The Importance of Health Coaches in Combating Chronic Disease

on November 29, 2017 by Chris Kresser

Whether you’re considering becoming a health coach or are a practitioner feeling overwhelmed with helping patients make lifestyle changes, this article is for you. Read on to learn why health coaches are essential to combating the epidemic of chronic disease that we face today.

With chronic disease on the rise, we simply can’t afford to continue doing the same thing over and over again. In my new book, Unconventional Medicine, I outline a new model of healthcare—one that relies heavily on allied providers like health coaches working alongside clinicians.

Health coaches are an incredible asset to any clinical practice and are an underutilized sector of the healthcare system. Health coaches support patients in making lasting diet, lifestyle, and behavior changes, free up physician time, and improve patient outcomes. From the health coach’s perspective, working collaboratively with doctors offers them a clear treatment plan and a meaningful and rewarding way to make a living. This article will discuss all of these topics and highlight the essential role that health coaches play in battling the chronic disease epidemic.

The ever-rising tide of chronic disease

When the conventional model of medicine was born, the primary causes of disease were acute infectious diseases: tuberculosis, typhoid, and pneumonia. The “one doctor, one cause, one treatment” paradigm was effective at restoring health.

Today, seven of ten deaths in the United States are caused by chronic disease (1). Consider the following statistics:

  • One in two Americans has a chronic disease; one in four has multiple chronic diseases (2)
  • 27% of children in the United States now have chronic disease (up from 13% in 1994) (3)
  • By 2030, chronic disease will account for $47 trillion in healthcare expenditures (4)

Moreover, chronic diseases are often multifactorial—the result of a complex interaction between genetic predisposition and several environmental factors. As of 2016, an estimated 85 percent of chronic disease can be explained by factors other than genetics (5).

Bad behaviors and the need for change

It’s evident that chronic disease is the single biggest threat to our health today. Moreover, it’s behavior change that is really needed to prevent and reverse chronic disease.

According to the CDC, the top five behaviors for preventing chronic disease include not smoking, getting regular physical activity, consuming moderate amounts of alcohol or none at all, maintaining a normal body weight, and obtaining daily sufficient sleep. Yet as of 2013, only 6.3 percent of Americans engage in all five of these health-promoting behaviors (6).

Why do only 6.3% of Americans engage in all top five healthy behaviors?

The reality is that behavior change is hard, and most people don’t know how to do it successfully. Everyone wants to get the most out of life. Everyone knows that eating junk food, remaining sedentary, and staying up all night aren’t good for them. Yet most people continue these behaviors anyway. They might try a drastic diet or exercise regimen, but these often aren’t sustainable in the long term. People need help making lifestyle habits that stick.

Physicians lack the time and training to implement behavior change

What about physicians? Can’t they help with behavior change? Unlikely. The average visit with a primary care physician lasts a meager 10 to 12 minutes—barely enough time to review the patient’s current medications, ask them about any new symptoms, and prescribe a new drug (7). It’s not even close to the amount of time necessary to assess their diet, behavior, and lifestyle; identify areas for improvement; and provide the support necessary for sustaining these changes. Even a Functional Medicine practitioner, who might spend 30 to 60 minutes with a patient, will be hard-pressed to instill lasting behavior change.

Moreover, most doctors, nurses, and physician assistants aren’t trained in behavior change. Instead, they are trained in the “expert” model of care, where they simply tell patients what to do and expect them to do it. This works when the patient is facing an acute health issue, but it fails miserably for long-term behavioral changes like managing stress, starting an exercise routine, or losing weight. For most people, information itself does not change behavior. Behavior change happens at home, not in the clinic.

Lastly, we simply don’t have enough physicians to make it happen. It’s estimated that we will have a shortage of 52,000 primary care physicians (PCPs) by the year 2025 (8). We’ll need PCPs to be focused on interpreting lab results, making diagnoses, and recommending treatment plans, not on primary prevention habits.

The role of health coaches

This is where health coaches come in. A recent review defined health coaching as “a client- or patient-centered process that assumes a working relationship/partnership develops between patient and [coach] to advance healthy lifestyle behavior change using tools such as nonjudgmental dialogue, goal setting, and accountability” (9).

In other words, health coaches can spend more time with the patient, walking them through ways to make behavioral changes last, and are often specifically trained in techniques like:

  • Habit formation and reversal. Since only 6 percent of people engage in the top five health behaviors, reversing bad habits like smoking and forming new habits like eating well and getting enough sleep are the key to reversing chronic disease.
  • Motivational interviewing, which encourages patients to link new behavior changes to their deepest needs and goals (for example: “I will change my diet and lifestyle because I want to live to see my grandchildren get married”).
  • Positive psychology, which uses the patient’s strengths, rather than their weaknesses, to make behavior changes

Ultimately, coaches act as allies, helping the patient to build confidence and self-awareness, encouraging them to become their own health advocate, and supporting them in developing the skills to sustain new behaviors.

Plus, studies consistently find that health coaches improve patient outcomes and patient satisfaction. One systematic review concluded that health coaching was effective for patients with cancer, diabetes, obesity, and heart disease (9). These are some of the top chronic diseases plaguing our nation. Can you imagine how much healthier we would be as a population if everyone was able to see a health coach once a week?

The perks of becoming a health coach

Now that we’ve discussed the benefits of the collaborative model for physicians and patients, let’s talk about the benefits for health coaches.

A clear treatment plan: while many health coaches can successfully work independently, working within a Functional Medicine practice enables the coach to be part of a care team that includes licensed clinicians and other allied health professionals. The combination of Functional Medicine diagnostic and treatment strategies with health coaching and nutritional support is the most successful approach when it comes to treating chronic disease.

Low barriers to entry: it’s much easier to become a health coach than to become a doctor, physician assistant, or nurse practitioner. While there are certainly benefits from having a medical license, health coaching is an excellent opportunity for those who want to help reinvent the healthcare system but aren’t necessarily science savvy or ready to spend four or more years in intensive graduate school.

The ability to make a difference: the first generation that is not expected to outlive their parents has just been born. Instilling lasting behavior change using evidence-based methods and witnessing patients rediscover their health and vitality is extremely rewarding. Health coaches can truly feel as though they are tackling the chronic disease epidemic, one patient at a time.

There’s no question in my mind that health coaching will play a vital role in the future of medicine. Given this, we’ll need millions of new health coaches with the skills and knowledge that I’ve outlined in this article. That’s why I’ve been working so hard over the past year to create the ADAPT Health Coach Training Program. It will offer training in core coaching skills, ancestral diet and lifestyle, and a collaborative practice model that links licensed clinicians with health coaches to provide the highest level of care for patients. We’ll be starting enrollment in April and beginning the course in June. Stay tuned for an announcement with more details (make sure to sign up here to receive notifications about this program).

Now I’d like to hear from you. Are you a health coach or thinking of becoming a health coach? If you’re a physician, will you integrate health coaches into your practice? Start the discussion in the comments below!

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  1. This is the news I’ve been waiting for!! It has been plan to start a health coaching certification program at the beginning of 2018, and ever since I found out that you’re planning to launch a program in the early part of the year, I’ve been waiting wth baited breath to hear more details! I’ve researched all the available programs and after listening to your podcast, reading your books and devouring all your website has to offer, I know your program will be exactly what I’ve been searching for. I cannot wait to hear more details and hopefully get signed up ASAP!!

  2. Hi Chris,

    I have been a follower of yours for years. I opted out of conventional medicine 4 years ago while dealing with chronic colitis. Moon face and a colostomy bag were not attractive options for me. It took 2 years of heavy metal detox, food eliminations and dialing in my sleep and stress. I am happy to say I have not had a flare up in 2 years. After years of doing my own research and following experts such as yourself, I decided to embark on a new career path.

    I attended the Nutritional Therapy Association and became a certified NTP this past June. I launched my practice The Feeling Groovy Project. My target market are women over 40 who fell victim to conventional wisdom and are now paying the price. My goal is to become more informed in supporting women with autoimmune issues. Currently, I am working one on one with clients while still working my full time job. I am not sure how best to make the financial leap to full time NTP/Health Coach, which is my goal. I am thinking I will need to partner with a functional practitioner at some point. I look forward to learning more about your programs.

    Thanks for all you do!
    Amanda Chocko

  3. I am a registre holistic nutritionniste (RHN) and am considering of getting certified as a health coach. However I live in Canada and am wondering if health coaches have as much of a chance to be accepted by the medical community ? Are we there yet ? I don’t have the answer because most research comes from the U.S.

  4. Love this article! I’ve been a personal trainer and almost done with school as a healthy lifestyle coach. Behavior change is much more complicated that one thinks and does require lots of teaching. It’s so hard to find a job that will incorporate healing not just using the band aid approach. It’d be amazing for more physicians to get on board with this idea!

  5. Nice article, much inline with my reading from books like “Switch” and “Mindless Eating”.

    I’ve been an online Health Coach for a few years now, on a very small scale (by choice). My most recent certification was offered by a company called Precision Nutrition. It’s an excellent Coaching program; very-much a “small habits” belief system for creating sustainable change.

    Change and Behavior coaching will be covered in the ADAPT Health Coach Training Program (AHCTP). instruction model. Also, with AHCTP, there will be a narrow focus on a shingle way of eating. With Precision Nutrition, practically all diets known to man were part of the training. You become a “jack of all trades” so to speak, but expert in none.

    My preference is to focus on a single way of eating; one that’s been proven to improve a large number of people’s looks and health. With the ADAPT Health Coach Training Program, students will focus mainly on the Paleo template / way of eating. That’s it.
    .
    I’m glad that I’ve had limited exposure to other meal plan and nutrition designs. But trying to settle on a single action plan, “system design for coaching” is impossible when it’s parameters and guidelines become stretched and overlapping at times in all directions.

    It’s inevitable, sooner or later all coaches develop a “niche”. When it comes to training vs earning, I believe “sooner” outweighs “later”.

  6. Chris,

    I love your work and have read your books. I currently work with 9 clients I have acquired through results and word of mouth over the last 12 months. I have also begun to work with one functional medicine doctor to help support his practice out of the office. Interested to learn more about your program.

    Thanks,
    Dave

  7. Hi Chris,
    As a health coach, of course I love this article! Thank you for the clarity defining the place for health coaches in health care. I’m excited to hear about your ADAPT coach training program. I’m hoping that you might create a version for certified coaches that have already invested heavily in their training and just need to build expertise in theories/areas to support a patient/client addressing health via Functional Medicine… that would be me!
    Thank you for all the good you are doing for so many!

  8. I’m extremely interested in becoming a health coach for a variety of reasons. I have a background in Occupational Therapy and will soon be qualified with a parent coaching license. Until recently, after having listened to your podcasts and reading your information, I never knew that a health coach was a job opportunity. The possibility of being able to combine this knowledge with my other certifications is extremely appealing. Even more so if there’s opportunity to turn it into a future viable career with the prospect of being self employed. I love the opportunity the role provides to support others in making healthy choices and hope to pursue this in the near future.

  9. I was a nurse (many moons ago) and am currently studying nutritional therapy.
    The health coaching courses out there FMCA (IFM) and IIN – are just way too expensive – however they do offer certification.

  10. Great article. Simple question: Where do I start? I am not a health professional and will be starting from scratch, more or less. Which programs, if any, can you recommend? I’ve been doing the research, but it is hard to find a path forward, especially in the online realm. I’m willing to put in the time and money. The question is: Where?

  11. As a health coach in the cancer realm…. I just want to say THANK YOU. When we finally get the NDs on board (it’s mostly NDs….still working on the MDs) they are very happy to see how compliant patients stay, how far the patients get, and that it’s done with greater ease.

  12. Hi Chris,
    I am seriously considering becoming a Health Coach. I have read your book and agree 100% with the content. BYW, in your references to Health Coach you refer to “she”. I would assume you would also think males would make good Health Coaches also? :-).

    I am 60 year old male and wanted to know you thoughts on Coaching others in the same age group, especially the ones that have been living the standard western diet for decades and are now have many chronic health issues.

    Thanks for writing this book and all that you do.

  13. Hi Chris! Yes, I’m becoming a health coach. Have listened to your podcasts and followed you for 6 or 7 yrs. Discovered you thru Robb Wolf 🙂 I earned my Primal Health Coach Certification this summer via Mark Sisson. Have been working full time in real estate for 17 months but plan to wrap that up next Spring/Summer. I am VERY INTERESTED in your ADAPT Health Coach Training Program. I’m almost finished listening to your latest book UNCONVENTIONAL MEDICINE…TERRIFIC! Thank you for all you have & are doing!

  14. I’m considering becoming a health coach but I just want to be sure there are opportunities in my area outside of owning my own business. Thanks for the info, I will sign up to receive info in the future 🙂

  15. Hi Chris,
    Thanks so much for all the work you are doing. You are truly an innovator. I’m a Health Coach but have been reluctant to start a business due to the lack of clarity around licensure. I’m excited to learn more about your course as you usually cover all the practicalities along with the academics.
    Wishing you all the very best and supporting you in your great work,
    Theresa

  16. Hi Chris and any Australian physicians/clinicians reading,
    Further to reading ‘Unconventional Medicine’ and listening to myriad podcasts and interviews with you, this article really drives home the role of health coaches in ‘battling the chronic disease epidemic.’ Thank you.
    Having researched different courses for some time now, I’m convinced the ADAPT Health Coach Training Program is the one for me. However, I have a logistical question about the program. I live in Australia, and assume I can still participate in the course(?). Will the coaching in the collaborative practice model that links licensed clinicians with health coaches be relevant in the Australian context? Certainly Australia also has soaring rates of chronic disease (for the same reasons, requiring the same behaviour change), but will your certification be ‘recognised’ by licenced clinicians/physicians in Australia?
    Many thanks,
    Jacki

    • Yes, our HCTP will be online and open to international students. All sessions will be recorded so you can access them at your convenience in the event you are unable to attend live webinars and calls. It is our belief that the collaborative practice model can – and will – be employed around the globe and our program will provide networking opportunities for coaches to team up with practitioners. One of the many benefits of becoming a health coach is that coaching sessions can be held virtually, removing location as an obstacle. As you know, Chris is a widely-recognized expert and thought leader in Functional Medicine and has trained over 400 practitioners though his ADAPT Practitioner Training Program. We have no doubt that our HCTP graduates will be highly sought-after health coaches.

  17. As a pharmacist I think this would be sooo helpful to have under my tool belt. I would be better able to help my patients

  18. Dear Chris,

    Just a quick note to say how much I’m enjoying your emails, blog posts and various forms and sources of information and ideas. Your approach to your work and life (to me summed up succinctly in your two sentence profile descript above) is something I both admire and aspire to.

    Cheers,
    Michaela

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