NEW YORK, January 13, 2025–(BUSINESS WIRE)–Recent findings from researchers at the Hospital for Special Surgery (HSS) indicate that comprehensive lifestyle medicine strategies, encompassing diet and physical activity, are exceptionally effective in enhancing patient health prior to elective orthopedic procedures.
The research, initially released online on May 16 in the American Journal of Lifestyle Medicine, detailed preliminary results for 54 individuals who participated in the HSS Lifestyle Medicine Program from March 2022 to December 2023. Nearly 90% of participants had two or more lifestyle-associated chronic illnesses. Almost all, 96%, successfully accomplished their health improvement targets prior to elective orthopedic surgery.
HSS orthopedic surgeons identify those at heightened risk for surgical complications and unfavorable outcomes due to lifestyle-related chronic conditions, such as obesity, type 2 diabetes, heart disease, metabolic disorders, and negative lifestyle habits including smoking, and subsequently refer them to the program. These conditions are known to correlate with extended hospital stays, heightened complications, increased rates of early surgical revision, and elevated readmission rates.
The HSS Lifestyle Medicine Program assists individuals in either enhancing their health prior to an upcoming elective procedure or becoming eligible for a surgery they were previously unable to schedule due to the seriousness of their chronic conditions. Participants collaborate with a multidisciplinary team to set personal objectives aimed at improving their pain, functionality, sleep, and overall wellness.
Among the 54 individuals, 41 had surgical dates already established, with 93% improving their health and undergoing surgery as planned. For the cohort of 13 individuals who were referred to the program to enhance their health before reevaluation for surgical eligibility, 85% were able to move forward with surgery. In total, 91% of participants underwent surgery following their enrollment in the program.
“We were astonished by how swiftly patients could implement lifestyle modifications,” commented HSS physiatrist Heidi Prather, DO, founder and Medical Director of the HSS Lifestyle Medicine Program and a Diplomat of the American Board of Lifestyle Medicine. “Transformations are truly challenging, so the success of our rigorous program in yielding such remarkable results is remarkable. We believe that reaching these personal health objectives will result in better post-surgical outcomes.”
“We employ motivational interviewing techniques to grasp patients’ unique health enhancement aspirations,” Dr. Prather stated. “The majority of individuals exhibit a strong desire to initiate changes and willingly participate in the program after recognizing that their pain and functional mobility challenges are connected to or aggravated by chronic diseases and lifestyle decisions.”
The comprehensive program centers on the “six pillars of lifestyle medicine,” which consist of consuming a whole-food, plant-focused diet; sustaining physical activity; practicing healthy sleep habits; managing stress; fostering positive social connections; and refraining from or limiting tobacco and alcohol. It is primarily conducted online over approximately three months.
Every participant receives a tailored plan based on their specific goals. A dedicated scheduler assists with appointment bookings, while a care navigator helps facilitate communication with program team members. The HSS multidisciplinary Lifestyle Medicine Team includes a physiatrist and nurse practitioner, both Diplomats of the American Board of Lifestyle Medicine, as well as an endocrinologist, nutritionist, health coach, exercise physiologist, physical therapist, and advanced practice providers specializing in smoking cessation.
Nearly 90% of participants suffered from two or more lifestyle-related chronic illnesses; 79% endured poor sleep quality; and 57% recorded zero total minutes of weekly physical activity. Most study subjects dealt with obesity, holding an average body mass index (BMI) of 43.2 kg/m2.
Overall, 42 participants (72%) shed weight and lowered their BMIs, albeit modestly: the average weight reduction was 11 pounds, while the average BMI decrease was 1.8 kg/m2.
“Addressing obesity is crucial for numerous patients, yet our program is not solely focused on weight loss. There is no singular weight-loss target to mitigate chronic disease risk,” Dr. Prather stated. “Instead, we emphasize reducing systemic inflammation through the six pillars of lifestyle medicine. Change is our key focus. Even a slight weight decrease, such as five pounds, accompanied by enhancements in sleep, physical activity, and diabetes management, can yield better surgical results.”
Participants in the study also indicated enhancements in pain levels, physical and mental wellness, along with scores for anxiety and depression.
“We are continually gathering information to assess the effect of the program on patient well-being, reduction in surgical risks, functional outcomes, patient satisfaction, and long-term results associated with the adoption of healthier lifestyle changes,” stated Dr. Prather. The team is also investigating innovative methods to make lifestyle-oriented strategies more attractive and attainable. For instance, later this year, participants in the HSS program will have the opportunity to join live online cooking demonstrations led by nutritional chef Caryn Dugan, a new consulting member of the HSS team and the founder of the Center for Plant-Based Living.
About HSS HSS stands as the premier academic medical institution worldwide dedicated to musculoskeletal health. Its foundation is the Hospital for Special Surgery, which has maintained a national ranking as No. 1 in orthopedics (for the 15th consecutive year), No. 3 in rheumatology by U.S. News & World Report (2024-2025), and recognized as the best pediatric orthopedic facility in NY, NJ, and CT by U.S. News & World Report’s “Best Children’s Hospitals” list (2023-2024). A survey conducted by Newsweek, involving medical experts from over 20 nations, ranks HSS as the world’s top institution in orthopedics for a fifth consecutive year (2025). Established in 1863, the Hospital showcases the lowest readmission rates in the country for orthopedic care, along with some of the lowest rates for infections and complications. HSS was the first institution in New York State to achieve Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center for five successive cycles. As an affiliate of Weill Cornell Medical College, HSS has its primary campus in New York City and other facilities in New Jersey, Connecticut, and the Long Island and Westchester County regions of New York State, as well as in Florida. Beyond patient care, HSS leads the realm of musculoskeletal health by excelling in research, innovation, and education. The HSS Research Institute encompasses 20 laboratories and 300 personnel dedicated to driving advancements in musculoskeletal health through the prevention of degeneration, tissue repair, and regeneration. Additionally, over 200 clinical researchers at HSS strive to enhance patient outcomes by devising better methods to prevent, diagnose, and manage orthopedic, rheumatic, and musculoskeletal disorders. The HSS Innovation Institute aims to unlock the potential of new pharmaceuticals, therapies, and devices. The HSS Education Institute is a recognized authority in advancing knowledge and research on musculoskeletal health for healthcare providers, including physicians, nurses, allied health professionals, academic trainees, and consumers across more than 165 countries. The institution collaborates with medical centers and other organizations to enhance the quality and value of musculoskeletal care while making world-class HSS services more accessible both nationally and internationally. www.hss.edu.