Meaning, Purpose, and Spirituality in the Clinical Practice of Lifestyle Medicine.

Résumé

BACKGROUND: Meaning, purpose, and spirituality (MPS) are central to human experience and closely linked to health behaviors, well-being, and clinical outcomes. Despite strong evidence and growing policy support, MPS remains underutilized in routine care. It is vital to the practice of whole-person lifestyle medicine (WPLM), where sustained behavior change depends on deeply held motivations.OBJECTIVE: To synthesize current evidence and expert consensus from a national MPS summit and translate it into practical guidance for integrating MPS into WPLM clinical practice.APPROACH: We summarize evidence for MPS as a driver of health, review definitions, and propose clinically feasible workflows, interprofessional team roles, and implementation tools (e.g., HOPE Note/PHI, FICA, HOPE, CLEAR). We outline community partnerships, documentation practices, and referral pathways, and address policy and payment environments that enable scalable, equitable adoption.FINDINGS: MPS-informed care strengthens therapeutic alliance, resilience, adherence, and patient satisfaction; aligns lifestyle goals with "what matters" to the patient; and fits naturally within team-based, whole-person models. Brief structured or conversational assessments can be embedded in intake, follow-up, and transitions, while documentation and huddles propagate insights across teams. Group medical visits and links to community programs extend continuity and belonging. Payment alignment (e.g., group visits, coaching, value-based models) and fit-for-purpose metrics are pivotal for scale. The six-pillar framework of lifestyle medicine (LM) has not previously included spirituality, but recent revisions now allow for initial integration of MPS and progress toward a more complete WPLM.CONCLUSIONS: Integrating MPS is not an optional add-on but a foundational component of quality WPLM practice. Clinicians can begin with small, repeatable steps-brief inquiry, purposeful documentation, warm referrals-while systems pursue policy, payment, and measurement alignment.IMPLICATIONS FOR PRACTICE AND RESEARCH: Priorities include establishing standardized, functionally accurate definitions; incorporating MPS components into clinical LM frameworks; conducting implementation studies across settings and populations; developing acceptable accountability metrics; and evaluating effects on clinician well-being.