Lifestlye Medicine
Core Competencies
We invite you to join the growing number of physicians who have become Diplomates of the American Board of Lifestyle Medicine.
The ABLM/IBLM certification exam is based on the lifestyle medicine core competencies as first published in JAMA in 2010.
The competencies were developed to provide guidance to clinicians, defining lifestyle medicine and outlining the knowledge and skills needed for health care practitioners to provide high quality lifestyle interventions.
The competencies focus on enduring clinical knowledge and skills and do not address evolving or globally/regionally divergent models of care and business administrative mechanisms of practice. The exception to the focus on clinical practice is the inclusion of leadership and advocacy skills, such as knowledge of the impact of lifestyles on planetary health.
Note: Competencies listed below with an asterisk (*) may be outside the scope of practice of non-provider healthcare practitioners.
Lifestyle medicine physicians become ABLM Diplomates by:
- Discuss lifestyle medicine and its unique role in healthcare practice
- Describe the lifestyle medicine core competencies as identified by a national consensus panel
- Compare and contrast lifestyle medicine with other fields of health and medicine
- Summarize the scientific evidence that shows health behaviors are associated with key health outcomes
- Describe the evidence showing that lifestyle interventions effectively impact disease pathophysiology
- Describe the priority of lifestyle medicine in the spectrum of treatment algorithms for chronic, lifestyle-related diseases across the lifespan
- Discuss the prevalence and associated cost burden of lifestyle-related diseases, such as hyperlipidemia, cardiovascular disease, prediabetes, diabetes, hypertension, obesity, and cancer
- Explain the impact of lifestyle choices on planetary health and sustainable living
The Role of the Practitioner’s Personal Health and Community Advocacy
- Examine scientific evidence that suggests practitioners who practice healthy lifestyles are more likely to offer counseling, serve as role models, and improve patient outcomes
- Develop a culture of leadership by modeling personal health behaviors
- Describe strategies for incorporating personal wellness for practitioners into clinics, medical offices, or other healthcare settings, including wellness programs
- Examine essential practitioner characteristics and practices that increase the capacity and impact of the therapeutic alliance
- Integrate personal readiness assessments and lifestyle action plans into sustainable life patterns for practitioners
- Explore the role of lifestyle medicine in promoting personal practitioner resiliency and reducing burnout
- Advocate for lifestyle medicine directly with patients and their families, as well as policy and decision makers within the community
Nutrition Science, Assessment, and Prescription
- Assess food intake patterns and nutrients of deficit and excess
- Analyze food labels for the health impacts of ingredients
- Discuss commonalities and key messages of global dietary guidelines.
- Summarize the health impact of prominent dietary patterns, including plant predominant and non–plant predominant patterns
- Describe how the level of processing in a food affects health and discuss the evidence base for these effects
- Describe the practice of culinary medicine and its role in sustainable healthy eating behavior
- Summarize the major studies of nutrition in the prevention, treatment, and reversal of hyperlipidemia, cardiovascular disease, prediabetes, diabetes, hypertension, obesity, and cancer
- Apply nutrition prescriptions based on science that shows how nutrition can address the pathophysiology of most chronic diseases, including inflammation, oxidation, glycosylation, epigenetic expression, and the microbiome*
- Demonstrate the ability to write evidence-based nutrition prescriptions*
- Describe indications for referral to a lifestyle medicine-trained registered dietician to translate and further personalize nutrition prescriptions
Physical Activity Science, Assessment, and Prescription
- Discuss the aerobic, strength, flexibility, and balance components of physical activity
- Examine the evidence and pathophysiology between physical activity components and health outcomes
- Describe the benefits of physical activity in preventing or treating disease in special populations, such as healthy older adults, pregnant women, children and adolescents, persons with obesity or disability, cardiovascular disease, diabetes, cancer, disability, and stroke
- Summarize the role of physical activity guidelines
- Integrate key physical activity assessment tools into clinical practice
- Define fitness terminology relevant to writing exercise prescriptions
- Integrate evidence from relevant physical activity literature into treatment protocols for management, remission, or reversal in patients with diabetes, cancer, cardiovascular, and cerebrovascular disease*
- Describe indications for referral to health fitness professionals
- Develop physical activity prescriptions appropriately modified for special populations, such as healthy older adults, pregnant women, children and adolescents, persons with obesity or disability, cardiovascular disease, diabetes, cancer, disability, and stroke*
Sleep Health Science and Interventions
- Describe sleep’s role with health and chronic disease pathophysiology
- Perform sleep assessments to identify patients with insufficient or poor-quality sleep
- Summarize lifestyle-based interventions that can improve sleep health
- Assess the risk for common sleep disturbances, such as obstructive sleep apnea, chronic insomnia, and restless legs syndrome, and refer to sleep specialists when applicable
- Describe the indications for referral to a sleep specialist or for a sleep study to assess for sleep apnea
- Describe indications for referral to a program or specialist in cognitive behavior therapy for insomnia
Treating Tobacco Use Disorder and Managing Other Toxic Exposures (Including Vaping, Alcohol Use, and Other Illicit Substances)
- Describe the health effects of tobacco, alcohol, and other frequently used substances and the benefits of cessation
- Apply patient screening tools for substance use
- Create patient-centered substance use treatment plans using practice guidelines and behavioral interventions*
- Summarize the diagnostic criteria for common substance use disorders Integrate behavior therapy with pharmacotherapy for tobacco and other substance use disorder plans, and refer to a substance use disorder specialist when indicated*
- Apply the United States Preventive Services Task Force guidelines for patients with tobacco use disorder
Key Clinical Processes in Lifestyle Medicine
- Integrate lifestyle vital signs into components of the patient history and physical exam
- Analyze and implement evidence-based clinical practice guidelines relevant to lifestyle medicine for prevention, treatment, and reversal of chronic diseases*
- Describe the treatment of disease with the lifestyle medicine pillars as compared with medication
- Demonstrate how to screen, diagnose, treat, and monitor a lifestyle-related disease and provide lifestyle medicine–focused anticipatory guidance*
- Discuss strategies for a clinical practice to access and implement use of local, national, and global resources
- Describe the key strategies for leveraging inter-professional teams to enhance health behavior change interventions
- Examine how group visits and telehealth can optimize lifestyle medicine treatment encounters
- Create and utilize data from office systems, such as electronic health records with lifestyle medicine guidance, in clinical decisions and care, including tracking screening frequency, test results, referrals, and recommended follow-up
- Analyze the evidence for collaborative and chronic care models on improved lifestyle outcomes
- Discuss successful primary care and office-based models for lifestyle modification
- Design a quality improvement project for lifestyle medicine clinical practice, using tools, such as Plan-Do-Study-Act (PDSA) cycles
- Explain principles of evidence-based medicine and their application to lifestyle medicine
- Describe methods of assessing effectiveness of interventions, such as patient activation measures and the therapeutic alliance measures
Fundamentals of Health Behavior Change
- Summarize health behavior change theories, such as the health belief model, the social learning theory, and the transtheoretical model (TTM), and their application to lifestyle medicine practice
- Demonstrate key elements of conducting a patient assessment within the TTM and collaborate to develop stage-matched responses
- Apply the process of building effective and therapeutic alliances with patients that foster their personal growth
- Explain how to collaborate with your patients to promote health behavior changes
- Apply motivational interviewing, cognitive behavioral, health coaching, and positive psychology techniques
- Summarize the evidence to support the use of behavior change techniques in clinical practice
- Use the skills of open inquiry, reflections, and empathy to develop and maintain a therapeutic alliance
- Describe the impact of positive emotions on the success of health behavior change
- Develop patient-centered, written action plans based on the appropriate stage of change of the TTM
- Summarize the process of follow-up for ongoing lifestyle change progress, including building patient self-efficacy and relapse prevention
- Describe the factors that support sustained behavior change
- Explain the role of family and other support to initiate and maintain health behavior change
- Manage disruptions to the therapeutic alliance
- Identify patient resources for sustainable behavior change in relation to the pillars of lifestyle medicine
Emotional and Mental Health Assessment and Interventions
- Apply screening tools for stress, depression, and anxiety in clinical practice
- Explain the relationship and pathophysiology between emotional and physical health
- Summarize the nature of stress, the role of stressors, such as adverse child experiences, and identify manageable elements of pathogenic stress reactions
- Describe and utilize evidence-based and patient-centered mental and emotional health, including self-management and resilience-building techniques
- Analyze the clinical relevance and evidence base for mindfulness-based stress reduction (MBSR) and related stress management strategies
- Manage treatment plans for lifestyle-related mental health diseases, such as depression and anxiety*
- Describe indications for referral to mental health professionals (versus when clinically indicated)
- Apply mindfulness skills to enable presence, clarity, and curiosity in the clinical encounter
The Role of Connectedness and Positive Psychology
- Apply positive psychology in health behavior change counseling
- Describe how positive psychology strategies support achieving and sustaining healthy behaviors
- Compare and contrast eudaimonia and hedonia, and explain their effect on physical health, including longevity
- Describe how social connectedness and social networks effect emotional well-being, physical health, and longevity
- Summarize the deleterious and positive effects social media has on emotional wellbeing and flourishing
- Explain the relationship among the lifestyle pillars, positive emotions, and flourishing
- Describe positive psychology activities that can boost emotional well-being and flourishing