SLIM TLC® Online

Welcome to TLC University!

It’s no secret that almost all of us need to improve our lifestyles, especially our diets – i.e., to eat more of what we should, and less of what we should limit.  Since, over the past few decades in America, our lifestyles and diets as a whole have deteriorated significantly, resulting in a literal “diabesity” epidemic, the whole health care system and our health are crumbling right before – and under – our eyes. 

As you know, many factors contribute to the difficulty of becoming, and then staying, slim, fit, and healthy.  For most, at least in developed countries, I'm convinced that the two greatest factors contributing to our unhealthy diets (the greatest contributor to the diabesity epidemic) are addictions and convenience.  Habits, culture, cost, time restraints, accessibility, a lack of knowledge, and many other factors contribute.  In other words, it’s just plain hard, and we simply need to make it easier. 

 “I’M NOT A BIG FAN OF COUNSELING PATIENTS [ABOUT LIFESTYLE CHANGES]...WE SIMPLY NEED TO MAKE IT EASIER.” — PETER KABOLI, M.D. 

Despite decades of fighting my own weight loss battle, and despite significant nutrition education and strategy, system, and program development (and testing everything on my patients), I was cursed with only partial success.  That is…until December 2023, at and after which time (I am absolutely thrilled and beyond grateful to report) everything jumped light years ahead, starting with the development of my “Free Food?  Whatever!” eating strategy!  This, combined with momentous changes in program approach and my goal-setting and tracking tools (the SLIM TLC Map and Log), provided such a huge leap forward in the efficacy, livability, and flexibility (i.e., customizability) of SLIM TLC that I cannot wait to share everything with you.  It has provided, finally, the answer!  I hope and pray that you will give it a valiant attempt. 

Do What’s Needed and Not What’s Not

When you go to the doctor or dentist, or take your car to the mechanic, unless you’ve already found someone you trust, you never know if they have your best interests in mind and at heart.  What you want is for them to do what is needed (fix the problem in the best and most economical way – and provide the best preventive care – possible) – and not what’s not.

“AT SLIM TLC®, WE HELP YOU LEARN THE REALITY ABOUT WHAT YOU NEED TO WORRY ABOUT AND WHAT YOU DON’T – IN OTHER WORDS, WHICH FACTORS NEED THE MOST FOCUS, AND WHICH MAY BE A POOR USE OF YOUR TIME AND ENERGY.”   

As you know, SLIM TLC stands for becoming SLIM through Therapeutic Lifestyle Changes (TLCs).  Of the primary TLCs that affect our weight (nutrition, physical activity, sleep quality, and stress management), nutrition is, by far, the most important.  That is why most everyone is focused on diets, or the eating/intake part of the energy equation – and that is why my “Free Food?  Whatever!” eating strategy requires our greatest focus.  I’ll use my Nutrition Star for reference:

The Whatever! Calorie (WCal©) Budget

You’ve heard of Calorie Budgets, right?  A Calorie Budget is essentially how many calories you should (be able to) consume each day in order to help you reach your weight goal.  To explain: 

There are 3500 calories in a pound of fat, so if you desire to lose a pound per week, you’ll have to consume an average of 500 fewer calories per day below your metabolic needs.  You can use a calorie calculator to determine how many calories you need to consume to maintain your weight (although different calculators will tell you different things – it is not an exact science).  Keeping a Calorie Budget requires that you count every calorie that crosses your lips.  Ummm…way too difficult, and therefore rarely sustainable long enough to make a long-term difference.

On the other hand, miracles will occur if all you do is track (when you start tracking) your Whatever! calories (WCal©), set a “WCal© Budget,” and try to stay under it!  Until you start counting them, you’ll never appreciate how quickly Wcal© add up, which is why I am convinced that the greatest driver of the obesity epidemic (and our poor health) is the consumption of too many WCal©!

My mission, therefore, which I have chosen to accept, is to convince you to swallow this (free, all-natural) magic “pill” – hook, line, and sinker.  I guess you could call it the “Whatever! Pill.”  And it will work for you, if you will swallow it.

“HOW WELL YOU DO ON THIS PROGRAM WILL BE COMPLETELY DEPENDENT UPON HOW WILLING YOU ARE TO SWALLOW THIS ‘WHATEVER!’ PILL.” 

I’ll explain more about what, how, and why soon. 

I respect your timing; I'm sure you'll do it whenever you see (others) fit.  But for whatever reason, if you find this pill to be a little bitter to swallow initially, please do not flush it down the toilet or otherwise discard or dismiss it.  You may decide to break it up and swallow it in pieces, whether referring to the learning process or implementation, or you may sugar-coat it in a way that it’s easier for you to swallow.  We’ll talk about ways to do so shortly. 

Prior to the advent of “Free Food?  Whatever!”, my eating strategy was this:  “Eat 4:1 when actually hungry.”  It focused on both quality and quantity.  My (previous version of the) SLIM TLC Map was designed to motivate you and keep you accountable by tracking what percentage of each day’s diet consisted of 4◊F (Four-Diamond Foods).  Needless to say, it was “hard to swallow” (yes, much more bitter than the Whatever! Pill) – but it worked…when you did it.  But it was not sustainable, and did not work anywhere near as much magic as “Free Food?  Whatever!”  When you swallow this Whatever! Pill and follow the “Free Food?  Whatever!” strategy as recommended, you will be at risk for the following magic to occur, and accomplish things you’ve likely (because of past experience) concluded are impossible.  You will:

1. Desire and be driven to make healthier eating choices (it’s EASIER because it takes less work!).
2. Be motivated to get off your rear end (and do more resistance exercises – because as fat melts, more muscle shows!).
3. (perhaps for the first time in your life) Appreciate more the flavor of real food.
4. See your overall “Drive to Eat” decrease as you gain power over food and break your addictions (remember, when it comes to food, “breaking” is defined as “controlling”) – which occurs naturally over time as you decrease your Whatever! intake.
5. Successfully create an environment of success (see Lesson 15, Surviving the Snack Attack), which will also improve the health of those around you.
6. Effectively troubleshoot what needs to be done, finally, to successfully move towards your weight loss goals!
7. See long-awaited, welcome improvements in your health (decreased blood pressure, cholesterol, glucose, gastroesophageal reflux disease, erectile dysfunction, constipation; and improved energy and endurance!).
8. Stop living in fear of regaining the weight you lose.
9. Save money (primarily from eating out less and eating less expensive foods…until you have to buy new clothes).
10. Lose weight in a more consistent manner (reduce plateauing), as long as you stay under/around your WCal© Budget.

What if I Don’t Agree with Your Nutrition Star?

Chances are, until and unless I’m successful at “converting” you, you are in the majority – however, once you fully understand its customizability, you may not need converting.

The Whatever! Pill is an integral part of the “Free Food?  Whatever!” eating strategy, which, if you will allow it, will change your life – even if you are absolutely convinced that your eating preferences are more effective or appropriate than my Nutrition Star, for whatever reason.  See Lesson 2 to learn more about how you can take advantage of the “Free Food?  Whatever!” eating strategy by adapting it to fit your preferences, and watch the magic happen! 

How Customizable Is SLIM TLC?

Let me count the ways.  SLIM TLC is fully customizable to meet your needs, whether you are what my kids call “totally CHILL,” on the nerdy side, or anywhere in between:

1. You get to define “Whatever!” and your version of “4◊F” (in other words, how you customize The 4:1 Rule discussed in Lesson 2)
2. You get to choose what percent of your BMR (basal metabolic rate) constitutes your WCal© Budget (huge range:  20-50%).
3. You develop your own Favorite List of Healthy Snacks (and Meals), creating a customized environment of success.
4. You get to choose which SLIM TLC tool(s) to use and what Program Intensity Level(s) suit(s) you the best.

And you can change any of the above as you see fit, as you learn what works and what doesn’t!  Do what you feel is needed, and not what's not!  Review this summary:

Simply weighing yourself once weekly and recording it on the SLIM TLC “Light” Log or SLIM TLC Map (Level 1) may be all you need to achieve success, of course combined with striving to create an environment of success.  Combining the rest of the Levels (2-7), which includes completing all components of the SLIM TLC Map, will require the up-front learning time described below (and requires the greatest ongoing time commitment), but it will also be the most effective – and yet it may only be needed initially, until you “learn the ropes.”  The good news is that you can combine any Levels you desire and go up or down in Level intensity (= commitment) whenever your needs and desires change!  However, we discourage you from ever stopping all Levels completely – consider at least continuing Level 3 for life.  Recording your progress is a way of being accountable to yourself – but to increase the power of accountability, we also recommend sharing your Log or Map once monthly with one or two people you know and trust, thus increasing your likelihood of success.  Those people can be us if you have joined the formal SLIM TLC program.

I do have to warn you that if you are all in, and want to maximize the value of the SLIM TLC program by “following” the full SLIM TLC Map, you will need to learn some new skills – and it will take a…very…long…hour (or two – really, not that long in the grand scheme of things!) to learn them.  But it will be the greatest time ROI (return on investment) you’ve ever experienced, i.e., the best rewards for the shortest investment of time (and money, for that matter).  And I’m beyond thrilled to be able to help you in this way.

Towards the end of this lesson you’ll see a preview of what happened (finally!) when I implemented the full SLIM TLC program (the “Free Food?  Whatever!” eating strategy and all components of the SLIM TLC Map).  The tools provided in SLIM TLC Online will help you achieve your weight loss goals and improve your overall health.  It is designed to provide you with all the tools and support you need to make lasting lifestyle changes.  In our formal SLIM TLC program we also offer one-on-one coaching, group support (and interaction through our Facebook group, Fit Together), personalized nutrition plans to help you reach your goals, and more.

My Philosophy

You’ll have to draw your own conclusions, but know that I have done my very best as a Primary Care Physician highly interested in health, nutrition, longevity, weight loss, truth, and reality (trying to leave bias out of the equation) to study the landscape thoroughly and obtain real-world experience, all with the end goal of putting it all together and providing you with the best possible advice and tools.  I have seen and studied a lot, and I truly believe that SLIM TLC, TLC University, and my nutrition guidelines (the Nutrition Star – see Lesson 2) will provide you with the answers for which you’ve long been searching.

The main purpose of TLC University is to teach you simple, invaluable principles of health (using what I consider to be the latest in nutrition science and lifestyle medicine, combined with an indispensable dose of livability), which will empower you to make the most sustainable changes in your lifestyle necessary to meet your long-term health and weight loss goals.  These “Therapeutic Lifestyle Changes” are the key both to preventing and reversing disease.  Without them, not only will your health suffer, but the entire health care system will continue to crumble.  The good news is that the power to prevent and reverse disease is in our hands.

The reality is that the grand majority of diseases from which Americans suffer and die can be prevented by a healthy lifestyle and achieving a healthy weight.  An individual who makes these lifestyle changes will not only significantly increase the chances of living a longer life, but it will also be a much more healthy, functional, and enjoyable life.  In other words, he or she will add both more and good years to his or her life.  In addition, he or she will be much less of a burden to the health care system – i.e., be part of the solution.

My hope is to make TLC University:

1. Understandable
2. Interesting, even enjoyable
3. Invaluable

I would appreciate any feedback that you can give me to help accomplish those goals, and if you find any errors in the text.

Lesson Format 

I initially thought it would be ideal to conduct these lessons in person, one-on-one, at whatever time or place was most convenient.  However, I realized that not only is it impossible for me (or anyone else) to teach all of these principles to everyone individually, it is essential to use the Internet and technology to allow me to reach you in various other formats than in person, at whatever time or place is convenient.  I then thought it would be helpful to create videos for you to watch, or interactive multimedia presentations in which to engage.  Doing so might be more enjoyable and less work for you.  However, trying to do so would not only come at a much greater (prohibitive) cost, but it would also prevent me from being able to easily update the lessons with the latest scientific and other helpful information available.  As such, I decided it would be best to create an “O (online)-book,” which would facilitate regular updating.  In addition, an electronic format allows the invaluable inclusion of links to content, files, and other websites, simple navigation (“jumps”) between topics, submittable forms, and simplified searching of content (press [Ctrl] + [F] or click the three dots in the upper right-hand corner, then click “Find”).

Yes, fortunately for you, the use of good old-fashioned text and graphics (or maybe “digital content” sounds more impressive), combined with the leveraging of technology, provide the best format for being able to keep your educational experience as up-to-date and dynamic as possible.

My Story

My interest in weight loss came as one of those necessity-mother-invention things.  I have told many people that I am a 350-pound man in about a 200- (now <190-) pound body – I say that because I love to eat every bit as much as (if not more than) the next guy – and had I not discovered what I am going to share with you, I am confident I would weigh that much or more.  I must inform you that I am used to telling everyone that I’m 6’5” (I was 6’5 3/8” at my peak), although now I’m actually 6’4 5/8” due to significant degenerative disk disease.  So, at a body mass index (BMI – recognized by most as an imperfect indicator of adiposity) of 24.9 I would weigh 208 (18.5-24.9 is considered “normal,” but a BMI of 18.5 is way too thin in the opinion of most).  Currently I’m well into the normal weight range (see my SLIM TLC Map towards the end of this lesson).

My weight gain started in my mid-20s (I was born in the mid-1960’s – I’ll let you do the math), around the time I met my wife, Sandy (funny how that works, huh?).  Prior to that, I was (younger and) active enough that I could eat about anything I wanted without gaining weight (saying nothing about the seeds of disease that were being planted because of my inflammatory diet, of which I was ignorant, erroneously equating health with a normal weight).  I was determined never to be one of those men who immediately gained a bunch of weight after getting married, so I was quite disappointed in myself when I quickly gained 20 pounds, passing the 200 pound mark (my average weight prior to that was a skinny 185, a BMI of 21.7).  Although I still tried to stay active, my focus shifted more and more from sports with the guys to spending time with my new-found love (yes, we should have spent more of our time together doing active things and eating healthier).

Over the next 10 years or so, my waistline kept expanding little by little, despite many weight loss efforts and short-term successes at losing a few pounds (which I guess cannot be defined as true success).  By the time I finished my residency, which provided an around-the-clock infusion of stress combined with free (unhealthy) food, I had added >50 pounds to my frame (my weight peaked a little over 235) – despite the fact that throughout medical school and residency I had developed several tools and strategies in hopes of reversing my weight gain.

It wasn’t until after residency – after I began to actively treat obesity – that I was able (finally) to begin seeing a promising reversal of my weight gain.  Like almost everyone else, over the many years since then it has been a (fortunately average downward) roller coaster, and I can attribute the most significant gains (i.e., losses) to specific things I learned and changes I made.  Within a few years of finishing residency, excited to share all I had learned and accomplished, I wrote a couple of books, held a weekly weight loss support group for three years (2003-2006), created a kids’ program, an online program (quite the joke compared to what you now have in front of you), and more.  Between those efforts and my own medical practice, I have counseled thousands of patients about how to lose weight and become healthy.

In spite of, and through, all that, I held onto an embarrassing secret:  I still struggled to achieve and maintain a normal weight, usually oscillating between 205-220 pounds – and, like everyone else, I continued to struggle with my “drive to eat” (which I’m convinced is stronger in overweight folks – not so strong in the thin people who look at overweight folks and ask, “Why don’t you just stop eating?”).  Also see Lesson 14 for a more in-depth discussion of our drive to eat.

“I HAVE SINCE LEARNED THAT THAT ONE’S DRIVE TO EAT IS MOSTLY DEPENDENT UPON HOW ADDICTED ONE IS TO THE MASSIVE NUMBER OF ‘WHATEVER’ FOODS PRESENT IN THE SAD (STANDARD AMERICAN DIET). AS ONE BEGINS TO REDUCE THE RATIO OF ‘WHATEVER!’ TO ‘4◊F,’ ONE’S ADDICTIONS DIMINISH ACCORDINGLY.” 

Besides being unable (until December 2023) to figure out how to break my addictions, I also struggled to stay active.  I (thought I) had all the right answers, and I thought I had a pretty good handle on what worked and what didn’t – and I also thought I knew a lot about nutrition.  As it turns out, at least until about 2012, I did not.  More about that in a minute.

Despite the reality that all weight lost through any modality comes back when that modality is stopped, time after time I had patients request phentermine (a potentially addictive appetite suppressant FDA-approved only for short-term use) to boost their efforts.  In 2009 I came up with a program to use it in a way that did not allow one to get addicted, and would hopefully give patients the highest chance of sustaining the weight loss they achieved.  The plan consisted of using phentermine Short-term, at a Low dose, Intermittently, and in the Middle of the day (it was a total fluke – and blessing – that it ended up as the acronym SLIM), instead of how it was usually prescribed, in the morning, which wore off in the late afternoon when people needed the most help – combined with the Therapeutic Lifestyle Changes (TLCs) necessary for long-term success.  I figured the phentermine would be a “carrot” of sorts, to get people into the program so I could teach them the TLCs necessary.  And thus was born SLIM TLC.

SLIM TLC has evolved significantly since then, and now it primarily means becoming SLIM through TLCs (although the medicine options have been part of that evolution, and as you likely know, the “SLIM” now also means “Shortest-term, Lowest effective and tolerated Intervention with Medicine” – but I no longer offer phentermine).  In reality, not only can it stand all on its own, it can be combined with any other effort, whether it be a medicine (to provide the best chances of long-term success once the medicine is stopped) or as the missing link between what you are doing now (or have done in the past) and true, long-term success. 

Permission Granted

As alluded to above, up until around March 2012 I thought I had a good handle on nutrition.  However, everything changed when I read Dr. Joel Fuhrman’s book Eat to Live, followed by many other books (and going to conferences) that I now consider representing the “new nutrition.”  I was so moved and convinced (“cognitive dissonance”) by Dr. Fuhrman’s work that I stopped recommending the 380-page book I’d written in 2006 (called SvelteLife:  The New Weight Loss Reality – don’t buy it) and started recommending Eat to Live.  Patients who read it were frequently also “converted,” and I started seeing the same miracles in them that Dr. Fuhrman saw in the patients highlighted in his book (which, until then, I just considered anecdotal, “results not typical”).  I started keeping a list of those patients, and started calling them “Fuhrmaniacs.”  

Problem:  One by one, over the subsequent few months, patients began falling off the list, as they slipped back into old habits.  Why?  Because his diet, as powerful (effective) as it is, is unsustainable for most.  

How can one get that magic intersection between both effective and livable?  Well, I combined all I had learned through the process (with just enough doses of livability), and after many iterations (it’s actually somewhat comical to me now), eventually came up with my Nutrition Star (Lesson 2).  For a few years it appeared as a rookie artist, doctor-drawn graphic, until my sweet niece Naomi Sweet (graduated in graphic design) created the current attractive iteration.  

However, the SLIM TLC program continued to evolve (and my roller coaster continued) until December 2023, when I came up with (more accurately, frankly, was inspired with the idea of) SLIM TLC’s “Free Food?  Whatever!” eating strategy.  Not only did that give me and my patients full “permission to eat” (primarily 4◊F, but also some Whatever! – I cannot tell you how refreshing and life-saving that was!), but other educational experiences over the years gave me “permission not to eat” when I wasn’t actually hungry, including intermittent Whatever! fasting (see Lesson 10).  All together, these strategies finally provided me and my patients with the tools necessary to achieve and sustain both a normal weight and many of our health goals!  Permit me now to share…

Warning:  Graphic Material!

You may cringe at the sight of my SLIM TLC Maps below, but remember how I warned you that it may take an hour or two to learn/digest/set it up?  Let's just say that once you learn how to set it up, it looks busier than it is difficult.  Fortunately, thanks primarily to a talented friend, Ben Campbell, we now have an Excel spreadsheet option, which drastically simplifies the set-up process!  However, be aware that, due to the nature of Excel, its bar graphs display total Calories Burned with physical activity and Total XWCal for the week instead of Exercise and Activity minutes as illustrated and tracked on the paper version of the SLIM TLC Map – see mine below, and Lesson 3 for detailed instructions.  

Before moving on to Lesson 2, I wanted to give you a preview of what might happen if you follow the full SLIM TLC program.  Being a study of one, I fully understand how biased or inadequate it could be, but know that I’m also seeing some promising results in my patients – hopefully in a few months, with their permission, I'll publish a few of their Maps, minus any personal identifiable information.  My SLIM TLC Maps below are current as of October 19, 2024.