A Practical, Achievable, and Durable Diet: The Garnick Portion Control Minus Method

Whether it's about the obesity epidemic affecting children, or the fattening of the America adult population, information about obesity and being overweight permeates the press each day. Put simply: Bulging waistlines are common. In my practice, it is especially disheartening as it relates to prostate cancer, since men with prostate cancer who are overweight have worse outcomes than men who are thin.

But what is a man with prostate cancer to do? He faces treatments which in and of themselves may cause weight gain and changes in the body's metabolism, plus they may cause a lessened exercise tolerance.

What follows is my sound advice to those who need to lose weight. This is not Atkins, South Beach, or the newest fad, but a tried and true method of thinking about weight loss, achieving it, and making it endure. I attribute this method to my wife, Bobbi Kates-Garnick, who, in her entire life has never been even a pound overweight, and who has had lifelong exemplary eating habits.

The diet has two major components and one minor one. I have dubbed it the Garnick Portion Control Minus Method (GPCMM).  I have now recommended it to countless patients—it works and the results endure. Here are a few starting principles:

• The weight loss has to be gradual—aim for one to two pounds of loss per month
• The results must be durable—most diet programs fail because even if participants lose weight, they often gain it back
• Though daily eating habits are somewhat disrupted, the change is not so drastic that it dominates conversations at the dinner table
• The dietary changes are ones that must be carried through life
• Your level of physical activity stays the same or, optimally, increased modestly
  

The first major component of the GPCMM is portion control. This is simple in its concept. It simply means decreasing the portion size of at least two meals daily; alternatively, if you are a "seconds" grabber, eliminate the second portion. So if your lunch consists of a sandwich, chips, and a cookie, you eat three-quarters of the sandwich, half the bag of chips, and two-thirds of the cookie—very simple. If your dinner is a piece of chicken, pasta, and bread, take a quarter to a third less than you normally would on both the chicken and pasta. If you would normally eat a slice of bread with butter, either eliminate the butter or have a half slice with butter.

The principle here is quite easy to understand—eat the foods you like, but eat a bit less. Ideally, each five or six days, I like to substantially lessen how many calories I take in for one meal. This could mean having a yogurt for lunch with a piece of fruit instead of sandwich and chips or having an egg and toast for dinner.

The second component is elimination of one of the more caloric elements of your diet. For example, if you normally eat a lot of bread, try cutting it out of your diet entirely. If you drink alcohol, you can't have dessert, or vice versa.  

Snacks are not completely taboo—but what you snack on may need to be modified. Here I like to insert an occasional hard candy (such as a coffee nip and something like soda water - which has a filling effect. It works very well. But no ultra caloric sweet snacks (and you know what they are—cookies, ice cream, donuts). This is the minus portion of the "GPCMM."

If you can increase your physical activity, excellent.  If not, it is not a key or mandatory component of this dietary plan.

My typical patient is a 60 year old man who in college weighed 175 pounds and who now weighs 230 pounds, with a big gut. On day one of the program, I ask him to have lost five to six pounds when I next see him for a visit in three months—which boils down to one to two pounds of weight loss per month. At the end of the year, the patient's weight should be around 210 to 212; at the end of the second year, close to 190. I am amazed at the acceptance of this approach, its short term success, and its durability.

I have also found that the tangible results spur my patients to increase their exercise, and take fitness in a new and serious light. I believe that this practical, achievable, and durable diet is appropriate to anyone who is serious about losing and keeping off excess weight. For the patient with prostate cancer, adhering to this approach and shedding pounds may even be associated with brighter outcomes.

Give it a try and let me know what you think, and if successful, all of the credit goes to my wife, Bobbi Kates-Garnick.

Have you tried to lose weight?  What works for you?  What has not worked for you?  What do you find challenging about changing your diet?

Marc Garnick, M.D., is an internationally renowned expert in medical oncology and urologic cancer, with a special emphasis on prostate cancer. He is a Clinical Professor of Medicine at Harvard Medical School and maintains an active oncology practice at Beth Israel Deaconess Medical Center. Dr. Garnick serves as Editor in Chief of Perspectives on Prostate Diseases, a quarterly report from Harvard Health Publications.

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