Look again at the case of heart patients. The best minds at Johns Hopkins and the Global Medical Forum might not know how to get them to change, but someone does: Dr. Dean Ornish, a professor of medicine at the University of California at San Francisco and founder of the Preventative Medicine Research Institute, in Sausalito, California.

Ornish ... realizes the importance of going beyond the facts. "Providing health information is important but not always sufficient," he says. "We also need to bring in the psychological, emotional, and spiritual dimensions that are so often ignored."

Ornish published studies in leading peer-reviewed scientific journals, showing that his holistic program, focused around a vegetarian diet with less than 10% of the calories from fat, can actually reverse heart disease without surgery or drugs. Still, the medical establishment remained skeptical that people could sustain the lifestyle changes.

In 1993, Ornish persuaded Mutual of Omaha to pay for a trial. Researchers took 333 patients with severely clogged arteries. They helped them quit smoking and go on Ornish's diet. The patients attended twice-weekly group support sessions led by a psychologist and took instruction in meditation, relaxation, yoga, and aerobic exercise.

The program lasted for only a year. But after three years, the study found, 77% of the patients had stuck with their lifestyle changes — and safely avoided the bypass or angioplasty surgeries that they were eligible for under their insurance coverage. And Mutual of Omaha saved around $30,000 per patient.

Why does the Ornish program succeed while the conventional approach has failed? For starters, Ornish recasts the reasons for change. Doctors had been trying to motivate patients mainly with the fear of death, he says, and that simply wasn't working. For a few weeks after a heart attack, patients were scared enough to do whatever their doctors said. But death was just too frightening to think about, so their denial would return, and they'd go back to their old ways....

So instead of trying to motivate them with the "fear of dying," Ornish reframes the issue. He inspires a new vision of the "joy of living" — convincing them they can feel better, not just live longer. That means enjoying the things that make daily life pleasurable, like making love or even taking long walks without the pain caused by their disease. "Joy is a more powerful motivator than fear," he says....

[It is also] vital to give people the multifaceted support they need. That's a big reason why 90% of heart patients can't change their lifestyles but 77% of Ornish's patients could — because he buttressed them with weekly support groups with other patients, as well as attention from dieticians, psychologists, nurses, and yoga and meditation instructors.