Policy Design and Preventive Care: The Governance Deficit in Lifestyle Medicine

Abstract

The American College of Lifestyle Medicine (ACLM) offers a model for whole-person healthcare that reduces the burden of chronic disease on patients and healthcare systems. As of June 2025, only about 3,800 out of over 1 million American physicians were Board-Certified in Lifestyle Medicine, and although the method has seen success in various medical settings, growth has been hindered by bureaucracy and policy. While the positive impact of Lifestyle Medicine (LM) on chronic disease and health outcomes has been documented, research on successful, widespread policy implementation of LM methods remains underdeveloped. This study explores the foundational praxis of the ACLM, the current barriers facing wider adoption, and the necessary social and political processes for enforcing effective Lifestyle Medicine application. This research seeks to explain why removing policy barriers to the implementation of Lifestyle Medicine should be prioritized as a crucial step toward lowering costs and utilizing effective methodologies in the American healthcare system. Using a comparative multi-case study with embedded policy mapping, I conduct a systematic review of policies and regulations related to Lifestyle Medicine implementation, categorizing and reviewing implementation barriers by type, level of governance, and mechanism of impact. My study finds that the lack of LM education in the administrative regulation of health systems and the need for sociocultural influence on LM policy are two of the most significant barriers faced by the ACLM for imposing policy-based implementation.