Could Fitness Professionals and Doctors work together?
“Lifestyle medicine” is being explored as a potential intervention for preventative healthcare.
What has always frustrated me about working in fitness are the stark differences between thought processes
Between how medical doctors (and even physical therapists!) understand the realm of exercise.
I’m sharing opinions and anecdotes of my experience in eight years as a trainer in today’s newsletter, so I welcome disagreement on some of these ideas, but I’m fairly certain anyone who’s worked with a fitness professional and a doctor will notice these discrepancies.
For example, post-surgery, depending on the severity, doctors and surgeons will recommend protocols to their patients like “no lifting anything heavier than 25 pounds for 4 weeks.”
I’d imagine this is a measure to avoid re-injury, hernias, or undue stress to the body. But it’s also a silly recommendation, in my view.
Where does the number 25 come from? (Yes, I’ve heard this exact recommendation repeated to me by clients)
Why four weeks? Does the doctor know that I’ve been training this client to create enough intra-abdominal pressure to deadlift 250+ pounds for more than a year?
I’m not saying they need to return to lifting maximal weight post-op, but surely, a 50 pound squat is not going to do any harm.
Or take the classic nutritional literature screw-ups that have likely misled patients for years. “Avoid red meat” due to its misguidedly-cited cardiovascular drawbacks or “cut back on sodium” to lower blood pressure (sodium can actually aid in proper hydration, which is a benefactor for those with renal cardiometabolic issues) are ideas that are outdated, yet still repeated among doctors today.
I’ve been trying to bridge this gap for a while — earning a level of trust with my clients (and readers!) that begets the same respect as those with 10+ years of schooling and degrees, not because doctors are always incorrect, but because many could benefit from working directly with exercise scientists (see what I did there? we’re not just trainers).
Thankfully, some new lines of thinking are prevailing, and I want to highlight how this could paint a model for better healthcare in the near future.
Lifestyle Medicine: A New Concept
“Most chronic diseases — cardiometabolic, certain cancers, and certain forms of dementia — share at least some, and often many, of the same underlying biological mechanisms. What we eat, how much we exercise, and how much social support we have play a critical role in chronic inflammation, oxidative stress, changes in the microbiome, and overstimulation of the sympathetic nervous system during times of stress.”
— Neha Pathak, Medscape.com
This paragraph encapsulates what I’ve talked about in previous newsletters — a collaborative effort between doctors, the hard scientists, and public health workers like myself, the “soft” ones — to create new policies and interventions in the health world that are cost-effective for patients.
Leaders from the American Cardiology Association, American Cancer Society, the Obesity Medicine Society, and American Psychiatric Association recently gathered to discuss Lifestyle Medicine: the practice of implementing daily habit change and small-scale interventions like diet modification and exercise prescription, a practice most doctors have never followed through with, despite vaguely recommending.
One thing was abundantly clear at the ACLM 2025 summit.
The vague, parameter-less recommendation that we always get from our primary care physician after physicals, “watch your calories, eat fewer carbs, exercise more, sleep better,” leaves the average, overworked individual trying to juggle 8 things at once with no actionable steps to take care of their own health.
So doctors began sharing their stories about how more detailed prescriptions — like implementing whole food, minimally processed food diets with 3x a week strength training and 30 minutes per day of walking — can help patients reduce symptoms of age-related illnesses like Alzheimers.
Studies like the one cited above, which occurred over 2 years, are examples that Lifestyle interventions need to be specific, long-standing, and measured.
In other words, you can’t just change a few random things in your lifestyle, not track those changes, and expect change to happen.
“People can get sick quickly, and they can also get better very quickly. But as with the early Alzheimer’s intervention, Ornish explains that the dose makes all the difference.”
We’re still a ways away from a real, concentrated, and collaborative effort from doctors around the world implementing routines like this (and hopefully working with trainers like me) to make these changes happen.
What The Model Could Look Like
Imagine, though, just for a second with me…
A pre-diabetic patient fills out an intake form at a new doctor’s office for their annual physical.
This doctor’s office is one of the future — it has a gym inside it, with trainers contracted, for miniature prescribed exercise regimens, where trainers, nutritionists, and other fitness-adjacent professionals are a part of the intake process.
Instead of a 20-minute appointment, sending a patient home with a piece of paper and a benign list of things to do, they participate in a 20-minute regimen with their assigned trainer, where they learn exactly what protocol they should follow to improve their health.
From there, they report back to their trainer once a week, and back to the doctor after 2 months to identify results.
Could this possibly overwhelm already overbooked physicians’ offices? Maybe.
But let me romanticize a bit.
There are definitely enough people in need of exercise to go around for trainers across the globe. Why shouldn’t they be looped in on more medical visits?
Just a thought.