Dear DOCTOR Owen:

I need structure when trying to lose weight. I know all the things that I should do, but I don’t do them. Do you have any KISS (Keep It Simple, Stupid) methods at your disposal?

KISS

Dear “KISS”:

At my clinic, we diet and health counselors use a simple program as a fundamental tool in our weight-loss and weight-maintenance practice: the Triple Imperative® developed by Health Management Resources (HMR®) in Boston, Massachusetts. HMR®, which has trained more physicians and clinical staff in Diet Therapy than any one group of its kind in the country, is a database organization. That is, the HMR® programs are based on data collected and have their basis in science.

The three imperatives* are simple to plan and to follow:

1. 35 meal/replacement supplements/week—some taken in place of regular meals.
2. 35 servings of vegetables and fruits/week.
3. 2000 calories of exercise/week.

Studies show that the less these “imperatives” are followed, the less the weight loss. Adherence to them gives people an 89% chance of achieving their weight goals and of keeping that weight within 10%—as long as the imperatives are followed. (Compare that to a 5% chance of being successful on your own and not using a method—about as stark a difference as anyone can see.)

Let us think about these three imperatives.

• Take pre-packaged meal replacements, which is easy to do and logical. Most high-calorie portions these days are found in fast food restaurants. Taking fixed-calorie “filler,” whether a beverage or a pre-packaged meal, simply controls the portion size. Most meal replacements are balanced in nutrition, so people taking them tend to be less hungry. Replacements are also “sugar friendly”—that is, they do not raise insulin levels, as promoted in diets like Doctor Atkins’ or Sugar Busters! TM If you pack 35 replacements into your week, there is less room for other foods.
• Eat 35 servings of vegetables and fruits per week, which also accomplishes some of the goals mentioned directly above (in the meal-replacement discussion). While not nutritionally balanced, veggies and fruits do take up space in your stomach and give you something to chew on. And, eating them five times/day entails considerable time and volume. When buying these food items, plan how and where to place them for consumption. For example, they need to be in your home (on the kitchen counter), in your car, at work—everywhere—and must be handy whenever you decide to eat. Best of all, they may thwart a trip down the fast food lane.
• For the average 150-pound person, exercising 2000 calories/week amounts to approximately 3 miles of walking/day, for seven days. This imperative takes time and planning, so you will likely avoid detrimental behaviors if you put that much time and effort into your day. In addition, this much exercise amounts to an extra 0.6 pounds of weight loss/week, or almost 30 pounds/year. That’s not chicken feed. Over a five-year period, this amounts to 150 pounds. Adds up, doesn’t it?

While the three imperatives are simple and do-able, they take planning and implementation. Once put into practice, they need to be carried out over long periods of time—as long as. . . forever. So, mark them on your calendar for a seven-day week. Even if you are celebrating with high-fat, high-calorie foods, you will find a marked decrease in your overall food intake once you start practicing the Triple Imperative®—there simply will be no room for anything else!

*The word “imperative” was not chosen lightly. The dictionary definition is “expressive of a command; an order.”