By Laura Smith, Slate

In January, a 13-year-old patient named Kelssi came to Dr. Robert Zarr’s office at Unity Health Care, a community health center in Washington, D.C. Kelssi had struggled with her weight for as long as Zarr had known her and was now obese. But during this visit, she looked at Zarr and told him she was finally ready to do something about it.

Zarr told me that exhorting patients to “get more exercise” was too vague. Last year, he decided to start trying something different. He stopped asking his patients, “Do you move?” and began asking “Where do you move?” He discovered that many spent very little time outdoors, and he began prescribing time outside for conditions as wide-ranging as ADHD, high blood pressure, asthma, obesity, anxiety, diabetes, and depression.

With Kelssi, Zarr figured out that she could squeeze outdoor time into her commute. Kelssi lives in Northeast D.C. but goes to school in Northwest. Every day, she takes a bus to a train, and the commute lasts about an hour each way. Zarr and Kelssi decided she would get off the bus to school four stops earlier and take a walk through a park.
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At Kelssi’s next visit, she was no longer obese; her weight was within the “overweight” range, a feat that Zarr described as no small victory. But perhaps even more strikingly, she seemed much happier and more positive. “It’s working,” she told Zarr.

Why don’t more doctors prescribe nature? They used to do so regularly. The practice gained popularity in the mid-19th century as cities rapidly expanded. In Your Brain on Nature, Eva Selhub and Alan C. Logan explain that sanitariums, or health resorts, gained popularity during the Industrial Revolution as concerns increased about overstimulation, noise, and smoke in cities. Doctors began prescribing their patients visits to more hospitable climes such as the Swiss Alps or the Adirondacks for afflictions from tuberculosis to mental health issues. A thriving industry of sanitariums sprang up with names like the Pines, Lake View, and River View.

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