Integrative Medicine Strategies for Changing Health Behaviors Support for Primary Care Ruth Q. Wolever, PhD a,b, *, Karen L. Caldwell, PhD c , Lindsey C. McKernan, PhD b,d , Marni G. Hillinger, MD d NEED FOR LIFESTYLE CHANGE An estimated 86% of US health care expenses are related to chronic diseases: type II diabetes, heart disease, stroke, and obesity, driven by unhealthy lifestyles. 1,2 Preven- tion and mitigation of these diseases involve cultivation of health through daily lifestyle Disclosure: See last page of article. a Department of Physical Medicine and Rehabilitation, Osher Center for Integrative Medicine at Vanderbilt, Vanderbilt University Medical Center, Vanderbilt University School of Nursing, 3401 West End Avenue, Suite 380, Nashville, TN 37203, USA; b Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; c Department of Human Development and Psychological Counseling, Appalachian State University, 151 College Street, Boone, NC 28608, USA; d Department of Physical Medicine and Rehabilitation, Osher Cen- ter for Integrative Medicine at Vanderbilt, Vanderbilt University Medical Center, 3401 West End Avenue, Suite 380, Nashville, TN 37203, USA * Corresponding author. 12 Hopewell Drive, Durham, NC 27705. E-mail address: ruth.wolever@vanderbilt.edu KEYWORDS  Primary care  Lifestyle  Behavior change  Health coach  Integrative medicine KEY POINTS  Integrative Medicine approaches are particularly useful to support lifestyle change.  Addressing behavior change from a holistic perspective allows for success in an area in which the patient has intrinsic motivation. Success breeds further success.  Sustainable behavior change is quite complex and lengthy; it requires much more than ed- ucation and advice. Neither the primary care provider nor the individual patient should expect to carry the full burden alone.  The primary care provider has a key role in health behavior change, namely catalyzing change, educating and linking to available resources, and supporting the patient in the background while health coaches or others guide the change process in the foreground.  Stress undermines behavior change; stress must be addressed first or at least simulta- neously to enact sustainable behavior change. Prim Care Clin Office Pract 44 (2017) 229–245 http://dx.doi.org/10.1016/j.pop.2017.02.007 primarycare.theclinics.com 0095-4543/17/ª 2017 Elsevier Inc. All rights reserved.