Lifestyle Medicine for the Consultation-Liaison Psychiatrist

Abstract: Lifestyle medicine (LM) is a medical specialty that uses therapeutic lifestyle interventions as a primary modality to treat chronic conditions including, but not limited to, cardiovascular diseases, type 2 diabetes, and obesity. Lifestyle medicine certified clinicians are trained to apply evidence-based, whole-person, prescriptive lifestyle change to treat and, when used intensively, often reverse such conditions. Applying the six pillars of lifestyle medicine—a whole-food, plant-predominant eating pattern, physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connections—also provides effective prevention for these conditions (Clayton 2023). More recently, there has been attention to the need to incorporate mental health into the field of LM and to attend to the bidirectional role of mental health and lifestyle. (Merlo 2022).

While most consultation-liaison (CL) psychiatrists agree that lifestyle factors play an important role in mental health, many are unprepared to address these in the clinical encounter and are unfamiliar with the growing field of lifestyle psychiatry. This course will provide a foundational review of the science, literature, and practical tools for the clinician both as primary interventions and in conjunction with psychopharmacology and/or psychotherapy. We will begin with an overview of lifestyle psychiatry and will present the evidence for lifestyle interventions in the treatment of mental illness and potential applications to CL psychiatry. We will explore the bi-directional relationship between mental health and chronic medical illness using a transdiagnostic approach through the lens of the bio-psycho-social-lifestyle model with special attention to social determinants of health. We will highlight existing models of practice and reimbursement, discuss education for trainees, as well as propose new collaborations with outpatient integrated care that could shape the future of CL psychiatry. Lastly we will emphasize the self-practice of lifestyle principles as a foundation for clinical work and physician wellness.

This symposium will engage participants through modalities of pair-share, didactic learning, break-out groups and self-directed reflection. Throughout the presentation, participants will be asked to build a LM “prescription” for a patient (or themselves) using a SMART goals handout with each of the six LM pillars to be reviewed later in break out groups.

Format:

Dr. Merlo (15 minutes) will provide an overview of lifestyle medicine and the bidirectional relationship between mental health and lifestyle

Dr. Quraishi (15 minutes) will discuss potential applications of lifestyle medicine to CL psychiatry and propose future models for practice and education

Small group breakout sessions (15 minutes) each group will review their smart goals with a panel member

Dr. Viswanathan (15 minutes) will lead a discussion and summary of key take home points

Q&A with panel (10 minutes)