Lifestyle medicine in the workplace:  A critical art of a healthy life 

Patients spend about 2,000 hours a year working at their jobs. Failing to factor workplace barriers into a lifestyle medicine treatment plan is a missed opportunity, but there are questions clinicians can ask to spark those conversations.    

By Rich Safeer, MD, FACLM, FAAFP, DipABLM | Chief Medical Director of Employee Health and Well-being at Johns Hopkins Medicine 

November 13, 2025

You’ve trained in lifestyle medicine, even have a certificate, read a thing or two about coaching and maybe even attended a presentation or workshop. You feel ready to help whoever walks through your door with the benefits of healthy choices and a positive mindset. But let’s look at what you’re up against. 

You only see a patient once or twice a year–maybe more if you have a concierge practice–for 20 minutes or so per appointment. Your patient arrives at your office with a full childhood of experiences that shaped their mental health and their habits. Are you prepared to unwind more than a couple decades of their parents’, siblings’, teachers’ and friends’ influence on their health and happiness? People who spend more than 20 minutes with them at a time? 

Most likely your patient is also either coming from or going to their job from your office. Your patients spend almost 2,000 hours a year working. It’s not just the amount of time; it’s the co-workers, the manager, and the physical work environment that your patients are exposed to that shape their daily lifestyle behaviors.  

Your patients spend more waking hours working than doing anything else. If you’re not addressing your patient’s workday, then what are the chances you’ll be able to genuinely help your patients find a healthier path forward? 

Let’s look at some of the challenges your patients face in every category of lifestyle medicine in the workplace: 

• Physical activity – If your patient has a desk job, they aren’t likely moving. 

• Stress management – The majority of Americans rank their job as a top stressor. 

• Nutrition – What food options are available in the workplace? It’s easy for a busy employee to grab fast food for lunch. 

• Restorative sleep – About a 1/3 of Americans suffer from insomnia and one of the leading causes is stress.  It’s quite likely your patients are losing sleep over their job. 

• Connectedness – Record numbers of employees report feeling disconnected from their co-workers, and it’s not just those that work remotely. 
  
• Avoidance of risky substances – Although many employers offer services, such as an employee assistance program, to help with addictions, they are underutilized. Your patient’s job might be contributing to the reason why your employee is using a risky substance, or at least why it’s difficult to stop.  

There are several other workplace influences that may make it difficult for your patients to follow through on your carefully crafted plan to adopt a healthy lifestyle. 

1. Peer support – we’re greatly influenced by our friends and our co-workers. We’re likely to adopt similar eating and movement patterns. Our emotional state is also influenced by our co-workers. If your patient is having lunch or taking their breaks with co-workers who have unhealthy habits, it will be difficult to overcome their influence. 

2. Norms – groups of people, such as work teams, have accepted and expected behaviors.  For example, one team norm might be to eat lunch at one’s desk while working.  Another team might have the norm of eating lunch together outside. The results of these team norms are very different. One gets the benefit of nature and social connectedness, and the other doesn’t. It’s very difficult to act outside the norm as humans generally want to be accepted as part of group.  Even when we know the healthier choice, swimming upstream can be more than we can handle. 

3. Manager – the relationship with our manager is critical in our outlook. If our manager is supportive, considerate, and helps us grow, we will feel more relaxed and upbeat. When our manager is a role model of self-care during the workday, it’s more likely we’ll take similar steps to address our health during work. When our manager is a source of stress, it keeps us in a heightened state of alertness. After eight hours, that can be exhausting–enough to skip the gym but paradoxically keep us awake at night. 

1. Social climate – when your patients feel like they fit in or belong in their company, there is a generally positive outlook and feel they have a purpose, these are all ingredients to a happier workday. Happiness makes it easier to make healthy choices – plain and simple. 

While some ACLM clinicians work inside a company and can help the organizational strategy, more often ACLM clinicians see their employed patients in the exam room. When this is the case, three questions can help your patient navigate their workday with a healthier outcome: 

• How is your relationship with your manager? 

• What is the most difficult part of sticking with your healthy lifestyle plan during the workday? 

• Is there someone at work who is also trying to make healthier choices, and can you team up to support each other?  

Each of these questions can lead to a meaningful discussion that includes potential solutions. 

Why do you think heart attacks are more common on Monday mornings? Our workplace can have immediate and long-term consequences on our health, both good and bad. Jobs can bring friendships, joy, and fulfillment, but they can also bring stress, chronic disease, and an early death.ⁱ It doesn’t take much to step up your game and make a significantly greater impact on your patients. You just have to consider their job when addressing their health. 

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