Lifestyle Medicine Review Questions
fn fn fn
WhichfnoffnthefnfollowingfnstatementsfnisfnmostfncharacteristicfnoffnIntensivefnTherapeuticfnLi
festylefnChangefn(ITLC)?
a.fnGradualfnchangesfnarefnencouragedfninfnone'sfndailyfnroutine,fnincludingfnhabitsfnaroundfn
sleep,fndiet,fnphysicalfnactivityfnandfnstressfnmanagement.
b.fnTherefnisfnafnsingularfnfocusfnonfnonefnhealth-
relatedfndomainfntofnensurefnthatfnpatientsfnmakefnsubstantialfnchangefninfnthisfnarea
c.fnProgramsfnneedfntofnbefndeliveredfnin-personfntofnbefneffective
d.fnThesefnutilizefnmultiplefnmodalitiesfnandfnafnmultidisciplinaryfnteamfn-fncorrectfnanswer✔
✔ D.fnThesefnutilizefnmultiplefnmodalitiesfnandfnafnmultidisciplinaryfnteam
ITLCsfnencouragefndrasticfnchangesfninfnone'sfndailyfnroutine,fnnotfngradualfnchanges.fnITLC
sfnproducefnthefnessentialfninductionfnphasefnthatfnisfnneededfnforfnpeoplefntofnmakefnthefndr
amaticfnlifestylefnchangesfnnecessaryfnforfntreatingfnseverefndiseasefnandfnprecedesfnthefnm
aintenancefnandfnsupportfnphasesfninfnlifestylefnchange.fnITLCfntreatmentfnprogramsfnarefnu
suallyfnadministeredfninfnafngroupfnsettingfnandfntypicallyfnfocusfnonfnmultiplefnmodalitiesfnan
dfngenerallyfnutilizedfnafnmultidisciplinaryfnteam.fnTheyfncanfnbefndeliveredfnin-
personfnorfnvirtually.
Overallfnannualfnmedicalfnexpendituresfnamongfnpeoplefndiagnosedfnwithfndiabetesfninfnthef
UnitedfnStatesfnarefnhowfnmuchfnhigherfncomparedfnwithfnpeoplefnwithoutfndiabetes?
n
a.fn1.5fntimesfnhigher
b.fn2.3fntimesfnhigher
c.fn3.5fntimesfnhigher
d.fn6.2fntimesfnhigherfn-fncorrectfnanswer✔ ✔ B.fn2.3fntimesfnhigher
WhatfnpercentagefnoffnUSfnadultsfnwithfndiabetesfnarefnunawarefnthatfntheyfnhavefnit?
a.fn27%
,b.fn16%
c.fn23%
d.fn34%fn-fncorrectfnanswer✔ ✔ C.fn23%
AccordingfntofnthefnCDC,fn23%fnoffnUSfnadultsfnwhofnmetfnlaboratoryfncriteriafnforfndiabetesfn
werefnnotfnawarefnoffnorfndidfnnotfnreportfnhavingfndiabetesfn(undiagnosedfndiabetes).fnAppr
oximatelyfn11%fnoffnthefnUSfnpopulationfn(adultsfnandfnchildren)fnhavefndiabetesfnandfnnearl
yfn15%fnoffnUSfnadultsfnhavefndiabetes.
Whichfnoffnthefnfollowingfnisfntruefnaboutfnpositivefnpsychology?
a.fnItfnacknowledgesfnthefnvaluefnoffnnegativefnemotions,fnalonefntime,fnandfnreflectingfnonfnp
reviousfnfailures
b.fnItfnreinforcesfnautonomyfnandfnself-efficacy
c.fnAvoidancefnoffnnegativefnthoughtsfnandfnemotionsfnisfnpreferablefnasfnthesefncanfnservefn
asfndetractorsfntofngrowth
d.fnItfnemphasizesfnself-
improvementfnbyfnfocusingfnonfnstrengtheningfnareasfnoffnweaknessfn-fncorrectfnanswer✔
✔ B.fnItfnreinforcesfnautonomyfnandfnself-efficacy
Positivefnpsychologyfnreinforcesfnautonomyfnandfnself-
efficacyfn(b),fnandfnemphasizesfncurrentfnskillsfnabilities,fnstrengths,fnandfnpositivefnactionsfn
(d).fnItfnacknowledgesfnthefnvaluefnoffnpositivefnemotions,fnengagement,fnrelationships,fnme
aning,fnandfnaccomplishmentfn(a).fnPositivefnpsychologyfnimprovesfnattention,fnopen-
mindedness,fnandfncreativity.fnItfnalsofnrecognizesfnthatfnafnhealthyfnratiofnoffnpositivefntofnne
gativefnemotionsfn(notfnthefnavoidancefnof)fnbuildsfnresiliencefnthatfnfosterfnadaptationfnandfn
changesfn(c).
Afn45-year-
oldfnmanfnwantsfntofnmakefnlifestylefnchangesfntofnreducefnhisfnbodyfnweightfnandfnincreasefn
regularfnmoderatefnintensityfnexercise.fnHefnwantsfntofnaddressfnweightfnlossfnfirstfnbutfnisfnfr
ustratedfnbecausefnhefnfeelsfnlikefnhisfnpastfneffortsfnhavefnfailed.fnHisfnhealthfncarefnprovider
,fn decidesfnthatfnsupportingfnhisfnself-
efficacyfnwouldfnbefnuseful.fnWhichfnoffnthefnfollowingfnisfnthefnmostfnappropriatefninquiryfntofn
makefnatfnthisfnpoint?
a.fn"Whofninfnyourfnlifefnisfnmostfnlikelyfntofnsupportfnyoufntofnachievefnyourfnweightfnlossfngoalf
nrightfnnow?"
b.fn"Tellfnmefnaboutfnafntimefnwhenfnyoufnovercamefnafnchallengefntofnaccomplishfnsomethin
gfnyoufnreallyfnwantedfntofnachieve."
c.fn"Whatfnfactorfninfnyourfnlifefnwouldfnmostfnmotivatefnyoufntofnworkfntowardsfnweightfnlossfnr
ightfnnow?"
d.fn"Decidingfntofnimprovefnyourfnhealthfnisfnafngreatfndecisionfn-
fn howfnwillfnyoufnfeelfnwhenfnyoufnachievefnthis?"fn-fncorrectfnanswer✔ ✔
B.fn"Tellfnmefnaboutfnafntimefnwhenfnyoufnovercamefnafnchallengefntofnaccomplishfnsomethi
ngfnyoufnreallyfnwantedfntofnachieve."
Thefnprimaryfnfoundationfnoffnself-
efficacyfnisfnmasteryfnexperiences.fnThefninquiryfninvitingfnthefnmanfntofndescribefnafnpreviou
sfnexperiencefnoffnovercomingfnafnchallengefnisfnafnstrongfninvitationfntofnreportfnafnmasteryfn
experience.fnOtherfnoptionsfninvitefnhimfntofndescribefnotherfnsupportivefnpeoplefnorfnfactorsf
nratherfnthanfnself-efficacyfnexperiencesfnorfnarefnlikelyfntofnnegativelyfnimpactfnself-
efficacyfnduefntofnthefnpractitioner'sfn"cheerleading".
Whenfnaskedfnafnscalingfnquestionfntofnassessfnhisfnconfidencefntofnmakefnafnlifestylefnchan
ge,fnafn48-year-
oldfnmanfnrespondsfnthatfnhefnisfn"4fnoutfnoffn10fnconfident."fnHisfnhealthfncarefnproviderfnresp
ondsfnwithfnafnfollow-
upfninquiry:fn"Whatfnstopsfnyoufnfromfnbeingfn8fnorfn9fnoutfnoffn10?"fnThisfnresponsefnisfnanfnex
amplefnoffnwhichfnoffnthefnfollowing?
a.fnAnfninvitationalfnchallenge
b.fnSettingfnafnstretchfngoal
c.fnThefnrightingfnreflex
d.fnRollingfnwithfnresistancefn-fncorrectfnanswer✔ ✔ C.fnThefnrightingfnreflex
, MillerfnandfnRollnickfndefinefnthefnrightingfnreflexfnasfnattemptsfntofnusefnanfnexpertfnstancefnt
ofnurgefnpatientsfnintofnchange.fnSuchfnchallengesfnarefnlikelyfntofnevokefnafnself-
defensivefnreactionfnratherfnthanfnfurtherfndiscussionfnaboutfnthefnpossibilityfnoffnchange.
Afn43-year-
oldfnmanfnwithfntypefn2fndiabetesfnhasfnhadfnunstablefnandfnhighfnhemoglobinfnA1cfn(HbA1c)f
overfnafnnumberfnoffnyears.fnHefnhasfnrecentlyfnmovedfntofnanotherfncityfnandfnisfnseeingfnafn
n
newfnprimaryfncarefnprovider.fnOverfnthefnpastfn12fnweeks,fnhisfnHbA1cfnhasfndecreasedfnfro
mfn7.9%fntofn6.7%.fnWhichfnoffnthefnfollowingfnphysicianfnattributesfnwouldfnmostfnlikelyfnexpl
ainfnthis?
a.fnInsightfulfnreflectionsfnoffnadaptivefnpatientfnbehaviors
b.fnHighlyfndevelopedfncapacityfnforfnempathy
c.fnAutonomy-supportivefninformationalfnapproach
d.fnCuriousfnopenfninquiryfnaboutfnthefnreasonsfnbehindfnfluctuationsfn-fncorrectfnanswer✔
✔ B.fnHighlyfndevelopedfncapacityfnforfnempathy
Patient-
ratedfnphysicianfnempathyfnhasfnbeenfnshownfntofnresultfninfnpatientsfnbeingfnmorefnlikelyfntof
achievefngoodfnHbA1cfncontrol.fnItfnisfnalsofnafnfactorfninfngoodfnoutcomesfnforfnhypertensio
n
nfnandfnbloodfnglucosefnlevels.
Afn22-year-
oldfnwomanfnhasfnbeenfnworkingfnwithfnafnhealthfncoachfntofnmakefnchangesfntofnherfnsleepfn
practices,fnwhichfnshefnhasfnbeenfnintermittentlyfnimplementing.fnDuringfnthefncurrentfncons
ultation,fnshefnappearsfnagitatedfnasfnthefncoachfnusesfnthefndecisionalfnbalancefntoolfntofnad
dressfnambivalencefnwithfnher.fnThefncoachfnremindsfnherfnclearlyfnthatfnherfnhealthfnisfnatfnst
ake.fnShefnsuddenlyfnstatesfnquitefnforcefully:fn"Youfndon'tfnunderstandfnhowfnhardfnthisfnallfn
is."fnWhichfnoffnthefnfollowingfnisfnthefnmostfnappropriatefnresponsefnandfnwhatfnisfnitfndemon
strating?
a.fn"Ifncanfnseefnyou'refnreallyfnangryfnwithfnmefnrightfnnow."fn(AccuratefnDeepfnEmpathy)
fn fn fn
WhichfnoffnthefnfollowingfnstatementsfnisfnmostfncharacteristicfnoffnIntensivefnTherapeuticfnLi
festylefnChangefn(ITLC)?
a.fnGradualfnchangesfnarefnencouragedfninfnone'sfndailyfnroutine,fnincludingfnhabitsfnaroundfn
sleep,fndiet,fnphysicalfnactivityfnandfnstressfnmanagement.
b.fnTherefnisfnafnsingularfnfocusfnonfnonefnhealth-
relatedfndomainfntofnensurefnthatfnpatientsfnmakefnsubstantialfnchangefninfnthisfnarea
c.fnProgramsfnneedfntofnbefndeliveredfnin-personfntofnbefneffective
d.fnThesefnutilizefnmultiplefnmodalitiesfnandfnafnmultidisciplinaryfnteamfn-fncorrectfnanswer✔
✔ D.fnThesefnutilizefnmultiplefnmodalitiesfnandfnafnmultidisciplinaryfnteam
ITLCsfnencouragefndrasticfnchangesfninfnone'sfndailyfnroutine,fnnotfngradualfnchanges.fnITLC
sfnproducefnthefnessentialfninductionfnphasefnthatfnisfnneededfnforfnpeoplefntofnmakefnthefndr
amaticfnlifestylefnchangesfnnecessaryfnforfntreatingfnseverefndiseasefnandfnprecedesfnthefnm
aintenancefnandfnsupportfnphasesfninfnlifestylefnchange.fnITLCfntreatmentfnprogramsfnarefnu
suallyfnadministeredfninfnafngroupfnsettingfnandfntypicallyfnfocusfnonfnmultiplefnmodalitiesfnan
dfngenerallyfnutilizedfnafnmultidisciplinaryfnteam.fnTheyfncanfnbefndeliveredfnin-
personfnorfnvirtually.
Overallfnannualfnmedicalfnexpendituresfnamongfnpeoplefndiagnosedfnwithfndiabetesfninfnthef
UnitedfnStatesfnarefnhowfnmuchfnhigherfncomparedfnwithfnpeoplefnwithoutfndiabetes?
n
a.fn1.5fntimesfnhigher
b.fn2.3fntimesfnhigher
c.fn3.5fntimesfnhigher
d.fn6.2fntimesfnhigherfn-fncorrectfnanswer✔ ✔ B.fn2.3fntimesfnhigher
WhatfnpercentagefnoffnUSfnadultsfnwithfndiabetesfnarefnunawarefnthatfntheyfnhavefnit?
a.fn27%
,b.fn16%
c.fn23%
d.fn34%fn-fncorrectfnanswer✔ ✔ C.fn23%
AccordingfntofnthefnCDC,fn23%fnoffnUSfnadultsfnwhofnmetfnlaboratoryfncriteriafnforfndiabetesfn
werefnnotfnawarefnoffnorfndidfnnotfnreportfnhavingfndiabetesfn(undiagnosedfndiabetes).fnAppr
oximatelyfn11%fnoffnthefnUSfnpopulationfn(adultsfnandfnchildren)fnhavefndiabetesfnandfnnearl
yfn15%fnoffnUSfnadultsfnhavefndiabetes.
Whichfnoffnthefnfollowingfnisfntruefnaboutfnpositivefnpsychology?
a.fnItfnacknowledgesfnthefnvaluefnoffnnegativefnemotions,fnalonefntime,fnandfnreflectingfnonfnp
reviousfnfailures
b.fnItfnreinforcesfnautonomyfnandfnself-efficacy
c.fnAvoidancefnoffnnegativefnthoughtsfnandfnemotionsfnisfnpreferablefnasfnthesefncanfnservefn
asfndetractorsfntofngrowth
d.fnItfnemphasizesfnself-
improvementfnbyfnfocusingfnonfnstrengtheningfnareasfnoffnweaknessfn-fncorrectfnanswer✔
✔ B.fnItfnreinforcesfnautonomyfnandfnself-efficacy
Positivefnpsychologyfnreinforcesfnautonomyfnandfnself-
efficacyfn(b),fnandfnemphasizesfncurrentfnskillsfnabilities,fnstrengths,fnandfnpositivefnactionsfn
(d).fnItfnacknowledgesfnthefnvaluefnoffnpositivefnemotions,fnengagement,fnrelationships,fnme
aning,fnandfnaccomplishmentfn(a).fnPositivefnpsychologyfnimprovesfnattention,fnopen-
mindedness,fnandfncreativity.fnItfnalsofnrecognizesfnthatfnafnhealthyfnratiofnoffnpositivefntofnne
gativefnemotionsfn(notfnthefnavoidancefnof)fnbuildsfnresiliencefnthatfnfosterfnadaptationfnandfn
changesfn(c).
Afn45-year-
oldfnmanfnwantsfntofnmakefnlifestylefnchangesfntofnreducefnhisfnbodyfnweightfnandfnincreasefn
regularfnmoderatefnintensityfnexercise.fnHefnwantsfntofnaddressfnweightfnlossfnfirstfnbutfnisfnfr
ustratedfnbecausefnhefnfeelsfnlikefnhisfnpastfneffortsfnhavefnfailed.fnHisfnhealthfncarefnprovider
,fn decidesfnthatfnsupportingfnhisfnself-
efficacyfnwouldfnbefnuseful.fnWhichfnoffnthefnfollowingfnisfnthefnmostfnappropriatefninquiryfntofn
makefnatfnthisfnpoint?
a.fn"Whofninfnyourfnlifefnisfnmostfnlikelyfntofnsupportfnyoufntofnachievefnyourfnweightfnlossfngoalf
nrightfnnow?"
b.fn"Tellfnmefnaboutfnafntimefnwhenfnyoufnovercamefnafnchallengefntofnaccomplishfnsomethin
gfnyoufnreallyfnwantedfntofnachieve."
c.fn"Whatfnfactorfninfnyourfnlifefnwouldfnmostfnmotivatefnyoufntofnworkfntowardsfnweightfnlossfnr
ightfnnow?"
d.fn"Decidingfntofnimprovefnyourfnhealthfnisfnafngreatfndecisionfn-
fn howfnwillfnyoufnfeelfnwhenfnyoufnachievefnthis?"fn-fncorrectfnanswer✔ ✔
B.fn"Tellfnmefnaboutfnafntimefnwhenfnyoufnovercamefnafnchallengefntofnaccomplishfnsomethi
ngfnyoufnreallyfnwantedfntofnachieve."
Thefnprimaryfnfoundationfnoffnself-
efficacyfnisfnmasteryfnexperiences.fnThefninquiryfninvitingfnthefnmanfntofndescribefnafnpreviou
sfnexperiencefnoffnovercomingfnafnchallengefnisfnafnstrongfninvitationfntofnreportfnafnmasteryfn
experience.fnOtherfnoptionsfninvitefnhimfntofndescribefnotherfnsupportivefnpeoplefnorfnfactorsf
nratherfnthanfnself-efficacyfnexperiencesfnorfnarefnlikelyfntofnnegativelyfnimpactfnself-
efficacyfnduefntofnthefnpractitioner'sfn"cheerleading".
Whenfnaskedfnafnscalingfnquestionfntofnassessfnhisfnconfidencefntofnmakefnafnlifestylefnchan
ge,fnafn48-year-
oldfnmanfnrespondsfnthatfnhefnisfn"4fnoutfnoffn10fnconfident."fnHisfnhealthfncarefnproviderfnresp
ondsfnwithfnafnfollow-
upfninquiry:fn"Whatfnstopsfnyoufnfromfnbeingfn8fnorfn9fnoutfnoffn10?"fnThisfnresponsefnisfnanfnex
amplefnoffnwhichfnoffnthefnfollowing?
a.fnAnfninvitationalfnchallenge
b.fnSettingfnafnstretchfngoal
c.fnThefnrightingfnreflex
d.fnRollingfnwithfnresistancefn-fncorrectfnanswer✔ ✔ C.fnThefnrightingfnreflex
, MillerfnandfnRollnickfndefinefnthefnrightingfnreflexfnasfnattemptsfntofnusefnanfnexpertfnstancefnt
ofnurgefnpatientsfnintofnchange.fnSuchfnchallengesfnarefnlikelyfntofnevokefnafnself-
defensivefnreactionfnratherfnthanfnfurtherfndiscussionfnaboutfnthefnpossibilityfnoffnchange.
Afn43-year-
oldfnmanfnwithfntypefn2fndiabetesfnhasfnhadfnunstablefnandfnhighfnhemoglobinfnA1cfn(HbA1c)f
overfnafnnumberfnoffnyears.fnHefnhasfnrecentlyfnmovedfntofnanotherfncityfnandfnisfnseeingfnafn
n
newfnprimaryfncarefnprovider.fnOverfnthefnpastfn12fnweeks,fnhisfnHbA1cfnhasfndecreasedfnfro
mfn7.9%fntofn6.7%.fnWhichfnoffnthefnfollowingfnphysicianfnattributesfnwouldfnmostfnlikelyfnexpl
ainfnthis?
a.fnInsightfulfnreflectionsfnoffnadaptivefnpatientfnbehaviors
b.fnHighlyfndevelopedfncapacityfnforfnempathy
c.fnAutonomy-supportivefninformationalfnapproach
d.fnCuriousfnopenfninquiryfnaboutfnthefnreasonsfnbehindfnfluctuationsfn-fncorrectfnanswer✔
✔ B.fnHighlyfndevelopedfncapacityfnforfnempathy
Patient-
ratedfnphysicianfnempathyfnhasfnbeenfnshownfntofnresultfninfnpatientsfnbeingfnmorefnlikelyfntof
achievefngoodfnHbA1cfncontrol.fnItfnisfnalsofnafnfactorfninfngoodfnoutcomesfnforfnhypertensio
n
nfnandfnbloodfnglucosefnlevels.
Afn22-year-
oldfnwomanfnhasfnbeenfnworkingfnwithfnafnhealthfncoachfntofnmakefnchangesfntofnherfnsleepfn
practices,fnwhichfnshefnhasfnbeenfnintermittentlyfnimplementing.fnDuringfnthefncurrentfncons
ultation,fnshefnappearsfnagitatedfnasfnthefncoachfnusesfnthefndecisionalfnbalancefntoolfntofnad
dressfnambivalencefnwithfnher.fnThefncoachfnremindsfnherfnclearlyfnthatfnherfnhealthfnisfnatfnst
ake.fnShefnsuddenlyfnstatesfnquitefnforcefully:fn"Youfndon'tfnunderstandfnhowfnhardfnthisfnallfn
is."fnWhichfnoffnthefnfollowingfnisfnthefnmostfnappropriatefnresponsefnandfnwhatfnisfnitfndemon
strating?
a.fn"Ifncanfnseefnyou'refnreallyfnangryfnwithfnmefnrightfnnow."fn(AccuratefnDeepfnEmpathy)
