Jimmy did construction work. At fifty-six he was an interesting mix of youth and age. His hair was light brown dappled with gray; his face was boyish, but pale and tense.

“My doctor says I’ve got to take off some weight. He’s been telling me for years, but now it’s serious.” He went on to talk about his high blood pressure, his backaches, and his father, who died at age fifty-eight. “I have to take off at least thirty pounds,” he said.

Jimmy had tried diets in the past but, he told us, “I couldn’t work on cucumber sandwiches or child-sized portions. I get too hungry. It just doesn’t feel like real food. It’s not enough for me.

“And I can’t carry a measuring cup and food scale with me to the twentieth floor of a construction job. Or those exchanges—they wanted me to eat one exchange of this and two exchanges of that. I can’t live like that. I don’t eat exchanges, I eat real food that gets all the exchanges mixed together. It got really ridiculous, trying to figure out exchanges while the guys are ordering sandwiches from the deli.”

Jimmy’s Carbohydrate Addict’s Test revealed he had only a Mild Addiction. We told him about the three-meal-a-day plan, two of them low in carbohydrates, the third the Reward Meal. We explained the insulin connection, too, and he nodded in agreement. He’d try it.

Jimmy was between jobs, so for the first two weeks of the diet he had little difficulty following it. In fact, he was losing weight almost too quickly, at a rate of about three pounds a week. But then he was called back to work.

“Now let’s see how the diet holds up on the job,” he said with a laugh.

It proved to be a difficult challenge. A basic part of Jimmy’s work, we learned, was an almost ritual approach to eating. Breakfast with the guys was first. Then after a couple of hours of work came coffee break. Then some more work and lunch. In the middle of the afternoon came another break. Then everybody went home for dinner.

The sum total of this eating-working schedule was five mealtimes daily. Not surprisingly, Jimmy didn’t do as well the first week back on the job.

“Breakfast is no problem,” he assured us. “Bacon and eggs I love and I don’t really mind giving up the bread.

“The morning coffee break, though, that’s tough. I don’t know exactly what to do. For the first couple of days I just had coffee, but then I started adding rolls toward the end of the week. Lunch is okay, I bring that from home.

“The real tough one is the coffee break in the afternoon. By then I’m tired and cold and hungry and the thought of just coffee when everyone else is eating is impossible.”

Even with his rule breaking, however, Jimmy lost three pounds. Still, from experience we knew we couldn’t let him eat carbohydrates as often as he wanted to: it would inevitably lead to an appetite rebound and the end of his weight loss.

Given his rapid weight loss, we recommended that Jimmy follow plan A. This would help avoid hyperinsulinemia but still suit his needs. We recommended the following: his breakfast would remain the same Low-Carbohydrate Meal, and we reminded him that he’d have to forgo the rolls that he had added to his morning coffee break. He agreed, he could manage that. Lunch was to be as usual, low-carbohydrate foods. But Plan A added a Low-Carbohydrate Snack.

Jimmy was now able to follow a plan that included a snack at afternoon break, like a chicken leg and dill pickle. Jimmy suggested celery stuffed with cream cheese, a favorite snack of his. We told him that was perfectly acceptable, too.

It worked. Breakfast and lunch remained his Low-Carbohydrate Meals, dinner his Reward Meal. At the midafternoon break, Jimmy had some meat or his cheese and celery snack.

On his next visit, Jimmy told us a story about his daily throwing away of the bread that came with the deli sandwich he had started ordering for that snack. “So help me,” he said, chuckling, “I swear the pigeons know I’m coming now and they head for the trash can nearest me.” His weight dropped steadily—but not too fast. He reached his desired weight loss of thirty-two pounds in less than four months. And, two years later, his yearly check-in revealed his weight was still level.

The Carbohydrate Addict’s Diet had worked well for him. “I’m thinner than I was in high school, and my blood pressure is like that of a kid. That’s it for me—for life.”

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