NYC Gazette

New research from the Hospital for Special Surgery (HSS) highlights the effectiveness of lifestyle medicine interventions in improving patient health before elective orthopedic surgeries. The study, published online on May 16 in the American Journal of Lifestyle Medicine, observed outcomes for 54 patients enrolled in the HSS Lifestyle Medicine Program between March 2022 and December 2023. Almost all participants successfully achieved their pre-surgery health improvement goals.

HSS orthopedic surgeons identify patients at elevated risk for surgical complications due to lifestyle-related chronic diseases such as obesity, type 2 diabetes, and cardiovascular disease. These conditions are linked to longer hospital stays and increased complications. Patients are referred to the program to improve their health or qualify for surgery previously deemed unsuitable due to chronic disease severity.

The program involves an interprofessional team helping patients set personal goals to enhance pain management, function, sleep, and overall health. Among the 54 patients studied, 41 had scheduled surgeries; 93% improved their health sufficiently to proceed with surgery on time. Of those initially unable to schedule surgery due to health issues, 85% eventually qualified after participating in the program.

Dr. Heidi Prather, founder and Medical Director of the HSS Lifestyle Medicine Program, stated: “We were surprised at how quickly patients could make lifestyle changes.” She added that achieving personal health goals is expected to lead to better post-surgical outcomes.

The program employs motivational interviewing techniques and focuses on six pillars of lifestyle medicine: diet, physical activity, sleep, stress management, social connections, and limiting tobacco and alcohol use. Delivered mainly online over three months, it provides each patient with a personalized plan facilitated by a dedicated scheduler and care navigator.

Almost all participants had multiple chronic diseases; most reported poor sleep and lack of physical activity. The average participant had a body mass index (BMI) of 43.2 kg/m². Seventy-two percent lost weight during the program with an average reduction of 11 pounds and a BMI decrease of 1.8 kg/m².

Dr. Prather emphasized that while addressing obesity is crucial for many patients, “our program is not a weight loss program.” Instead, it aims at lowering systemic inflammation through lifestyle changes.

Participants also noted improvements in pain levels as well as physical and mental health scores. Dr. Prather mentioned ongoing data collection efforts to evaluate long-term impacts on surgical risk reduction and patient satisfaction.

Additionally, HSS plans to introduce live online cooking sessions led by nutritional chef Caryn Dugan later this year as part of expanding lifestyle-based approaches.