Getting old is inevitable. Getting sick is not. 

There is a common misconception in our country that growing older is synonymous with growing sicker. As you age, you will get sick, and there is not much you can do about it. This belief is so entrenched in our collective consciousness that it’s hardly questioned.

It is not hard to understand why. The trajectory of chronic disease in the U.S. is grim, with 129 million adults already diagnosed with at least one major chronic disease. More than 40 percent of adults have at least two chronic diseases and an alarming 12 percent have at least five. Nearly 14 million Americans ages 65 and older are expected to be living with dementia by 2060. 

We’re a much sicker country than our high-income nation peers.

There are many reasons for this default condition of sickness. There is our food industry, laden with ultra-processed foods. There is our health care system, which traditionally rewards professionals for addressing the symptoms of disease (often with increasing quantities of costly pharmaceuticals and procedures) instead of their often lifestyle-related root causes.

As a result, physicians are untrained and too often unincentivized to help patients make evidence-based, sustainable lifestyle changes, even though most chronic disease clinical practice guidelines recommend lifestyle intervention as a first and optimal treatment option. The message does seem clear: “You will get sick.”

But what if that wasn’t the message? What if the message were instead that you are not automatically doomed to a future of sickness and suffering? That there are lifestyle behavior changes you can make right now that increase your ability to live not just longer, but with more vitality and less disease? 

What if the message was one of empowerment, that individuals can influence their health outcomes with informed choices and add life to years, not merely years to life?

It is true that our bodies change as we age, and that can make us more susceptible to illness and injury. But these changes do not necessarily lead to disease.

In fact, many of the diseases often associated with aging — heart disease, type 2 diabetes and certain cancers — are often related to unhealthy nutrition, lack of physical activity, unmanaged stress or use of risky substances. More than 90 percent of type 2 diabetes, 80 percent of coronary artery disease, 70 percent of stroke and 70 percent of colon cancer cases among U.S. adults have shown to be preventable by lifestyle modification.

We know that adults with strong social connections tend to experience lower rates of depression and cognitive decline. The practice of stress management methods, such as mindfulness, can significantly contribute to overall health. 

While there is no changing the genes we are born with, we can influence epigenetic changes in how those genes function through our everyday choices — what we eat, how we sleep, how we manage stress — in ways that can help treat or prevent certain diseases. Even small lifestyle changes can make a difference. 

But how often do you hear any of this during a routine doctor’s appointment?

Making sustainable lifestyle behavior changes is not easy. If it were, we may not find ourselves in this ugly epidemic of chronic disease. That’s why it is critical that patients have access to health care providers educated and trained to help them make evidence-based, sufficiently dosed lifestyle behavior changes (yes, lifestyle behavior change can be prescribed and dosed just like drug prescriptions). 

These providers are out there, and fortunately, their ranks are growing. There are now almost 6,700 physicians and health professionals certified in lifestyle medicine, a medical field that applies six pillars: a whole food, plant-predominant eating pattern, physical activity, restorative sleep, stress management, positive social connections and avoidance of risky substances. 

They have the knowledge and skills to coach patients using lifestyle medicine interventions and also help them devise strategies to overcome obstacles to their behavior change, such as food insecurity, lack of transportation or difficult working conditions.

In 2025, lifestyle medicine-certified clinicians can pursue recognition as either a Blue Zones Certified Physician or Healthcare Professional, a new designation that combines lifestyle medicine with the principles of Blue Zones, the well-known organization named for specific areas where people experience less disease and live longer lives. 

Lifestyle medicine is also increasingly being integrated into medical school curricula and residency programs to prepare future generations of physicians to incorporate lifestyle interventions into patient care.

With the population of adults ages 65 and older expected to surge from 58 million in 2020 to 82 million in 2050, the stakes are high. It’s time to challenge the notion that poor health is an inevitable consequence of aging. 

The choices you make today, tomorrow and throughout your life can help determine whether your future is marked by health and joy or sickness and suffering. That is a message we should all get behind so we may have the opportunity to live younger, longer, happier, healthier and cheaper.

Richard Carmona, MD, MPH, FACS, is a distinguished laureate professor at the University of Arizona and was the 17th U.S. surgeon general.