Ornish Living: Feel better, love better

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Blogger David Katz opens his article by describing a new FDA approved implant device that stimulates the vagus nerve with intermittent electrical pulses in order to help people lose weight.  The description is meant to illustrate what he calls “ the fundamental limitations of ourselves, and our culture, when it comes to managing obesity and the chronic diseases it portends.”

The lifestyle intervention studied by Dr. Ornish in the ’90s is now reimbursed by Medicare and many private insurers as an alternative to coronary bypass surgery.

He then goes on to contrast this more typical approach to medicine and the obesity epidemic with the efforts of Dr. Dean Ornish and the Ornish Program, which is now covered by Medicare.

Dr. Ornish, as I trust most readers here know, demonstrated – way back in 1998 – that a lifestyle intervention could actually cause regression (i.e., shrinkage) of atherosclerotic plaque in coronary arteries. In subsequent studies, he showed that the intervention cut rates of heart attack dramatically, too. In more recent studies, he and colleagues have shown that lifestyle interventions can favorably affect even gene expression; we can, in fact, nurture our very nature.

But while Dr. Ornish’s exemplary career is on the one hand a beacon of success for those of us in Lifestyle Medicine, it is, on the other hand, a precautionary tale.

Yes, the lifestyle intervention studied by Dr. Ornish in the ’90s is now reimbursed by Medicare and many private insurers as an alternative to coronary bypass surgery. But to make that happen took 17 years! It took 17 years of indefatigable effort by Dr. Ornish and others, even after the evidence was published. Does anyone think we will be still debating reimbursement of the vagal stimulator in 2032? If so, I have a bridge on sale I’d like to show you.

We live in a system that demonstrates almost no interest in wellness. The big drug and device companies exert a great influence on the big insurance companies, and the rest of us are spectators. So the default decision is to cover most new drugs, devices and procedures as soon as they come along – while more powerful, but less patentable, alternatives languish. They usually languish forever, but the best-case scenario appears to be: They languish for the better part of 20 years.

So while it’s almost certainly true that the right kind of schools can do for adolescent obesity what scalpels are doing ever more often, we fund the latter and the let former languish.

It may have taken 17 years, but The Ornish Program is now thriving in hospitals around the country, and every little step forward towards a culture that respects wellness helps the lifestyle medicine movement grow.

Contributed by

Rachel Lehmann-Haupt
Editorial Director

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