It’s a holiday week. We just wrapped three intense days at the American College of Lifestyle Medicine conference - 2,200 practitioners, researchers, and changemakers gathering around a board certification that could eliminate 60-70% of established chronic disease costs. The crowd was significantly larger than last year, which tells you something about momentum. But as always with healthcare transformation, the picture is complicated. We thought this video would be a fun during and after from the American College of Lifestyle Medicine Conference.
The Core Tension: Healthcare Can’t See Food (Unless It’s a Drug)
Our conversation with Dr. Sachin Jain crystallized something we’ve been wrestling with: it’s incredibly difficult to get our minds out of the economics of one industry versus the other and think about it as a system design challenge of chronic disease.
Healthcare wants to keep people sick - that’s how the engine runs. Food, on the other hand, is neutral. Food just wants to keep people happy and buying product. They don’t have a vested interest in whether you’re sick or healthy. If you could feed somebody the same calories in a much healthier configuration for the same amount of money, food wouldn’t care. They’d just redesign to match demand.
That’s why we increasingly believe food needs to lean into healthcare, not the other way around. There’s less friction. Food has less skin in the game of staying entrenched in the current system. Healthcare is reimbursed, it’s regulated - food’s not. You can change your diet tomorrow. Nobody’s going to step in and say that’s not allowed.
The Practitioner’s Dilemma: When the CEO Won’t Expand the Program
There was a revealing moment during Dr. Joseph’s keynote—the cardiologist who launched the lifestyle medicine program at St. Francis in Tulsa. Someone from the audience asked: “How did you get your CEO to buy into this?”
That question is endemic of what’s happening. The majority of lifestyle medicine assets today are those clinicians. About half are independent practitioners who could potentially deploy differently. The other half? They’re employed by incumbent legacy health systems operating under the current healthcare finance model. Systems that see lifestyle medicine like primary care—it doesn’t make money. It’s much better to do more joints, have more beds, deliver more acute care.
There’s still political discourse about how that program fits in. It was the perfect epitome of what we’re up against: over 2,000 people came together around something so simple in it’s delivery that could take 60-70% of chronic disease costs out of the system. Yet we still monetize sickness to keep the engine running.
Five Forces Converging (Finally)
Despite the friction, we see five powerful forces all moving toward transformation:
* The sickest patients on GLP-1s now generate less revenue for hospitals - the economic model cracking
* Patients without chronic disease are taking control - they’re avoiding the system entirely
* Geopolitical pressure - when you look at US and China, both spend heavily on healthcare and military. When GLP-1s go off patent in China in 2026, they can spend more on defense. The US government has interest in making Americans healthy from a national security standpoint
* Enhanced benefits and HSA funding potential - we posed the question of what happens if HSAs were well-funded, if there was more cash in consumers’ hands. That was a market force people hadn’t considered
* Next-generation GLP-1s and innovation in lifestyle medicine - from frontline practitioners creating new business models all the way to Washington
Lily Goes Direct: Getting Closer to the Signal
Since ACLM, Eli Lilly announced they’re going direct to corporations with GLP-1s -bypassing PBMs, bypassing the traditional systems. They’re getting closer to the consumer signal. And this matters because the disintermediation of healthcare - how we’ve disconnected people’s license to choose from the funding of it - has made it so that latent consumer demand can’t be felt. Those signals are getting lost.
Anyone who gets closer to the consumer has the opportunity to build a better product. If Lilly can integrate food and nutrition into their approach, if they’re delivering value to consumers while competition remains open - that’s productivity. That’s progress.
The consumer already sees food and healthcare as integrated. They’re spending on both. The rest of the system may not see it, but at the end of the day, it’s all integrated at the consumer level.
The Middle Ground We’re Missing
We kept coming back to this: there’s always going to be a need for acute care. But we don’t have the middle care figured out. The interventions that keep you from needing that expensive diagnostic panel to find something - or better yet, keep you from developing the condition in the first place.
Companies like L-Nutra with their fasting-mimicking diet (Prolon), the innovations happening at places like Eudemonia, the evidence around autophagy and cellular renewal—these are the middle-ground interventions we currently consider “woo-woo.” But they’re what keep you from sliding into System B. And the younger generation is willing to pay cash for them because they don’t expect much from traditional healthcare.
System C: Where Two Trains Need to Merge
We keep framing this as three systems:
* System A: Inherent health, food systems we were designed with
* System B: Our effort to scale food and the healthcare we needed because we were making people sick faster than we wanted them to die
* System C: What we need and are building - taking the best of A and B, getting back to human-based outcomes
The problem is we have two trains running—food running off one cliff, healthcare running off another. They need to come together, which is never easy. But if we focus on first-principle human-based outcomes and start working on those economic models, we’re looking at about a 20-year correction for a problem that took 50 years to create.
What We’re Taking Forward
The crowd at ACLM? Ninety percent are already converted. They’re the choir. Our job is to find the conductors - the people who have a place in actually transforming this system. We need to help Wall Street and capital providers understand that the merging of these trains is happening, whether the incumbents like it or not.
The forces at play here, the way we’ve lined up the world, the pressure from every tier - from frontline practitioners to Washington - it’s all moving in the direction of food itself becoming healthcare.
When we redesigned computers, the revolution came from outside - Gates, Jobs, the people IBM forgot. It’s often very difficult for insiders to drive transformation. But the ethical impact matters. Food has a responsibility to think about its off-target effects. Either they change what they do, or someone slightly outside sees the opportunity to fix it.
Our goal: Make sure the vision is clear. Make sure we bring the players to the same table. Make sure we create convenings and use cases. Make sure the capital’s there to fund what needs to happen next. That’s 2026. Game On.
