I eat only once a day. Why can’t I lose weight?

I hear this lament from patients frequently, often several times a day. It doesn’t seem to make sense. How can you eat only one meal out of three, deprive yourself of calories for much of the day, yet continue to gain weight? Well, contrary to common sense and popular perceptions, missing meals can be a sure-fire way to gain weight. And are you really eating only one meal a day?


Mrs. Matthews walks into our clinic: weight 188 lb, an increase of 4 pounds in 6 weeks. “I don’t understand it! Why am I not losing weight? I’m only eating one meal a day.”

Nurse Carol: “Okay. You’re right, that doesn’t make sense. Let’s start by doing a quick dietary check. What do you eat for breakfast?”

Mrs. Matthews: “I don’t like eating breakfast. I only have 1-2 cups of coffee with 1 creamer and one packet of Splenda in each.”

Nurse Carol: “Do you snack in the morning?”

Mrs. Matthews: “Only when co-workers bring in baked goods or some other snack, otherwise I don’t snack.”

Nurse Carol: “How many times per week do co-workers bring in goodies?”

Mrs. Matthews: “3, maybe 4 times a week.”

Nurse Carol: “What do you eat for lunch?”

Mrs. Matthews: “Usually a small salad with low-fat salad dressing, diet Pepsi, and a handful of crackers. Hardly worth mentioning.”

Nurse Carol: “Do you indulge in any afternoon snacks?”

Mrs. Matthews: “Not usually, maybe a handful of pretzels, if anything.”

Nurse Carol: “Tell me about your dinners.”

Mrs. Matthews: “We eat a lot of fish, chicken, lean pork. My husband loves spare ribs, pasta, baked potatoes, and we always have a vegetable with our meals. I’m usually pretty hungry by this time, so I may have seconds.”

Nurse Carol: “Do you do the cooking?”


Mrs. Matthews: “Most of the time, unless we eat out.”

Nurse Carol: “When you prepare your meals, do you do taste your sauces to make sure they taste just right or snack when you cook?”

Mrs. Matthews: “Oh sure, I’ll have a glass of red wine, maybe some cheese and crackers, possibly a second cocktail or glass of wine.”

Nurse Carol: “Lastly, any after-dinner snacks or desserts?”

Mrs. Matthews: “I may nibble on some M&M’s or popcorn, but nothing after 9 p.m., I make that a rule.”

So, What is Mrs. Matthews Doing Wrong?

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