The food as medicine movement is evolving fast, driven by exploding funding, new technologies and solutions, and mass experimentation. In just a few years, the movement has gone from wind in the face to wind in the sails. However, to sustain progress senior executives in the movement need to shift from being fixated on quick-fix interventions to becoming obsessed with outcomes, recognizing that funding and technologies are merely the building blocks of change. Delivering the promise of food as medicine requires five principles of change and will demand a new kind of cross sector collaboration as well as new expectations of senior executives in health and food.