Continuing Lifestyle Intervention, Part 2

There are said to be six “pillars” of lifestyle medicine: “plant-based nutrition, physical activity, stress management, avoidance of risky substances, restorative sleep, and social connections.” According to the same source, lifestyle medicine itself (familiarly known as LM)…

[…] is a medical specialty that primarily uses lifestyle changes to treat chronic diseases. It is an evidence-based practice that helps individuals and their families implement and maintain healthy behaviors impacting the quality of life.

Lifestyle medicine is definitely not an afterthought or an inconsequential footnote to treatment. All the six types of intervention are important, and this is certainly true of recovery from obesity, and avoidance of its return.

What does the American Gastroenterological Association (AGA) say? That organization, like so many others, has developed a set of guidelines for weight loss, to encompass a minimum of six months of intensive lifestyle interventions in three areas: reduced-calorie diet, increased physical activity, and behavior therapy.

This boils down to eating in a way that brings in 500 to 750 fewer calories per day than the individual had been accustomed to consuming. Physical activity should be 150 minutes, or better yet, 180 minutes of aerobic activity each week. Here is an interesting detail: “Physical activity alone, however, contributes minimally.”

Acknowledged as key is behavioral therapy, “which provides a set of strategies and techniques to modify diet and physical activity patterns.” Strategy is a thing that most of us might have trouble putting together on our own, but with guidance, we come to understand that self-monitoring is an excellent tactic. As the AGA says, “technological advances provide new ways for patients to self-monitor.”

A vital ingredient

This group’s definition of short-term intensive lifestyle intervention includes “16 individual, on-site counseling sessions with a registered dietitian in the first 6 months.” Psychologists have long noted that personal contact and attention have a strong effect, and this will continue to be true no matter how much assistive technology is added to the arsenal.

The AGA also has an agenda for long-term maintenance, because after six months or even a year of intensive lifestyle intervention, weight regain is widely and regrettably common. According to AGA,

With no further treatment (or with infrequent follow-up meetings) patients typically regain one third of lost weight in the first follow-up year, with continuing weight gain thereafter. Patients, on average, return to their baseline weight within 4-5 years.

By the way, readers of Childhood Obesity News are familiar with two programs that include the means for self-monitoring, and so much more — W8Loss2Go and BrainWeighve.

More on this subject is coming up, but until next time, let us leave readers with this thought: Seriously, a person could look around (including a glance into a mirror) and wonder, “Is there anyone I know who couldn’t use a little bit of lifestyle intervention?

Your responses and feedback are welcome!

Source: “The Impact of the Six Pillars of Lifestyle Medicine on Brain Health,”, 02/03/23
Source: “Intensive Lifestyle Intervention for Obesity: Principles, Practices, and Results,”, May 2017
Image by watchsmart/CC BY 2.0

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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