular, people who are obese — those with a body mass index of 30 to 35 — need help making necessary lifestyle changes and incorporating physical activity.
“This is not something that is done by yourself. You really need to have a coach who prompts you: ‘How are you doing?’ ‘Stick with it.’ ‘It’s New Year’s. Don’t go off the wagon.’ You really need some assistance to accomplish this,” Baum says.
Healthcare providers are in a unique position to counsel patients about the benefits of physical activity and the dangers of a sedentary lifestyle. But many healthcare professionals are more focused on reactive care, instead of preventive care. To be fair, that’s also what many patients want. We want a pill to make what ails us better, not a recommendation that will keep us out of the doctor’s office in the first place.
So what can you do? First, realize it starts with you. You are your own best healthcare advocate; it’s up to you to ask for what you need.
If you’re ready to make a change and you need a program of physical activity to lose weight and manage your chronic health condition, you’ll need a doctor who will guide and support you.
Baum encourages people to find a doctor who embodies fitness.
“I really believe [doctors] have got to set the example. . . . Don’t go to a heavy doctor and have him help you lose weight.” He recommends finding a doctor who believes in nutrition, exercise, and a positive mental attitude. “Someone who understands the importance of good lifestyle.”
Once you’ve found a healthcare provider who supports your goals, ask him or her to work with you to tailor an approach to meet your individual needs. The first step is to assess your condition and determine what you need to reach your goals.
Some of your needs may be beyond what your doctor can offer, but he or she should be able to refer you to a physical therapist, fitness trainer, gym, nutritionist, perhaps even community programs, and help you establish a team of healthcare professionals who will support you.
So if your doctor hands you a prescription for exercise, embrace it! If you need support, ask for it.
Keep in mind you don’t need to wait for someone to hand you a slip of paper — you can write and fill that prescription on your own. There are many resources to help you set and achieve your fitness goals. Numerous organizations offer online programs and recommendations. Look for online meet-up groups for walking or other activities. Explore programs at your local YMCA or community center. Hire a personal trainer (or share one with a friend) at your local gym. Just get moving! It’s one of the best things you can do for your health.
February 18, 2020
Christopher Nystuen, MD, MBA