Timing of Meals

Of great importance, but commonly ignored, is the timing of meals. These, whatever their number, should be consumed at regular,though not necessarily equal, intervals. Meal schedules should be set and followed consistently seven days a week. Only in this manner can the rhythmic pattern be developed that is essential for long-term adherence to a reducing and especially a maintenance regimen. Meals should be leisurely, stress-free, preferably family occasions where quarreling and other upsetting emotional elements are not allowed to interfere with eating. Here too, the sound general nutrition practices embodied in the reducing regimen hopefully will be emulated by other members of the family circle, especially the youngsters. In the event of disagreement, it is the others in the family rather than the patient who must be urged to conform.

Results unquestionably depend upon how often the patient sees his doctor, notably in the early stages of the regimen when weekly visits are all but essential. The desired permanent weight is commonly achieved in practical stages through a succession of short-term goals. Although planned interruptions reportedly are desirable in some instances, weight loss seems generally best accomplished by a steady downward progress.

Weight objectives may be set for periods of 4 to 12 weeks. Regardless of the criteria adopted, the patient should be given family as well as medical support throughout the period of weight loss. This support should continue to the point where his maintenance program hopefully will become an established way of

life. He should become free from the thrice or more daily decisions about what and how much to eat that jeopardize adherence to his permanent program of weight control. Weight reduction is never an objective in itself. It is part of the total program for helping the obese person become generally well-nourished and adjusted.

Good nutritional therapy directed to an obese person may favorably influence the eating pattern of other members of the family, primarily the mother who plans, purchases, and prepares the meals for her spouse and children. The resulting general improvement in dietary habits should help to prevent all types of malnutrition including overeating.

Since there is nothing really new in the management of obesity, emphasis must be on this and other preventive aspects—especially in the younger age groups where many are otherwise destined to join the hard core of obese adults. The serious, sustained cooperation of parents unquestionably is essential, but a coordinated school program is equally important. Emphasis should be on the positive, dynamic ("thou shalt" rather than "thou shalt not") approach to weight control as an integral part of physical and total fitness. Example must be provided as well as encouragement. The educational potential of the school lunch program surely can be exploited to great advantage and school athletic facilities can be utilized more fully.

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