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From Hospitals to Homes

The story behind an effective weight-loss program that should be on your radar.
To some, success is marked by constant change to what’s bigger and better. For others, like the weight-loss and lifestyle-change program offered by Health Management Resources (HMR), it comes by staying true to your roots.

Thirty-five years ago, HMR Founder Lawrence Stifler, Ph.D., developed a program on the basis that losing weight isn’t just about knowing what to do. It’s a skill that requires learning, and practicing new lifestyle health habits over the long term.

This is HMR’s story, as shared by the program’s creators and staff, from its early days as a medically supervised very low calorie diet (VLCD) program offered exclusively in hospitals and medical centers, to expanding its options to include an at-home program, and securing a No. 1 spot as a Best Fast Weight-Loss Diet in U.S. News & World Report’s rankings for the past two years.
IN THE BEGINNING …
Lawrence Stifler, Ph.D., HMR Founder: I was teaching at Boston University and had been asked to develop a weight management program for students. It became obvious to me that [weight management] wasn’t a psychological or emotional problem; it was an environmental issue. People are surrounded by high calorie foods everywhere they go. They’re exercising less and less.

In a culture where convenience is king, it’s extremely challenging to manage your weight. In 1983, we started HMR on $350,000 of our own money and by 1990, we were featured in Inc. Magazine as a business success story.

Rick Riess, Director of Behavioral Program Development: In the early days of HMR, medically supervised VLCD programs were popular. They helped people significantly limit their calories which helped them lose a lot of weight quickly. Because these diets essentially removed all the decisions about what to eat, many people could lock in on this super-simplified structure and get on a real roll. This basic principle of simplifying decisions about what to eat is still at the heart of our program today.
"Many people could lock in on this super-simplified structure and get on a real roll. This basic principle of simplifying decisions about what to eat is still at the heart of our program today."
—Rick Riess, Director of Behavioral Program Development
Stifler: If you were choosing a VLCD, you were not a casual dieter. And while the approach may have been considered extreme, many people who joined the program back then were ready for “extreme.” Back then, only 39 percent of Americans were either overweight or obese. This placed a great deal of social pressure on obese individuals to lose weight. Today, 71 percent of Americans are overweight or obese, and there’s much less social pressure to do anything about it.
A NEW DECADE BRINGS NEW CHANGES
Stifler: In the ‘90s we had close to a dozen treatment variables. One of the biggest changes we made in the program was to simplify that. Being the math stats nerd that I am, we did a comprehensive data analysis to determine which variables were the most important for weight loss. We realized that just five accounted for most of the success.

And to this day, our program still revolves around these five variables:

1. Weekly attendance at group coaching sessions
2. Simple record keeping
3. 2,000 calories of physical activity burned each week
4. Five full-cup servings of fruits and vegetables per day
5. The use of meal replacements for weight-loss and as a strategic tool in the maintenance phase
Riess: Over the years, we’ve really worked to simplify our treatment, and package it in easy-to-understand plans. By keeping it simple, participants can practice the program at a higher level, and be even more successful.
FOR THE GOOD OF THE PATIENT
Bob Moore, Director of Training Operations (HMR): Because people can lose a lot of weight on the program, they can also improve their health. The program helps people to practice and sustain high levels of different health behaviors, such as eating five or more servings of fruits and vegetables every day and engaging in regular physical activity. We estimate that at least half of the health benefits people experience are a result of these lifestyle changes, independent of their weight loss.
"Most of the people who come to us have tried many other diet programs without reaching their goals. At HMR people tend to have a very different experience. Our program is clinically proven to work."
—Lawrence Stifler, Ph.D., HMR Founder
Stifler: Most of the people who come to us have tried many other diet programs without reaching their goals. At HMR people tend to have a very different experience. Our program is clinically proven to work. We have 117 studies published on record with, what we think, are the best outcomes in the field.
PARTNERSHIP WITH MERCK – HELPING MORE PEOPLE
Moore: In 2011, HMR was approached by Merck to scale the program to help more people. Those discussions eventually led to Merck acquiring HMR in 2013 as part of its strategic focus on preventative healthcare services to complement its traditional pharmaceutical business.

This partnership has allowed us to develop new technology and infrastructure. It’s a perfect complement to our historical approach of licensing and training health systems to deliver the HMR program within their own facilities. HMR is now in a better position to work with its healthcare partners to offer both in-person and remote treatment options.

The behavioral program itself has not changed. What has changed is the addition of digital experiences that allow people to access the program online and participate with both digital and live coaching support from wherever is convenient for them.
YESTERDAY’S MILESTONES, TODAY’S SUCCESS
Riess: A big factor that has contributed to HMR’s unique success is the simplicity and structure of the plan, which people desperately need. The simplicity itself supports higher compliance, and our program members tell us this all the time.

Stifler: This program offers significant rapid weight loss plus healthy lifestyle changes, which can lead to sustainable improvement in health and quality of life. And it’s easier to stick with than you think. The structure makes it a no-brainer.

Moore: HMR’s mission has always focused on making a measurable difference in the health and quality of life of its participants. For decades, HMR has produced some of the best outcomes in the field. In 2018 and beyond, HMR’s focus on bringing this treatment to more people through digitally enabled solutions is a key part of us fulfilling on our mission.
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