When Healthiness Is the Treatment

I recently came across a CNN article on lifestyle interventions for early Alzheimer’s. It affirmed something I’ve long believed—and something research increasingly supports: that living healthily, both physically and mentally, is not only preventative; it can also be a form of treatment.

That claim can be misused. In recent years, we’ve seen a dangerous narrative emerge: that getting sick is a personal failure, that “responsible” people stay healthy, and that access to care should depend on how well someone takes care of themselves. I reject that completely.

Many diseases—Alzheimer’s, cancer, schizophrenia—have genetic and environmental causes far beyond individual control. No amount of broccoli or breathwork makes you a better person, or guarantees protection. But what lifestyle can offer—when made accessible and supported—is not blame, but a path toward healing.

When I was in medical school more than 25 years ago, conditions like Alzheimer’s or heart disease were often spoken of with resignation—especially if they “ran in the family.” The unspoken assumption was that genetics equaled destiny. Research since then has reframed that fatalism. While we cannot change our genes, we can influence our biology through our habits, relationships, and environment. This shift moves the locus of control away from what we inherit and toward how we live.

The idea that how we live affects how we heal is not new. What’s new is the growing body of science confirming what many cultures have long practiced: that healing is relational, collective, and built through everyday actions. Healthiness is not a reward. It is a form of ongoing treatment.

Rather than separating lifestyle from medicine, this framework proposes that the very ways we nourish, move, regulate, and connect are themselves clinical interventions. And when done consistently, communally, and culturally grounded, they are often as effective as pills and procedures. The structure that follows—Eat Well, Move More, Stress Less, Love More—borrows directly from the framework used in Dean Ornish’s lifestyle intervention studies, and offers a practical entry into this paradigm shift.

Eat Well

Food is biology, but it is also culture. The American diet—reductionist, hyper-processed, and stripped of meaning—is an outlier on the global stage. It is not just unhealthy; it is unrooted. As Michael Pollan writes in Food Rules, Americans don’t eat food, they eat nutrients. The result is a population that is both overfed and undernourished.

Eating well is not just about avoiding disease; it is about aligning with the systems the body evolved to thrive in. A wide range of studies show that diets high in fiber, whole plants, and unsaturated fats are associated with lower rates of cardiovascular disease, diabetes, depression, and cognitive decline. What’s often missing in public discourse is that eating well is, itself, medical treatment.

Plant-based diets have been linked with improvements in blood pressure, cholesterol, insulin sensitivity, and inflammation. Dean Ornish’s lifestyle interventions for heart disease and a 2024 randomized trial on early-stage Alzheimer’s—though intensive—demonstrated that food, when combined with other lifestyle changes, can reverse pathology once thought permanent. But cultures around the world have shown this for generations: longevity in so-called Blue Zones—regions like Okinawa, Ikaria, and Nicoya where people live unusually long and healthy lives—isn’t driven by isolated nutrients, but by communal meals built on vegetables, grains, legumes, and ritual.

The intervention isn’t just the food—it’s the meaning. Eating well is more than what you eat, but with whom. Eating together, preparing meals, honoring familial or culturally inherited recipes: these are forms of relational nourishment.

Move More

Exercise is not just for weight loss or aesthetics. It is a primary treatment for both physical and mental illness. Regular physical activity can treat depression as effectively as medication or psychotherapy, based on findings from a 2024 meta-analysis. Regular movement improves executive function, memory, cardiovascular health, immune regulation, and sleep quality.

The EXERT trial showed that both aerobic and low-intensity exercise helped maintain cognitive function and in the memory brain structures in older adults with mild cognitive impairment. Exercise post-heart attack reduces risk of recurrence, lowers all-cause mortality, and improves quality of life. Movement activates the endocannabinoid system, reduces inflammatory markers, and stimulates new nerve growth (neurogenesis).

What matters most isn’t just intensity. Healthiness has qualities of consistency and sustainability, and this also applies to healthy movement. Movement that feels enjoyable, accessible, and meaningful is more likely to be maintained over time.

Stress Less

Stress is not just a feeling; it is a physiological cascade. And when chronic, it is deeply corrosive to both body and brain. Elevated cortisol disrupts memory, immune function, sleep, and emotional regulation. It fuels systemic inflammation and accelerates the aging process.

Mindfulness-based interventions—like the programs pioneered by Jon Kabat-Zinn—are clinically validated treatments for conditions ranging from depression and anxiety to irritable bowel syndrome and chronic pain. Meditation has been shown to reduce amygdala activity, improve prefrontal regulation, and increase gray matter density in the brain. Prayer, breathwork, and contemplative practices across cultures also provide these benefits, often embedded in relational or spiritual meaning.

One study that I came across that really opened up my own thinking showed that massage therapy significantly reduced symptoms of Generalized Anxiety Disorder. It shows that the mind-body connection is also a body-mind connection. Also that somatic regulation is more than relaxation—it is therapeutic. Stress reduction therefore isn’t a luxury or an indulgence; it can be a medical necessity.

Love More

If there is a single variable most predictive of long-term wellbeing, it is not cholesterol, income, or even disease burden. It is the quality of our relationships. The Harvard Study of Adult Development, which followed men for over 75 years, concluded that close relationships are the strongest predictor of life satisfaction and health.

Connection also protects. Longevity studies show that people with consistent social ties live longer, recover faster, and experience fewer chronic illnesses. A 2023 analysis in PNAS found that social attributes—like family contact, community engagement, and perceived trust—were among the strongest predictors of long life, surpassing many medical conditions in their predictive power. A separate study on intergenerational caregiving showed that emotional support, babysitting grandchildren, and maintaining a large network of relatives were all associated with lower risk of dementia.

The therapeutic effects of love are not sentimental; they are biological. Oxytocin release, parasympathetic activation, reduced inflammatory cytokines—all triggered through affection, touch, and belonging. Healing doesn’t just happen in clinics. It happens at dinner tables, during get-togethers, in text threads, and during bedtime stories.

Healing Needs a Village

None of this works without support. Not food, not movement, not emotional regulation, and not love. Every one of these behaviors—simple in theory—is shaped by systems of access, safety, and shared responsibility.

You can’t eat well if you live in a food desert. You can’t move more without time, safe spaces, or childcare. You can’t relax when you’re managing racial trauma, economic precarity, or unrelenting caregiving. And you can’t cultivate deep relationships in a culture that rewards productivity over presence.

That’s why health isn’t a solo project. It’s a shared outcome.

Each pillar—eat, move, stress, love—gains its power through context. Cultural food traditions, collective rituals of movement, rhythms of rest embedded in shared routines, and everyday acts of support between family and friends: these are not accessories to health. They are its contextual foundation.

To say healing needs a village is not just metaphor. It’s measurable, including in the cost of not having help or resources. Studies show that social isolation increases mortality risk as much as smoking and more than obesity or inactivity. The Pair of ACEs framework shows how chronic stress and adversity are often rooted in structural environments. Whereas the longevity benefits of connection, trust, and shared caregiving are now well-documented across cultures and life stages.

So if we are serious about medicine, we must be serious about community.

Support Over Willpower

What the Ornish studies also reveal is that intensive behavior change is possible—but rarely in isolation. Participants received meals, guidance, social support, and a structured environment. In the real world, people don’t have that scaffolding. Expecting transformation through willpower alone is not only unrealistic—it reflects a cultural bias toward autonomy and self-reliance that often ignores how deeply health is shaped by environment, access to resources, and social infrastructure.

Healthiness, when practiced relationally, becomes treatment. Not as a substitute for medical care, but as a powerful form of it. To embrace healthiness as treatment is to reclaim something that has always been known but rarely respected in modern systems: that bodies are ecosystems, and ecosystems do not heal in isolation.

This reframing requires boldness from public health—and humility from medicine. It demands that we measure success not only in risk reduction but in agency, dignity, and connectedness. It asks us to center cultures that have always understood healing as layered, slow, and interdependent. And it challenges the belief that better health comes from better choices, rather than better conditions.

What if we stopped treating lifestyle as a side dish and recognized it as the main course? What if healthcare systems were built to make healthiness easier, not harder? What if treatment plans began not with a prescription, but with a nap? A parents’ night out? A neighborhood stroll? A massage?

The path forward is not utopian. It is ancestral. And it is already here—in the evidence, in the traditions, in the collective memory of what it means to be well.

But America’s public health infrastructure tells a different story. Our system is built around acute illness, not chronic care. Prevention is underfunded, underprioritized, and often inaccessible. Patients see doctors when they are already sick, not to stay healthy—largely because our healthcare system is expensive, insurance-driven, and commodified. In a model where patients self-pay or navigate high deductibles, routine care becomes a luxury, and maintenance is deferred until crisis.

The cultural roots of this failure are just as significant. The same toxic individualism that shames people for their health conditions also undermines collective action. During the COVID-19 pandemic, countries like South Korea and Taiwan saw significantly better outcomes—not just because of better public health infrastructure, but because of stronger collectivist values that prioritized mutual care, compliance, and rapid response. In contrast, the U.S. response was fractured by political polarization, mistrust of experts, and resistance to even minor behavioral change in service of the common good.

A system that medicalizes illness but marginalizes prevention is not broken by accident—it was built this way. The call to treat healthiness as treatment is not a substitute for healthcare access—and not just about individual behavior change. It is a call to change the culture that surrounds medicine, the incentives that shape care, and the policies that determine who thrives and who falls through the cracks.

The more we recognize that, the more humane and effective—and collective—our models of care will become.