Dear DOCTOR Owen:

I recently re-married after many years of being single. My children are grown and no longer live at home. My new husband insists on having breakfast and makes my life miserable if I don’t join him. I have never eaten breakfast. Being “full” so early in the day makes me sluggish, which I just don’t like. I have gained 20 pounds in six months. He makes me feel stupid for missing “the most important” meal of the day.

Early Bored

Dear “Bored”:

This guy is going to kill you—not with hate, but with “love” and single-mindedness. Instead of a gun or club, the weapon will be diabetes, hypertension, heart attack, or stroke. And I bet he’ll be the first to call you “Fatty.”

First, let us discuss the breakfast “myth.” Three meals/day are necessary in an agricultural society where there is mechanical labor and not much dietary fat (scenario: the United States and our culture in the early 20th century). This does not describe the current culture, where virtually no physical activity occurs on a regular basis for the average person, and where high-fat food rules.

In the early 1900s, the average male and female ate 20% more calories/day than they do now, yet we were only 5% obese as a culture. Now, we are more than 35% obese as a culture (using 30% over lean body mass as the parameter of “obese”). How can this be? Because of work! Years ago, it took major amounts of physical labor to exist; it takes no work to exist nowadays.

Unless you plan to do some very disciplined activity on a daily basis, you ought to decide which meal to omit or replace with low-calorie options. It has become apparent to the scientific community studying obesity data that low-calorie meal replacements are the most successful method of avoiding the custom of high-calorie meals three times/day.

If breakfast is the meal you most likely can avoid or diminish, go with it. There are little data to suggest that this is in any way harmful. There are ample data, however, to suggest that 20 pounds-plus are harmful. I have yet to see a case of accidental malnutrition in my practice, but do see “over-nourishment” diseases all day long.

It staggers my senses daily to see how the “latest” breakthrough of one decade becomes the “dogma” of another—even in the face of overwhelming evidence. Breakfast is one such dogma. How many times have you heard that children perform better in school after they have eaten a “hearty” breakfast? Have you ever seen school lunches? They are “hearty” all right. (“Hearty” is one of the most accurate words ever contrived.)

How should you cope with your new husband? If “Bonehead” is a listener, explain the importance of your health, the need to avoid calories, and that breakfast is the meal you can most do without. If he is not a listener, which seems most probable, you need more help than a diet specialist can offer. You need a negotiating specialist—like a lawyer.