What Is an “Exercise Prescription” and How Can It Work for You?

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Exercise can help prevent or treat dozens of diseases. A doctor’s ‘prescription’ for exercise can help patients meet their goals.

Exercise is strongly recommended as an essential part of treating or preventing dozens of physical and mental health conditions by major health organizations, including the Centers for Disease Control (CDC), the World Health Organization, and the American Heart Association.

It is such an essential tool in promoting health that the American College of Sports Medicine (ACSM) advocates treating physical activity as a vital sign at each medical visit. Although some doctors have started to evaluate their patients’ physical activity levels and provide individualized “exercise prescriptions,” most have yet to adopt this practice. Here’s why they should.

Move More, Live Better

Among the few major modifiable risk factors for chronic disease outlined by the CDC—such as smoking, poor nutrition, inactivity, and excessive alcohol consumption—inactivity may be the one to get the least attention. But it shouldn’t.

Physical inactivity is a significant risk factor for many serious health problems, including Type 2 diabetes, obesity, cardiovascular disease, high blood pressure, anxiety, depression, and numerous cancers. Increasing one’s fitness level can effectively reduce the risk of each of these conditions and yield “side benefits” like improved sleep quality, memory, and cognitive skills.

“As a spine and pain management doctor, I see every day how powerful exercise can be for my patients,” Dr. Taher Saifullah, double board-certified in anesthesiology and pain medicine and founder of the Spine & Pain Institute in Los Angeles, told The Epoch Times. “Whether it’s managing chronic pain, recovering from an injury, or simply staying healthy, regular physical activity often makes a world of difference.”

A review article published in the Primary Care: Clinics in Office Practice journal points out that physical inactivity (not obesity) was the fourth leading cause of death globally in 2013. Also, a 2016 research article published in Circulation noted that low cardiorespiratory fitness, the ability of an individual’s cardiovascular and respiratory systems to supply oxygen to cells, “is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus.” Other experts have identified physical inactivity as “the biggest public health problem of the 21st century.”

The Power of Exercise, Prescribed

While Western medicine tends to favor a pharmacological approach to treating chronic conditions, incorporating exercise as both a preventive tool and a part of treatment plans is low-risk, inexpensive, and effective.

The ACSM and the American Medical Association launched the “Exercise is Medicine“ initiative in 2007, intending to make ”physical activity assessment and promotion a standard in clinical care.“ The ACSM recommends that physical activity be assessed as a vital sign, right alongside blood pressure and temperature, at every patient visit and that health care providers ”provide brief advice/counseling (or an exercise prescription)“ and ”refer the patient to appropriate physical activity resources (programs, professionals, facilities).”

“The idea of an ‘exercise prescription’ (ExRx)—where doctors formally prescribe exercise like they would medication—is a growing trend,” Saifullah said. “It’s rooted in solid research showing how effective exercise is for preventing and treating a huge range of conditions.”

The ACSM (and others) also offers resources to help primary care physicians encourage their patients to effectively incorporate more physical activity into their daily routines. They provide guidance on assessing a patient’s level of physical activity and risk factors, choosing an appropriate exercise prescription, and making a plan for reevaluation at follow-up.

Barriers to Exercise Prescription

Despite growing awareness of the health benefits of exercise and the dangers of inactivity, many physicians do not ask their patients about their levels of physical activity or encourage behavioral change in this area. There may be several reasons for this.

For one, a 2015 review of medical education curricula taught in the United States found that over half of the doctors trained in the country received no formal exercise-related education, so they may feel unprepared to counsel patients on the subject.

“Most doctors don’t write exercise prescriptions because of time constraints, lack of training in exercise science, and a focus on medication-based treatments,” Saifullah said. “To write a true exercise prescription, you have to assess the patient’s current physical state, design a safe and effective plan, and monitor their progress over time—all of which takes more time than just recommending a pill.”

Also, several studies have found a correlation between the personal exercise practices of health care providers and their willingness to counsel their patients about exercise. Those who were more physically active themselves were more likely to encourage their patients to exercise. Yet 40 percent of primary care doctors in the United States do not meet physical activity recommendations themselves.

The Doctor Will See You Now–for a Walk

Some physicians, however, like Dr. David Sabgir, a cardiologist in Ohio, have taken a creative approach to this problem and are exercising with their patients.

Sabgir, frustrated by his inability to affect behavioral change within a clinical setting, invited his patients to meet him in a local park for a walk. To his surprise, many patients showed up, and “Walk with a Doc“ was formed, which now includes hundreds of chapters worldwide.

It involves a doctor giving a short talk on a health topic and then taking participants on a leisurely walk at their own pace.

How to Get an Exercise Prescription

Changing established behaviors with regard to exercise can be difficult. Still, there is evidence that primary care providers talking to their patients about physical activity and giving them an ExRx yields positive results. “When exercise is given the same level of attention as a medication prescription, patients tend to take it more seriously,” said Saifullah. “They’re more likely to follow through on exercise when it’s treated as a specific plan they need to follow.”

Many patients do want the support of their doctor. Australian writer Stacey Harder shared her personal experience with The Epoch Times. “As someone who has struggled with weight loss for years, I’ve often been told by doctors to lose weight, but without practical, personalized guidance, it feels more like a vague suggestion than a supported health goal. … For those of us facing health risks associated with obesity—like heart disease and diabetes—the added layer of partnership with a physician could make all the difference.”

It’s worth doing a little research to see if your insurance plan offers any discount toward gym memberships or workout programs. Patients are not aware of them. Also, health savings accounts (HSAs) or flexible savings accounts (FSAs), which are tax-advantaged financial accounts, can be used for wellness-related expenses, including exercise programs or equipment. If a patient obtains a Letter of Medical Necessity (LMN) from their physician stating that an exercise program (or product) is a necessary part of the treatment or prevention plan for their specific condition, it may be possible to use HSA or FSA funds to pay for it.

Patients may not be aware that they can actually request an exercise prescription from their doctor. “Patients can and should ask for an exercise prescription if they’re interested,” Saifullah said. They “can ask for a specific plan or to be referred to someone who specializes in exercise-based treatment, like a physical therapist or exercise physiologist,” he noted. “Patients and doctors alike should feel empowered to explore ExRx as an option, as it could be an incredibly valuable part of both preventive and therapeutic care.”