What Lifestyle Medicine Gets Wrong: You’re Not Fully in Control
We’ve all heard the advice: Eat healthy. Move your body. Get sleep. Manage stress. Do these things, and you can supposedly prevent—or even reverse—almost any health condition.
But what if you’re doing all of that, and you're still struggling?
I’m Dr. Rebecca Berens, family physician and founder of Vida Family Medicine. In this post, I want to explore what lifestyle medicine often overlooks: the role of genetics, environment, and why blaming yourself for your health challenges isn’t just unhelpful—it can be actively harmful.
Let’s reframe this with real science and compassion.
You’re Doing Everything “Right”—But Still Struggling
Many of my patients work hard to make healthy lifestyle choices. They eat nutritious foods, exercise regularly, manage stress, and try to sleep well. And yet, they still struggle with high blood pressure, high cholesterol, or blood sugar issues.
When that happens, they often feel like they’ve failed.
And it gets worse when they hear messages like, “You just need to try harder” or “You can reverse this without medication.” These narratives imply that taking medication is a sign of weakness or failure.
That simply isn’t true.
What Lifestyle Medicine Often Misses
Health is complex. It's shaped not just by what you eat or how often you exercise—but also by:
Genetics and epigenetics
Exposure to infections
Socioeconomic status
Environmental conditions (like pollution or access to safe housing)
The built environment (such as whether your neighborhood is walkable)
These are not things you can fully control. And yet, they play a major role in your health outcomes.
For example, someone living in a car-dependent suburb may not have time to walk or exercise regularly because of long commutes, work, and caregiving responsibilities. Or someone living in the inner-city or a rural area may live in a food desert with limited access to affordable fresh produce.
Telling that person to simply “make better choices” ignores the reality of their situation.
Systemic Change Has the Biggest Impact
Some of the greatest improvements in human health haven’t come from individual behavior change—they’ve come from system-level interventions:
Clean water and sanitation
Vaccination campaigns
Improved food safety
Smoke-free public policies
These are not changes individuals could make alone—they required collective action, infrastructure, and policy changes.
Similarly, many people today face health challenges that can't be “fixed” with lifestyle alone. That’s where tools like medication, community support, and systemic improvements come in.
The Harm of Shame-Based Health Messaging
One of the most damaging outcomes of oversimplified lifestyle messaging is the shame and guilt people feel when they get sick.
They may think:
“Maybe I didn’t try hard enough.”
“Maybe I caused this.”
“If I was just more disciplined, I wouldn’t be in this situation.”
This mindset can damage self-esteem, increase anxiety, and even lead to disordered behaviors—like obsessively avoiding certain foods or skipping social events to maintain a “perfect” routine.
We have to stop promoting health in a way that erases the complexity of real life. It’s not all or nothing. You can live a full, meaningful life and take care of your health—even if that includes medication or less-than-perfect habits.
The Role of Your Doctor
Working with a compassionate, well-informed physician is key. A good doctor will:
Help you identify lifestyle changes that actually fit your life
Acknowledge what’s out of your control
Offer tools (like medication) without judgment
Walk with you as a partner in your health journey
At Vida Family Medicine, this is exactly what we do. We combine science-backed medicine with real-world compassion to help you find a path that works for you—without shame, rigidity, or unrealistic expectations.
Final Thoughts
Yes, healthy habits matter. Yes, lifestyle changes can be powerful. But they are not the only factor—and they are not a moral obligation.
You’re not a failure if your health isn’t perfect. You deserve care that sees the full picture—and supports you with evidence-based tools, not guilt trips.
If you’re tired of oversimplified wellness advice and want thoughtful, personalized care, we’re here to help.
Need a physician who understands nuance?
Schedule a visit with Vida Family Medicine to get judgment-free support for your health journey.
📞 Call the office or schedule online at www.vidafamilymed.com
Want to Learn More? Watch the Full Video
In this video, I break down what lifestyle medicine often overlooks—and how to approach your health with more compassion and less pressure.
👉 Watch the full video here: What Lifestyle Medicine Gets Wrong: You’re Not Fully in Control
Don’t forget to subscribe to the Vida Family Medicine YouTube channel for more empowering, evidence-based health content.
