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Objective To evaluate the effectiveness of a multidisciplinary, nonpharmacological, integrative approach that uses shared medical appointments to improve health-related quality of life and reduce opioid medication use in patients with chronic pain. Design This is a retrospective, pre–post review of “Living Well with Chronic Pain” shared medical appointments (August 2016 through May 2018). Setting The appointments included eight 3-hour-long visits held once per week at an outpatient wellness facility. Subjects Patients with chronic, non–cancer-related pain. Methods Patients received evaluation and evidence-based therapies from a team of integrative and lifestyle medicine professionals, as well as education about nonpharmacological therapeutic approaches, the etiology of pain, and the relationship of pain to lifestyle factors. Experiential elements focused on the relaxation techniques of meditation, yoga, breathing, and hypnotherapy, while patients also received acupuncture, acupressure, massage, cognitive behavioral therapy, and chiropractic education. Patients self-reported data via the Patient-Reported Outcomes Measurement Information System (PROMIS-57) standardized questionnaire. Use of opioid medications was evaluated in morphine milligram equivalents. Results A total of 178 participants completed the PROMIS-57 questionnaire at the first and the last visits. Statistically significant improvements in all domains (Physical Functioning, Anxiety, Depression, Fatigue, Social Roles, Pain Interference, and Sleep Disturbance) were observed (P

Healthy lifestyle modifications, including weight management, regular physical activity, prudent diet, and stress relief, have been identified as key components of tertiary cancer prevention. In this study, we evaluate the effectiveness of a comprehensive, lifestyle medicine intervention, Lifestyle 180Retrospective subgroup analysis of a clinical program.An outpatient medical facility.Lifestyle 180 participants with a diagnosis of past cancer.Sixty-four hours of intensive nutrition, culinary medicine, physical activity, and stress relief practices over a 6-month period, with 9- and 12-month follow-up.Pre-postanalysis (baseline vs. 12 months) included biometrics: weight, body mass index (BMI), waist circumference, and blood pressure; standard laboratory tests: lipids, C-reactive protein, fasting insulin/glucose, and insulin resistance; and empirically validated questionnaires: perceived stress, depression, and quality of life.Fifty-eight cancer survivors participated in Lifestyle 180. Average age was 63 years, roughly 75% of participants were female, and the greatest majority had a diagnosis of breast, prostate, or skin cancer. Diagnosis of hyperlipidemia, hypertension, diabetes, and prediabetes presented in 47%, 57%, 22%, and 50% of patients, respectively. Forty-five percent of patients were obese, 24% were overweight, and 16% were depressed. At 12 months, participants lost an average of 14 pounds (-6.6%, p 0.001) and 2.6 inches off their waist (-5.9%, p 0.001). BMI decreased significantly by an average of 2.4 kg/mCancer survivors participating in a comprehensive intervention could employ the prescribed lifestyle modifications to produce clinically relevant health and quality-of-life benefits. These data support the American Cancer Society (ACS) and American Society of Clinical Oncology (ASCO) recommendations to incorporate healthy lifestyle modifications into long-term cancer survivorship care.

Although yoga may help manage conditions comorbid with overweight and obesity, such as low back pain, whether yoga helps with weight loss or maintenance beyond that which can be achieved with diet and exercise remains unclear. A search of multiple databases through September 2012 was undertaken identifying peer-reviewed studies on yoga, meditation, mindfulness, obesity, and overweight. Studies on yoga and weight loss are challenged by small sample sizes, short durations, and lack of control groups. In addition, there is little consistency in terms of duration of formal group yoga practice sessions, duration of informal practices at home, and frequency of both. Studies do however suggest that yoga may be associated with weight loss or maintenance. Mechanisms by which yoga may assist with weight loss or maintenance include the following: (a) energy expenditure during yoga sessions; (b) allowing for additional exercise outside yoga sessions by reducing back and joint pain; (c) heightening mindfulness, improving mood, and reducing stress, which may help reduce food intake; and (d) allowing individuals to feel more connected to their bodies, leading to enhanced awareness of satiety and the discomfort of overeating. Thus, yoga appears promising as a way to assist with behavioral change, weight loss, and maintenance.