Health Management Resources Corporation

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IN THE MATTER OF HEALTH MANAGEMENT RESOURCES CORPORATION CONSENT ORDER, ETC., INREGARD TO ALLEGED VIOLATION OF SECS. 5 AND 12 OF THE FEDERAL TRADE COMMISSION ACT Docket C-3455. Complaint, Aug. 17, 1993--Decision, Aug. 17, 1993 This consent order prohibits, among other things, a Massachusetts-based marketer of very-low-calorie diet programs (rapid weight loss, modified fasting diets of 800 or fewer calories per day) from making false or unsubstantiated claims about health risks, weight loss, weight loss maintenance, acceptance of its program by the medical profession, or low success rates of other diet programs; and requires certain disclosures in conjunction with safety and weight loss maintenance claims in the future, and scientific evidence to back up comparison studies or claims of acceptance by the medical profession. Appearances For the Commission: Renate Kinscheck and Richard F. Kelly. For the respondent: James Sneed, McDermitt, Will & Emery, Washington, D.C.

COMPLAINT The Federal Trade Commission, having reason to believe that Health Management Resources Corporation, a corporation (hereinafter “respondent’’), has violated the provisions of the Federal Trade Commission Act, and it appearing to the Commission that a proceeding by it in respect thereof would be in the public interest, alleges:

PARAGRAPH 1. Respondent Health Management Resources Corporation is a Nevada corporation, with its offices and principal place of business at 59 Temple Place, Boston, MA. PAR. 2. Respondent is engaged, and has been engaged, in the sale and offering for sale of physician-supervised very-low-calorie Complaint 116 F.T.C.

diet (““VLCD”) programs and related nutritional products to the public through cooperating hospitals and clinics. VLCDs are rapid weight-loss, modified fasting diets of 800 calories or less per day requiring medical supervision. The HMR VLCD diet programs provide between 520 and 800 calories per day. Relying on training provided by respondent, staff of hospitals and clinics participating in the HMR program frequently advise patients to remain on the HMR VLCD program until they reach their goal weight, even when such advice results in patients remaining on the VLCD for extensive periods of time. The HMR diet programs include “foods” or “drugs” within the meaning of Section 12 of the Federal Trade Commission Act, 15 U.S.C. 52.

PAR. 3. Respondent has created and placed advertisements, and provided camera-ready advertising copy to its participating hospitals and clinics for placement in various periodicals that are in general circulation to the public, to promote its diet programs to prospective patients. Typical of respondent’s advertising, but not necessarily inclusive thereof, are the materials entitled “Are You Considering a Fasting Program?,” and “‘The treatment of choice for serious weight problems,’” attached hereto as Exhibits A-1 and A-2. Respondent further advertises its diet programs to the public by means of brochures, leaflets, and newsletters which it provides to participating hospitals and clinics to give to patients and prospective patients, and sample promotional articles for insertion in newsletters for dissemination to patients and prospective patients. Typical of respondent’s brochures, leaflets, newsletters and promotional articles, but not necessarily inclusive thereof, is the brochure entitled “When Your Next Diet Fails... .,’” Exhibit B-l; the leaflet entitled “The Weight & Risk Factor Management Center,” Exhibit B-2; the newsletter entitled “For Your Better Health,” Exhibit B-3, and the promotional article, untitled, Exhibit B-4. Respondent also promotes its diet programs to the public by means of orientation sessions for prospective patients. Respondent provides training, including written scripts and audio tapes, to staff of participating hospitals and clinics for use in conducting these orientation sessions. Typical of respondent’s orientation session scripts is Exhibit C-1. Respon- HEALTH MANAGEMENT RESOURCES CORPORATION 801 799 Complaint dent further provides training to staff of participating hospitals and clinics upon which staff relies in making representations and recommendations to patients and prospective patients regarding the use of respondent’s VLCD programs.

PAR. 4. The acts and practices of respondent alleged in this complaint are, and have been, in or affecting commerce, as “commerce” is defined in the Federal Trade Commission Act. PAR. 5. Respondent's advertising and promotional material contains the following statements:

a. “Safe, rapid weight loss.” (Exhibits B-1 pp. 2 & 3; A-1; A-2; B-2; B-3 p. 2) b. “Completely safe” (orientation tape) c. “Why is it [the diet] safe? The quality of the VLCD ... high quality supplements associated with medical supervision and effective education ... The medical supervision makes it safe.” (Exhibit C-1, pp. 11-12) PAR. 6. By and through the use of the statements referred to in paragraph five, and others not specifically set forth herein of similar import and meaning, respondent represents, and has represented, directly, or by implication, that the HMR diet programs are unqualifiedly free of health risks. Respondent has failed to disclose that physician supervision is required to minimize the potential risk to patients of the development of health complications on very-low-calorie diets. In view of the representation that the HMR program is free of health risks, the disclosure as to the requirement for medical supervision is necessary. Therefore, in light of respondent’s failure to disclose, said representation was and is misleading.

PAR. 7. Respondent’s advertising and promotional material contains the following statements:

a. “Its been clear now for a number of years, around 15 years, that the use of very low calorie diets with high biologic value protein supplementation and appropriate amounts of carbohydrates with a little bit of fat... .is very, very widely accepted by the medical profession as a whole.” (orientation tape) b. “The VLCD is the treatment of choice” (Exhibit C-l, p. 14) Complaint N16 F.T.C.

PAR. 8. By and through the use of the statements referred to in paragraph seven, and others of similar import and meaning, respondent represents, and has represented, directly or by implication, that the HMR VLCD diet program, including the practice of advising patients to remain on the program for extensive periods of time, is widely accepted by the medical profession as a whole, and is considered to be the preferred treatment by most medical experts. PAR. 9. By and through the statements and representations referred to in paragraphs seven and eight, respondent represents, and has represented, directly or by implication, that at the time respondent made those representations, respondent possessed and relied upon a reasonable basis for those representations. PAR. 10. In truth and in fact, at the time respondent made the statements and representations referred to in paragraphs seven and eight, respondent did not possess and rely upon a reasonable basis for those representations. Therefore, the representation set forth in paragraph nine was and is false and misleading. PAR. 11. Respondent’s advertising contains the following statements:

a. “Over 60% of weight lost is kept off long term.” (Exhibits B-1 p. 4; B-2) b. “Our national data system assures that our patients receive the highest quality program with lasting results... . our patients who are three years out of maintenance have regained less than 40% of their weight... .” (B-3 p.2) PAR. 12. By and through the use of the statements referred to in paragraph eleven, and others not specifically set forth herein of similar import and meaning, respondent represents, and has represented, directly, or by implication, that: a. Over the long term, HMR patients on average keep off over 60% of the weight they lose;

b. Three years after ending maintenance, HMR patients on average keep off more than 60% of the weight they lose; and c. The HMR diet programs are successful long-term treatments for obesity.

HEALTH MANAGEMENT RESOURCES CORPORATION _— (93 799 Complaint PAR. 13. By and through the statements and representations referred to in paragraph eleven and twelve, respondent represents, and has represented, directly, or by implication, that at the time respondent made those representations, respondent possessed and relied upon a reasonable basis for those representations. PAR. 14. In truth and in fact, at the time respondent made the statements and representations referred to in paragraphs eleven and twelve, respondent did not possess and rely upon a reasonable basis for those representations. Therefore, the representation set forth in paragraph thirteen was and is false and misleading. PAR. 15. Respondent's advertising contains representations about the success of commercial weight loss programs in achieving and maintaining weight loss. Typical of respondent’s representations of commercial programs’ success, but not necessarily inclusive thereof, are the statements contained in Exhibit B-1 p. 4. The aforesaid advertising contains the following statements: a. “Average weight loss [in commercial programs] --11.5lbs.” (Exhibit B-1 p. 4).

b. “Less than 8% lose 40 or more pounds [in commercial programs].” (Exhibit B-1 p. 4) c. “One year after reaching goal weight over 90% regain all of weight lost.” (Exhibit B-1 p. 4) PAR. 16. By and through the statements and representations referred to in paragraph fifteen, and others not specifically set forth herein of similar import and meaning, respondent represents and has represented, directly, or by implication, that patients in commercial weight loss programs typically lose 11.5 Ibs, that less than 8% of such patients lose 40 or more pounds, and that 90% of such patients regain all of their lost weight one year after reaching goal weight. PAR. 17. By and through the statements and representations referred to in paragraphs fifteen and sixteen, respondent represents, and has represented, directly, or by implication, that at the time respondent made those representations, respondent possessed and relied upon a reasonable basis for those representations. Complaint 116 F.T.C.

PAR. 18. In truth and in fact, at the time respondent made the statements and representations referred to in paragraphs fifteen and sixteen, respondent did not possess and rely upon a reasonable basis for those representations. Therefore, the representation set forth in paragraph seventeen was and is false and misleading. PAR. 19. The acts and practices of respondent alleged in this complaint constitute unfair or deceptive acts or practices in or affecting commerce and “false advertisements” in violation of Sections 5(a) and 12 of the FTC Act, 15 U.S.C. 45(a) and 52. HEALTH MANAGEMENT RESOURCES CORPORATION Complaint EXHIBIT A-1 The Treatment of Choice for Serious Weight Problems PROGRAM iol Ace You Considering a Fasting Program? Choose...

Medica! supervision Safe, rapid w. ght loss Superior-tasting nutritional supplement Realistic approach to weight management Weekly educational sessions 18-month maintenance program Mom Plar Faulkner Hosoital Jamaica Plain. MA (617) 522-394) Neponset Health Center Dorchester, MA (617) 282-3200 Lawrence Memorial Hospital Mediord, MA (617) 395-2260 Norwood Hospital Norwood, MA (617) 769-4000, 2136 Skip Sviokla, MD Cambridge, MA (617) 864-6900 Hanover, MA (617) 871-5585 Dennis H. Rapa, MD Natick, MA (508) 665-0073 New England Center for Health Promotion Cranston, RI (401) 944.5703 HMR Fasting Program Chestnut Hill, MA (617) 232-4886 Emerson Hospital Concord, MA ($08) 369-4211 Newton-Wellesiey Hospital Concord, MA (617) 965-1273 The Benter Heath Corporation Saugus, MA 1-800-STA-SLIM Offered by hundreds of medical centers nationwide Health Management Resources, 54 Temple Place, Bosion, MA (617) 357-9876 Complaint 116 F.T.C.

EXHIBIT A-2 The HR Fasting Program at F Emerson Hospital “The treatment of choice for serious weight problems”

When vour weigint probleins are approached realistically ana vou re given accurate information about welgnt management. being overweight does not have to be a wav of Life. The to@ Fasung Program, offered by hundreds of hospitals anc medical centers natonwide, includes: * Medically supermsed suppiemented fast * Safe, rapid weight loss * Educauonal and behavioral sessions * No hist of resuicted foods * Intensive maintenance program You are invited to attend a FREE ORIENTATION Date: Thursday, January 5 Time: 5:30 - 7:30 p.m.

Place: New Assembly Room Emerson Hospital Old Road to Nine Acre Corner Concord, MA Seaung is limited.

RSVP (508) 369-4211 or (617) 357-9876.

HEALTH MANAGEMENT RESOURCES CORPORATION 807 799 Complaint EXHIBIT B-1 WHEN YOUR NEXT DIET FAILS...

noone T BON'T BLAME YOURSELF.

FIND OUT WHY.

“Our goal is to teach you the skills you need to self manage your weight for a lifetime.”

HMR Fasting PROGRAM Complaint EXHIBIT B-1 WHY | E Diets do not consider your individual eating style.

DIETS kt Diets do not teach you the facts FAIL about calories.

b Diets do not teach you how physical activity relates to your weight.

© Diets do not teach you how to keep off the weight you lose.

HEALTH | We understand why diets have fail- MANAGEMENT | €¢ for you in the past and we have RESOURCES developed a program that can be tailored to your individual lifestyle.

IS Our goal is to facilitate safe, rapid DIFFERENT | weight loss while teaching you the | skills you need to seli-manage your weight over a lifetime:

=. Our approach is educational and behavioral. 3 There is no list of “forbidden” or “restricted” foods. k We emphasize a calorie balancing system where you make your own food choices based on your own eating style.

E We teach you realistic ways to incorporate physical activity into your lifestyle.

A | The staff of HMR is comprised of PROFESSIONAL health care professionals: physicians, nurses, behaviorists and STAFF dieticians, who have expertise in developing and implementing high quality programs in behavioral medicine. We believe that it is the combination of medically supervised weight loss and intensive behavioral learning that accounts for our patients’ success.

002354 Hl6F.T.C.

HEALTH MANAGEMENT RESOURCES CORPORATION Complaint EXHIBIT B-1 A | HMR combines the most effective MEDICALLY | medical and behavioral methods to offer a comprehensive, medical- SUPERVISED ly supervised High Risk Program PROGRAM | for individuals who are 20% or more over their ideal body weight where weight loss would reduce their medical risk. The program includes a 520calorie supplemented diet, weekly physician visits, periodic lab tests and weekly 1% hour educational/behaviora! group sessions. WEIGHT LOSS CHART may ~_— + AVERAGE FIND | 1 AVERAGE AVERACE WEICHT LOSS YOUR AVERAGE WEIGHT LOSS MEICHT LOSS = EACH MONTH | CURRENT | WEICHT&OSS = EACH MONTH FIRST MONTH FOLLOWING WEIGHT FIRST MONTH FOLLOWING 31 2n 34 31 25. 22 275-300 28 23 23 + 18 250-275 25 19 20: 15 225-250 22 17 Foe 14 200-225 20 \ 15 15 : 12 175-200 17 13 13 ' 10 150-175 14 VW 1 ‘ 9 135-150 - :! — io 8 120-135 - 6 — Those enrolled inthe HMR program experience significant improvement in their health. Most patients with hypertension or Type Ii diabetes are able to reduce or totally eliminate all medications and all patients dramatically reduce their risk of heart disease and other medical risk factors.

SAFE, The program utilizes a superior RAPID tasting, high quality dietary supplement, HMR 500, to accelerate WEIGHT safe, rapid weight loss. HMR 500 LOSS | has been developed from many years’ experience working with thousands of patients in medically supervised, supplemented low calorie diet programs. HMR 500 exceeds all RDA recommendations and contains a high enough potassium content to render additional supplementation unnecessary. In taste tests, people prefer HMR 500 to other leading supplements over 95% of the time. 002355 Complaint EXHIBIT B-1 KEEPING We have an intensive Maintenance Program which teaches you skills WEIGHT and individual procedures to bal- OFF ance your calories and maintain your weight loss.

CONSIDER THESE DIFFERENCES Commercial Health Management to Programs; =e Resources a t Average weight boss—11.5 Ibs. verage weight [oss—49.8 Ibs. ‘Less than 8% lose 40 ‘or more pounds F-4 year after’ zeaching goal weight over 90% regain j all of weight lost ” Less than 10% of , weight lost is t kept off long term THE | If you are interested in learning FIRST | more about our program, contact TEP us for the date of the next free S educational orientation. There is no obligation and we assure you that the information you will receive will be useful to you in your future efforts to lose or maintain your weight.

EN, iMHHMIR.. Health Management Resources RISK FACTOR REDUCTION PROGRAMS $9 Temple Place, Boston, MA 02111! (617) 357-9876 002356 © 1986 Health Management Resources, Boston HEALTH MANAGEMENT RESOURCES CORPORATION Complaint EXHIBIT B-2 fo AT PASCACK VALL x min Ole Hook Rosas @ Wesinaoc ts! Diets dono:...

© consiger vour indivicuai eating sivic. ©@ teacr vou tne facts about calories @ teacn vou Row physical activity relates to your weignt © teach vou how to keep off the weigh: vou iose. We undersianc why ciets have failed for vou in the past and we have deveiopeo a program that ts tailored to vour individual lifestyle. Our goa! is to facilitate safe. rapid weigh: loss by offering a comprehensive medically supervised program while teaching you tne skii's you need to self- manage your weign: over a lifetime Consider these facis a: P\V'H's Center... - about werght loss.

© Averzge were © Over 50% lose 40 o: more pounds.

© Cvercd%e of weigh: lost is keot off long tern. 255-398 lbs.

. about Keeping :: off.

@ Our approach is ecucationa! and behavioral. © There is no list of “forbidden” or” restricted” foods. @ We emphasize a calorie balancing system where you make your own (ood choices based on vour own eating style.

@ Weteach vou rcaistic ways to incorporate physical activity into vour lifesrvle i attacunen with HMR Health Management Resources AA PACT OR DUCTION PRO rR Tear om anc man YES, | would like to learn more about the Weight and Risk Fazzor Management Center at J.isack Valiey Hospual If you prefer to call us directly, our number is (201) 358-4600. CG Cail me with the date of the next free educational orientation, O Sens me a brochure describing the programs available at the Center Name TELEPHONT ADORESS cin STATE ur cxhipit B-2 Complaint EXHIBIT B-3 |MANAGEMENT RESOURCES NEWSLETTER Surviving the Holidays: Weight Control Strategies The holidays are a special time of family gatherings. religious ceremonies, shared tnendship, beautiful traditions. and oh. yes. food. Lots and lots of high-calorie food. Aunt Emils’s pecan pie and Cousin Fred's famous gibler grass at Thanksgiving dinner kich off a sia-week parade of party feasting and seasonal snacking This doesn’t stop until January finds us at the beginning of a new year with an average holiday weight gain of 4 10 6 pounds.

The fesuvities are now over The tume has come to take off the extra weight In fact. S0% of us begin a diet thus year. But only about 2% to 3% will actually reach our goal weight and stay there for a year.

Why? Misunformauon Mos! people ahink Starch (pasta, potatoes. nce) ts their enemy. so they cul out carbohydrates This seems to work ai first. because the major result of allow carbohydrate diet is a shoni-term water loss When the body begins to reabsorb water the lost pounds seappear. and the dieter. discouraged and feeling luke a failure. gives up.

Know where the calories are The good news 1s you can lose weight.

keep 11 off. and sul) enjoy hearty meals. All you need 1s the nght informauon.

Your weight 1s controlled by the numbet of calones you consume and the number you expend in physical activity.

When you team to balance food calones “wth calories bummed. souri take the pounds off And keep them off.

You can substanually reduce vour calonc intake by cutting down on fats With nine calones per gram. fathas more than twice the calones of carbohydrates and protein which weigh in at only four per gram Sof you learn where the fats are lurking in your diet vou can avoid them. It takes only an extra 3.500 calones to put on one pound of body fas Eat more and weigh less Quanuty 15 nota reliable measure of how faneming a meal is. You don't have toeat less food. Just less fat. For example. a simple dinner of a 12-0z. T-bone steak and a cup of black coffee has a total of 1200 calones. (A 125-Ib woman needs only 1400 calones daily to maintain her weight.) However. a dinner of a 12-02.

broiled haddock fillet, a baked potato with a tablespoon of sour cream. 1/2 cup of broccoli. a salad with diet dressing. a dinner roll with a pat of butter. a scoop of ice cream. and two cups of coffee with cream and sugar serves up only 910 calones — and a lot more food.

see FEASTING, last page The Problem? Fai’ Americans are eat:

containing 3} percent mor equal volumes of than (wice the calones af pre + and carbons drase The Solution Look for ways ta de far Sour fond choc food. far has mm.

@ Reducing the amo;

we eat ts the singic fective way te cul caiones without eating fess food @ Gnii. bake. broil. and sur-irs ina dr wok instead of frying and sauteing @ “De-fat” your recipes by subsututing lower fat ingredients like skim milk reduced-calone marganne egg whites. sour cream. anc non-fat vogun @ Use more fish. chicken. or turkey instead of red meat You'll save 25 to 100! calones per oz @ Try reducing the amount: 0} oil and sugar in your recipes These changes often da noi affect flavor and texture Expenment’ @ Eat more fruits and vegetables. These contain hime or no fat. so large volumes don’t add up to high calones. Try meatless meals of use meal as a cond:ment.

nd3gge exyhibit 2 HEALTH MANAGEMENT RESOURCES CORPORATION 813 799 Complaint EXHIBIT B-3 Take Charge Of Your Health With The HMR Fasting PPOGD 4 osing weight and maintaining your correct body weight are the major steps you can take toward a longer and healthier life. People who are more than 20% over their ideal bods weight tnple their chances of developing diabetes while their nsh of hypenension could be as much as $.6 umes greater. Taking off extra pounds 1s more than just improsing your appearance — 11's a matter of improving your life Find the right weight-loss program tor yor A comprehensive. medically supenised SCORE Senoaw the question is how do sau dou? am offenng a Very Low-Calone Diets an eacelient way The HMR Fasting am combines mec. 3! and behavioral methods so efiecivels that our paventy “The HMR Fasting Program f more weight than (nese in commercial! weight loss programs. and maintain the! combines medical and weight loss fora longer ume behavi i] hod As you Investigate very low -calane diet programs. ask yourself these questions e aviora methods so © Is the program medically supervised? The HMR Fasting Program inciudes eleeny opment maes m , meekly phy ercian visits and bi-weekly fab testy Ail patients are screened to * ‘ be sure thes are medicalis eligsbie those in commercial 5 Is the supplement good tasnng and of high numtional qualin? Our suppie- weight loss programs, and ment, HMR Sits, has proven itself over the years with thousands of patents maintain their weight loss Nutnnonally complete it contains 1$0% af the Required Daniy Allow ances; ” and Necessary potassium Ir taste tests, people prefer HMIR Sk! to other jead- for a longer time. ing supplements more thar 9S of the ume © Does the program include ed’ canon? “ani weight loss 1s only the beginning A comprehensive educational! program «nich includes weeals i-1,2 hour educanonal ‘behav oral sessions 1s an imponani. required pan of the HMR Fasting Program We teach you the skills you need 10 manage your weight over the long term.

© dsthere a long term maintenance program? We want you to sheep your weigh: off perm rently That's why we will conunue teaching and refining your skills for 7 “er sou reach sour poal werght @ Whar kind of follow-up and staff support is there? HMR’s staff of health Care professionals knows that weight management 1s a learned skill They will work closely with you 10 taslor the program to fit your lifestyle. Do5 1 16 4 1 2 730 1973 31 14 92.262367 you5 1 16 4 1 3 769 1969 43 15 94.193787 learns 1 16 4 1 4 820 1969 48 15 96.693764 about5 1 16 4 1 5 875 1970 84 19 96.379028 balancing5 1 16 4 1 6 967 1971 64 15 95.242622 calories5 1 16 4 1 7 1039 1971 33 15 96.225243 ands 1 16 4 1 8 1078 1972 78 15 90.492378 exercise?5 1 16 4 1 9 1169 1971 44 17 95.187088 HMR5 1 16 4 1 10 1222 1975 59 15 96.468124 teaches5 1 16 4 1 11 1288 1974 23 15 96.383087 thea 1 16 4 2 0 700 1995 607 23 -1 5 1 16 4 2 1 700 1995 98 17 33.724754 rralionshup5 1 16 4 2 2 804 1991 35 31 15.246429 beim5 1 16 4 2 3 845 1991 27 31 15.246429 eens 1 16 4 2 4 881 1996 119 15 75.245186 calone-intake,5 1 16 4 2 5 1008 1996 39 15 88.794998 basics 1 16 4 2 6 1056 2000 75 12 42.289383 nutnition,5 1 16 4 2 7 1138 1998 28 14 96.917488 ands 1 16 4 2 8 1174 1999 67 18 95.753578 physical5 1 16 4 2 9 1249 2002 58 16 92.655403 activity4 1 16 4 3 0 700 2017 607 24 -1 5 1 16 4 3 1 700 2017 40 15 64.793350 “nh5 1 16 4 3 2 749 2022 24 10 72.770203 ours 1 16 4 3 3 780 2019 56 14 90.336403 calones 1 16 4 3 4 844 2019 80 19 89.369019 balancing5 1 16 4 3 5 932 2023 56 15 36.361652 systems 1 16 4 3 6 995 2024 29 14 89.970657 you5 1 16 4 3 7 1032 2025 27 10 91.954712 cans 1 16 4 3 8 1067 2021 39 14 82.796341 leam5 1 16 4 3 9 1114 2025 14 11 73.100769 105 1 16 4 3 10 1135 2022 43 14 96.544907 makes 1 16 4 3 11 1185 2027 37 14 81.786018 yours 1 16 4 3 12 1228 2027 35 11 94.804863 owns 1 16 4 3 13 1271 2023 36 15 94.804863 food4 1 16 4 4 0 698 2045 346 20 -1 5 1 16 4 4 1 698 2045 62 13 94.171539 choices5 1 16 4 4 2 768 2046 14 12 32.212616 lO5 1 16 4 4 3 790 2047 27 12 55.048576 Sul5 1 16 4 4 4 831 2048 37 11 65.112259 yours 1 16 4 4 5 875 2045 69 17 93.269463 personal5 1 16 4 4 6 951 2049 50 16 48.864471 eaung5 1 16 4 4 7 1009 2046 35 19 58.341122 siyte3 1 16 5 0 0 657 2079 682 95 -1 4 1 16 5 1 0 657 2079 674 24 -1 5 1 16 5 1 1 657 2079 10 11 25.229622 ©5 1 16 5 1 2 698 2079 40 16 41.779785 How5 1 16 5 1 3 740 2075 21 30 96.590263 do5 1 16 5 1 4 769 2085 31 14 86.708237 you5 1 16 5 1 5 805 2080 49 20 96.365051 judges 1 16 5 1 6 862 2081 25 15 96.959274 thes 1 16 5 1 7 895 2085 61 12 94.208527 success5 1 16 5 1 8 964 2082 31 19 92.781273 of5 1 16 5 1 9 990 2075 8 30 92.781273 a5 1 16 5 1 10 1002 2082 83 19 93.344368 program?5 1 16 5 1 11 1099 2082 30 16 94.627380 Ours 1 16 5 1 12 1137 2087 60 12 94.976204 success5 1 16 5 1 13 1204 2085 67 18 96.794067 depends5 1 16 5 1 14 1279 2089 19 11 96.394371 on5 1 16 5 1 15 1305 2089 26 12 96.021553 our4 1 16 5 2 0 698 2108 614 20 -1 5 1 16 5 2 1 698 2108 63 14 40.011898 Parents5 1 16 5 2 2 776 2109 66 12 91.163490 success.5 1 16 5 2 3 851 2110 17 11 18.212273 sO5 1 16 5 2 4 876 2110 21 11 91.241188 we5 1 16 5 2 5 904 2110 66 11 81.351044 Monitors 1 16 5 2 6 977 2108 32 14 94.435410 how5 1 16 5 2 7 1018 2108 32 17 78.777542 thes5 1 16 5 2 8 1062 2112 14 10 78.777542 ‘re5 1 16 5 2 9 1083 2108 45 19 78.884796 dong5 1 16 5 2 10 1136 2109 18 14 80.009796 al)5 1 16 5 2 11 1162 2112 51 12 57.331688 across5 1 16 5 2 12 1220 2110 23 14 93.242813 thes 1 16 5 2 13 1251 2114 61 14 63.664093 countn4 1 16 5 3 0 697 2128 642 26 -1 5 1 16 5 3 1 697 2128 32 16 95.116417 Ours 1 16 5 3 2 736 2131 66 14 88.431808 national5 1 16 5 3 3 810 2130 32 15 96.047539 data5 1 16 5 3 4 851 2133 57 16 83.393990 systems 1 16 5 3 5 916 2135 58 11 94.689438 assures5 1 16 5 3 6 982 2133 28 13 87.692749 that5 1 16 5 3 7 1018 2136 25 10 96.856094 ours 1 16 5 3 8 1051 2136 64 14 76.863541 patients5 1 16 5 3 9 1122 2136 57 12 41.831161 receives 1 16 5 3 10 1188 2134 23 14 96.247894 thes 1 16 5 3 11 1219 2134 58 19 93.099998 highest5 1 16 5 3 12 1285 2136 54 18 71.006927 quality4 1 16 5 4 0 697 2155 236 19 -1 5 1 16 5 4 1 697 2157 70 16 75.065491 programs 1 16 5 4 2 775 2156 35 14 88.995796 with5 1 16 5 4 3 818 2155 54 19 96.125572 lasting5 1 16 5 4 4 880 2156 53 15 93.349579 results2 1 17 0 0 0 629 2190 1098 240 -1 3 1 17 1 0 0 629 2190 272 19 -1 4 1 17 1 1 0 629 2190 272 19 -1 5 1 17 1 1 1 629 2190 38 17 96.658241 Thes 1 17 1 1 2 676 2191 72 17 96.120361 bottom5 1 17 1 1 3 757 2192 43 17 95.949654 line:5 1 17 1 1 4 816 2196 85 13 96.436478 success3 1 17 2 0 0 629 2219 754 26 -1 4 1 17 2 1 0 629 2219 754 26 -1 5 1 17 2 1 1 629 2219 32 16 78.928833 Thes 1 17 2 1 2 670 2219 46 16 93.234695 HMR5 1 17 2 1 3 726 2220 59 21 63.857430 Fasung5 1 17 2 1 4 794 2220 72 21 96.359352 Programs 1 17 2 1 5 875 2221 27 15 94.380684 has5 1 17 2 1 6 910 2226 18 10 94.380684 an5 1 17 2 1 7 936 2226 89 15 96.310982 impressive5 1 17 2 1 8 1034 2223 39 15 92.519562 tracks 1 17 2 1 9 1082 2224 57 15 95.955116 record.5 1 17 2 1 10 1153 2223 19 16 91.798889 Its5 1 17 2 1 11 1180 2224 27 15 93.235962 lows 1 17 2 1 12 1217 2226 56 14 88.141945 calones 1 17 2 1 13 1282 2226 101 19 40.401688 supplement.3 1 17 3 0 0 629 2247 753 26 -1 4 1 17 3 1 0 629 2247 753 26 -1 5 1 17 3 1 1 629 2248 87 15 26.763962 educanon,5 1 17 3 1 2 723 2247 88 16 72.502853 behavioral5 1 17 3 1 3 819 2251 70 17 50.053833 training.5 1 17 3 1 4 896 2248 82 21 94.727661 long-terms 1 17 3 1 5 985 2253 66 16 81.206757 support.5 1 17 3 1 6 1058 2250 29 15 87.941284 ands 1 17 3 1 7 1094 2250 132 20 42.955582 calone/physical5 1 17 3 1 8 1233 2255 60 17 75.363960 acuviny5 1 17 3 1 9 1303 2252 79 21 88.316788 balancing3 1 17 4 0 0 629 2274 755 25 -1 4 1 17 4 1 0 629 2274 755 25 -1 5 1 17 4 1 1 629 2274 27 14 96.125946 has5 1 17 4 1 2 662 2274 55 19 63.471783 helped5 1 17 4 1 3 723 2277 65 16 47.854034 pavents5 1 17 4 1 4 794 2275 31 15 84.046028 loses 1 17 4 1 5 832 2278 19 12 96.678650 an5 1 17 4 1 6 856 2278 65 17 96.663414 averages 1 17 4 1 7 927 2274 17 16 96.962250 of5 1 17 4 1 8 949 2274 35 17 96.381180 49.85 1 17 4 1 9 991 2275 26 16 79.300606 Ibs.5 1 17 4 1 10 1024 2277 89 18 14.982841 icompared5 1 17 4 1 11 1120 2277 35 15 87.097466 with5 1 17 4 1 12 1161 2281 17 11 96.539673 an5 1 17 4 1 13 1184 2281 64 17 96.539673 averages 1 17 4 1 14 1257 2278 33 16 89.218719 11.55 1 17 4 1 15 1296 2280 52 19 96.713768 pounds 1 17 4 1 16 1354 2279 30 17 94.278870 loss3 1 17 5 0 0 630 2300 752 24 -1 4 1 17 5 1 0 630 2300 752 24 -1 5 1 17 5 1 1 630 2304 14 11 76.521469 wi5 1 17 5 1 2 652 2300 99 16 80.100166 commercials 1 17 5 1 3 760 2304 92 16 78.147171 programs),5 1 17 5 1 4 869 2302 36 15 95.862854 Ands 1 17 5 1 5 914 2301 44 16 96.277092 while5 1 17 5 1 6 967 2301 36 16 61.611042 98%5 1 17 5 1 7 1013 2301 17 16 96.545677 of5 1 17 5 1 8 1038 2303 42 14 96.545677 those5 1 17 5 1 9 1090 2303 36 15 96.516716 who5 1 17 5 1 10 1135 2302 31 17 96.516716 loses 1 17 5 1 11 1175 2305 56 19 96.002663 weights 1 17 5 1 12 1240 2304 36 16 96.002663 with5 1 17 5 1 13 1285 2307 97 15 39.486687 commercial3 1 17 6 0 0 629 2327 754 22 -1 4 1 17 6 1 0 629 2327 754 22 -1 5 1 17 6 1 1 629 2330 78 16 92.751053 programs5 1 17 6 1 2 715 2331 34 16 72.428650 gains 1 17 6 1 3 754 2331 10 11 72.428650 it5 1 17 6 1 4 770 2327 19 15 45.404068 al)5 1 17 6 1 5 796 2327 37 15 96.792877 backs 1 17 6 1 6 841 2327 52 15 91.263000 within5 1 17 6 1 7 899 2331 7 11 94.607475 a5 1 17 6 1 8 913 2332 39 15 80.281494 year,5 1 17 6 1 9 962 2323 21 30 79.003540 ou5 1 17 6 1 10 990 2332 64 16 84.418045 pabents5 1 17 6 1 11 1062 2329 28 15 96.741417 who5 1 17 6 1 12 1097 2323 26 30 96.236816 ares 1 17 6 1 13 1131 2329 39 16 90.555954 three5 1 17 6 1 14 1177 2334 42 15 81.914902 vears5 1 17 6 1 15 1225 2330 48 17 95.289330 outs 1 17 6 1 16 1260 2323 15 30 93.293106 of5 1 17 6 1 17 1278 2336 105 12 44.659477 mamntenance3 1 17 7 0 0 630 2353 1097 48 -1 4 1 17 7 1 0 630 2353 1097 37 -1 5 1 17 7 1 1 630 2354 37 13 95.256210 have5 1 17 7 1 2 675 2353 71 19 92.508156 regained5 1 17 7 1 3 755 2353 29 15 91.835327 less5 1 17 7 1 4 792 2345 36 35 96.811974 than5 1 17 7 1 5 835 2345 31 35 95.514664 40%5 1 17 7 1 6 878 2353 17 16 96.988693 of5 1 17 7 1 7 902 2355 37 15 80.655701 they5 1 17 7 1 8 946 2355 61 19 80.638138 weight.5 1 17 7 1 9 1014 2355 29 16 92.479034 ands 1 17 7 1 10 1050 2358 44 16 96.434525 many5 1 17 7 1 11 1104 2355 37 16 93.287842 have5 1 17 7 1 12 1148 2355 35 21 67.259094 kepx5 1 17 7 1 13 1191 2361 8 10 92.311218 it5 1 17 7 1 14 1207 2357 19 15 94.822449 all5 1 17 7 1 15 1233 2357 28 16 90.253487 off.5 1 17 7 1 16 1583 2356 41 31 82.525421 ud5 1 17 7 1 17 1633 2355 16 32 97.008286 35 1 17 7 1 18 1657 2355 16 31 81.537811 g5 1 17 7 1 19 1682 2355 45 35 81.959267 334 1 17 7 2 0 655 2377 728 24 -1 5 1 17 7 2 1 655 2377 28 17 95.308464 We5 1 17 7 2 2 696 2382 47 12 69.008179 invites 1 17 7 2 3 755 2383 30 16 93.341782 you5 1 17 7 2 4 797 2382 15 13 94.977760 to5 1 17 7 2 5 823 2383 46 12 95.504387 comes 1 17 7 2 6 880 2383 16 12 95.504387 to5 1 17 7 2 7 906 2384 28 11 96.011230 ours 1 17 7 2 8 945 2379 37 17 95.078636 free.5 1 17 7 2 9 993 2385 20 11 92.871368 no5 1 17 7 2 10 1023 2381 88 20 69.735962 obliganon5 1 17 7 2 11 1122 2382 100 16 84.589966 educabonal5 1 17 7 2 12 1232 2388 96 12 87.459045 onentanon5 1 17 7 2 13 1351 2383 32 17 96.746384 Thee 1 17 8 0 0 629 2406 689 24 -1 4 1 17 8 1 0 629 2406 689 24 -1 5 1 17 8 1 1 629 2406 103 16 94.322327 information5 1 17 8 1 2 740 2411 31 15 96.867195 you5 1 17 8 1 3 779 2411 63 11 95.065887 receives 1 17 8 1 4 851 2406 32 16 62.485210 wil)5 1 17 8 1 5 891 2408 37 20 92.202759 helps 1 17 8 1 6 935 2412 31 16 77.691498 you5 1 17 8 1 7 973 2412 37 12 65.145256 starts 1 17 8 1 8 1018 2412 15 13 94.912529 to5 1 17 8 1 9 1040 2409 35 16 96.240067 takes 1 17 8 1 10 1083 2409 61 16 92.422638 controls 1 17 8 1 11 1151 2409 18 16 93.823486 of5 1 17 8 1 12 1176 2415 38 15 93.823486 yours 1 17 8 1 13 1222 2415 36 11 96.917839 owns 1 17 8 1 14 1265 2412 53 16 96.247650 health2 1 18 0 0 0 630 2448 1153 64 -1 3 1 18 1 0 0 630 2448 1153 64 -1 4 1 18 1 1 0 630 2448 1153 64 -1 5 1 18 1 1 1 630 2448 1153 64 95.000000 2 1 19 0 0 0 1577 2499 207 17 -1 3 1 19 1 0 0 1577 2499 207 17 -1 4 1 19 1 1 0 1577 2499 207 17 -1 5 1 19 1 1 1 1577 2499 32 17 95.412552 For5 1 19 1 1 2 1618 2499 40 17 95.830818 Yours 1 19 1 1 3 1666 2500 52 16 25.078133 Better5 1 19 1 1 4 1726 2500 58 16 9.465714 Heal:2 1 20 0 0 0 627 2489 65 19 -1 3 1 20 1 0 0 627 2489 65 19 -1 4 1 20 1 1 0 627 2489 65 19 -1 5 1 20 1 1 1 627 2489 65 19 95.000000 Complaint 116 F.T.C.

EXHIBIT B-3 Patient Profile:

One Step At A Time Jeanene Olson. age 65. was told a year and a half ago by a hear specialist that she would die if she didn't lose weight. Now seven months into maintenance. she 1s sustaining a 100 pound weight loss.

When Jeanene entered the HMR Fasting Program at Austin Diagnostics. TX in \fay of 1988 she was in a wheelchair with neuropathy of her legs. on high levels of insulin daily. and suffenng from severe heart problems—all associated with abeuty Jeanette tned a number of diet programs over the vears but was never able to sheep off weight she lost. “I'd be given a shp of paper and told to go on this 1S00 calone per das diet and lose weight Ir just never worked Maybe for 10.20 pounds tt wouid bur with the amount of werght | had to lose. 1 just was too difficult” — eee “Uf 1 had done this earlier I probably wouldn't have so many health problems today. I never thought 1 could come so far. But]'m proof that it's never too late.”

Jeanetie Olson (pictured on left) — I5 1 8 1 2 5 958 1300 40 12 39.530582 nave5 1 8 1 2 6 1005 1300 46 12 69.934174 never4 1 8 1 3 0 820 1320 231 16 -1 5 1 8 1 3 1 820 1324 41 12 87.961052 beers 1 8 1 3 2 868 1323 34 12 73.259964 abie5 1 8 1 3 3 910 1323 13 12 69.973755 to5 1 8 1 3 4 931 1323 45 12 4.077538 Maver5 1 8 1 3 5 993 1320 4 12 31.597519 |5 1 8 1 3 6 1003 1322 48 12 31.597519 woud4 1 8 1 4 0 820 1344 229 18 -1 5 1 8 1 4 1 820 1346 27 16 93.921768 Says 1 8 1 4 2 856 1346 44 12 9.695297 {gre5 1 8 1 4 3 909 1345 1 11 21.623985 I5 1 8 1 4 4 916 1344 40 13 59.372330 have5 1 8 1 4 5 963 1344 23 12 92.770020 thes 1 8 1 4 6 994 1345 55 14 95.616608 money4 1 8 1 5 0 856 1366 193 16 -1 5 1 8 1 5 1 856 1367 55 13 24.007027 Iwas5 1 8 1 5 2 918 1366 44 16 58.275486 really5 1 8 1 5 3 968 1367 70 12 63.002441 because5 1 8 1 5 4 1046 1368 3 7 63.002441 !4 1 8 1 6 0 901 1389 145 14 -1 5 1 8 1 6 1 901 1389 14 12 80.133316 et5 1 8 1 6 2 921 1389 59 12 29.355270 around5 1 8 1 6 3 987 1389 31 10 44.026024 wih5 1 8 1 6 4 1024 1389 22 14 81.470749 my4 1 8 1 7 0 912 1411 133 15 -1 5 1 8 1 7 1 912 1411 2 10 37.385883 i5 1 8 1 7 2 922 1411 40 12 37.385883 aor5 1 8 1 7 3 978 1412 39 12 0.000000 see=5 1 8 1 7 4 1024 1412 21 14 94.528313 my4 1 8 1 8 0 819 1431 228 18 -1 5 1 8 1 8 1 819 1435 62 12 36.528362 sisters 1 8 1 8 2 888 1431 20 15 88.776588 3S5 1 8 1 8 3 914 1434 45 15 38.601334 years5 1 8 1 8 4 966 1433 81 13 0.000000 because!4 1 8 1 9 0 849 1453 196 16 -1 5 1 8 1 9 1 849 1458 30 11 94.842781 was5 1 8 1 9 2 887 1458 26 11 0.000000 loo5 1 8 1 9 3 919 1456 77 12 0.000000 asnamed5 1 8 1 9 4 1015 1453 30 14 90.015472 This4 1 8 1 10 0 823 1476 223 19 -1 5 1 8 1 10 1 823 1476 109 19 10.527115 Tragnxsgiing5 1 8 1 10 2 940 1477 3 10 80.835602 |5 1 8 1 10 3 949 1478 58 12 52.218132 wentic5 1 8 1 10 4 1015 1478 31 12 76.956871 visit4 1 8 1 11 0 823 1498 220 19 -1 5 1 8 1 11 1 823 1503 22 14 89.874496 my5 1 8 1 11 2 853 1501 63 13 30.449486 sisters 1 8 1 11 3 925 1498 55 14 28.964775 Fiorda5 1 8 1 11 4 997 1500 10 11 39.872013 I5 1 8 1 11 5 1013 1501 30 11 90.733665 was4 1 8 1 12 0 952 1520 94 14 -1 5 1 8 1 12 1 952 1520 94 14 0.000000 wondewy!”2 1 9 0 0 0 820 1371 79 57 -1 3 1 9 1 0 0 820 1371 79 57 -1 4 1 9 1 1 0 820 1371 79 57 -1 5 1 9 1 1 1 820 1371 79 57 95.000000 2 1 10 0 0 0 1561 1567 350 7 -1 3 1 10 1 0 0 1561 1567 350 7 -1 4 1 10 1 1 0 1561 1567 350 7 -1 5 1 10 1 1 1 1561 1567 350 7 95.000000 2 1 11 0 0 0 1070 1257 466 343 -1 3 1 11 1 0 0 1070 1257 466 343 -1 4 1 11 1 1 0 1070 1257 466 343 -1 5 1 11 1 1 1 1070 1257 466 343 95.000000 2 1 12 0 0 0 764 1632 1079 701 -1 3 1 12 1 0 0 769 1632 750 131 -1 4 1 12 1 1 0 799 1632 720 23 -1 5 1 12 1 1 1 799 1635 91 20 96.288254 According5 1 12 1 1 2 901 1638 15 11 69.298233 to5 1 12 1 1 3 925 1634 76 15 88.489792 Jeanene.5 1 12 1 1 4 1012 1635 47 18 85.564552 bemg5 1 12 1 1 5 1069 1638 21 11 96.022614 on5 1 12 1 1 6 1100 1635 24 14 96.481491 thes 1 12 1 1 7 1135 1634 121 19 95.740166 supplemented5 1 12 1 1 8 1267 1634 39 19 85.774895 Very5 1 12 1 1 9 1319 1635 35 15 93.315140 Lows 1 12 1 1 10 1367 1633 63 17 0.000000 Calories 1 12 1 1 11 1442 1632 34 18 95.922760 Diets 1 12 1 1 12 1488 1638 31 10 83.841476 was4 1 12 1 2 0 769 1661 748 20 -1 5 1 12 1 2 1 769 1667 52 11 78.876007 easier5 1 12 1 2 2 828 1662 23 15 96.171585 for5 1 12 1 2 3 859 1662 26 15 94.536697 hers 1 12 1 2 4 892 1662 36 15 94.292671 than5 1 12 1 2 5 935 1662 44 15 96.710564 others 1 12 1 2 6 987 1662 39 14 96.197884 diets5 1 12 1 2 7 1034 1661 67 15 96.097244 because5 1 12 1 2 8 1110 1665 9 11 95.565536 it5 1 12 1 2 9 1126 1662 91 15 95.541664 eliminated5 1 12 1 2 10 1225 1661 38 16 96.239441 foods 1 12 1 2 11 1270 1662 70 15 92.913544 choices.5 1 12 1 2 12 1353 1662 23 14 86.878525 thes 1 12 1 2 13 1384 1662 34 19 89.126900 only5 1 12 1 2 14 1428 1662 56 15 88.497009 choices 1 12 1 2 15 1492 1662 25 14 96.838051 shea 1 12 1 3 0 769 1688 750 20 -1 5 1 12 1 3 1 769 1692 30 14 96.593918 had5 1 12 1 3 2 809 1693 31 12 92.907051 was5 1 12 1 3 3 848 1689 66 15 32.643990 “whether5 1 12 1 3 4 922 1692 16 12 96.648880 to5 1 12 1 3 5 945 1691 23 13 83.477356 eats 1 12 1 3 6 977 1689 60 15 27.948570 vanilla.5 1 12 1 3 7 1045 1688 79 16 94.825233 chocolates 1 12 1 3 8 1133 1692 16 11 94.825233 or5 1 12 1 3 9 1156 1689 64 15 96.756683 chickens 1 12 1 3 10 1229 1693 38 15 96.954895 soup.5 1 12 1 3 11 1286 1689 29 15 96.947166 She5 1 12 1 3 12 1324 1693 34 15 95.757965 says5 1 12 1 3 13 1366 1689 22 15 95.757965 thes 1 12 1 3 14 1398 1688 36 16 91.317062 staffs 1 12 1 3 15 1440 1688 18 15 94.682922 of5 1 12 1 3 16 1467 1690 52 14 28.801109 Austin4 1 12 1 4 0 769 1715 750 22 -1 5 1 12 1 4 1 769 1717 99 20 81.266151 Diagnosucs5 1 12 1 4 2 874 1717 34 14 93.806503 also5 1 12 1 4 3 915 1720 31 11 89.220612 was5 1 12 1 4 4 953 1719 33 16 94.204330 very5 1 12 1 4 5 996 1719 88 15 89.580887 Supportive5 1 12 1 4 6 1090 1716 30 15 96.756042 ands 1 12 1 4 7 1126 1716 24 15 96.756042 thes 1 12 1 4 8 1157 1716 64 15 71.429649 medica]5 1 12 1 4 9 1229 1720 95 14 17.876312 supersision5 1 12 1 4 10 1332 1720 30 11 96.331184 was5 1 12 1 4 11 1369 1716 74 19 92.515656 thorough5 1 12 1 4 12 1459 1715 60 15 18.433746 “When4 1 12 1 5 0 769 1743 716 20 -1 5 1 12 1 5 1 769 1749 30 11 70.978355 vow5 1 12 1 5 2 806 1746 38 14 95.462090 have5 1 12 1 5 3 851 1748 37 11 95.768188 avers 1 12 1 5 4 898 1743 28 15 88.849373 1005 1 12 1 5 5 932 1743 61 20 96.778824 pounds5 1 12 1 5 6 1001 1746 15 11 84.346100 to5 1 12 1 5 7 1023 1743 31 15 96.147598 loses 1 12 1 5 8 1062 1746 29 16 96.701683 you5 1 12 1 5 9 1099 1744 38 14 96.737885 needs 1 12 1 5 10 1144 1747 7 11 95.486877 a5 1 12 1 5 11 1159 1743 79 19 95.486877 physicians 1 12 1 5 12 1246 1747 14 11 96.139053 to5 1 12 1 5 13 1267 1746 65 12 90.009377 monitors 1 12 1 5 14 1340 1743 45 19 52.230839 vou.”5 1 12 1 5 15 1391 1743 26 15 96.363472 she5 1 12 1 5 16 1424 1743 61 15 92.297729 advises3 1 12 2 0 0 768 1769 751 49 -1 4 1 12 2 1 0 795 1769 724 22 -1 5 1 12 2 1 1 795 1771 52 16 92.395607 While5 1 12 2 1 2 859 1773 52 18 55.134804 losng5 1 12 2 1 3 924 1770 57 20 65.596771 weights 1 12 2 1 4 994 1770 37 15 92.759888 with5 1 12 2 1 5 1043 1770 24 15 96.235893 thes 1 12 2 1 6 1080 1769 46 16 94.965164 HMR5 1 12 2 1 7 1140 1769 62 21 95.831947 Fasting5 1 12 2 1 8 1214 1770 74 20 93.207932 Programs 1 12 2 1 9 1299 1770 70 15 57.090492 Jeanene5 1 12 2 1 10 1381 1770 63 16 69.084213 teamed5 1 12 2 1 11 1456 1770 33 15 95.387367 how5 1 12 2 1 12 1503 1774 16 11 95.266052 to4 1 12 2 2 0 768 1797 744 21 -1 5 1 12 2 2 1 768 1803 97 15 57.170990 incorpora..5 1 12 2 2 2 874 1798 71 15 38.080673 realistic5 1 12 2 2 3 952 1797 70 19 71.200363 Charges5 1 12 2 2 4 1030 1800 32 12 95.232895 into5 1 12 2 2 5 1069 1798 26 14 92.378082 hers 1 12 2 2 6 1102 1797 68 20 80.325623 lifestyie5 1 12 2 2 7 1177 1800 16 12 91.353333 to5 1 12 2 2 8 1200 1797 35 19 91.353333 helps 1 12 2 2 9 1242 1798 26 14 95.958527 hers 1 12 2 2 10 1275 1798 40 18 95.958527 keeps 1 12 2 2 11 1321 1797 25 15 96.149147 offs 1 12 2 2 12 1352 1798 24 14 96.397171 thes 1 12 2 2 13 1384 1797 57 20 88.258415 weights 1 12 2 2 14 1448 1797 27 15 96.879089 she5 1 12 2 2 15 1483 1797 29 15 93.915550 lost3 1 12 3 0 0 765 1824 752 130 -1 4 1 12 3 1 0 794 1824 723 20 -1 5 1 12 3 1 1 794 1827 69 14 65.807068 Jeanene5 1 12 3 1 2 877 1829 34 11 87.120605 now5 1 12 3 1 3 927 1824 40 15 95.968636 feels5 1 12 3 1 4 979 1824 83 15 96.328232 confident5 1 12 3 1 5 1076 1824 30 15 95.864136 that5 1 12 3 1 6 1120 1825 17 18 95.040771 by5 1 12 3 1 7 1153 1828 117 16 96.495438 incorporating5 1 12 3 1 8 1283 1825 72 19 96.388428 physical5 1 12 3 1 9 1368 1828 62 16 70.825333 activity5 1 12 3 1 10 1447 1828 32 11 91.091057 into5 1 12 3 1 11 1491 1825 26 14 94.130959 her4 1 12 3 2 0 767 1851 750 22 -1 5 1 12 3 2 1 767 1853 69 20 6.657341 ttestyle5 1 12 3 2 2 844 1853 30 15 94.121635 ands 1 12 3 2 3 880 1856 53 16 82.319748 cating5 1 12 3 2 4 941 1856 7 11 87.132843 a5 1 12 3 2 5 957 1852 49 14 87.132843 lowers 1 12 3 2 6 1013 1851 20 15 92.220657 fats 1 12 3 2 7 1040 1852 32 14 47.561264 dret5 1 12 3 2 8 1080 1851 26 15 95.297508 she5 1 12 3 2 9 1115 1851 30 15 34.372643 will5 1 12 3 2 10 1153 1852 18 14 95.814697 be5 1 12 3 2 11 1178 1852 36 15 93.921654 able5 1 12 3 2 12 1221 1855 15 12 93.921654 to5 1 12 3 2 13 1243 1852 65 15 93.300156 balances 1 12 3 2 14 1316 1852 67 15 88.445114 calones5 1 12 3 2 15 1390 1856 38 10 87.427055 overs 1 12 3 2 16 1435 1855 42 11 87.427055 time.5 1 12 3 2 17 1489 1851 28 15 96.817795 Fora 1 12 3 3 0 766 1879 751 20 -1 5 1 12 3 3 1 766 1881 81 18 81.533676 example,5 1 12 3 3 2 855 1881 26 14 95.386444 she5 1 12 3 3 3 891 1883 32 11 88.504967 eats5 1 12 3 3 4 931 1880 57 17 53.923641 mostly5 1 12 3 3 5 1000 1881 46 12 93.332909 whites 1 12 3 3 6 1056 1879 52 18 49.533215 turkey5 1 12 3 3 7 1119 1880 29 13 96.621124 ands 1 12 3 3 8 1157 1879 67 15 95.027519 chickens 1 12 3 3 9 1232 1883 21 10 77.835907 (at5 1 12 3 3 10 1261 1879 21 15 79.444885 445 1 12 3 3 11 1290 1879 68 15 91.466026 calones5 1 12 3 3 12 1366 1883 26 15 96.636284 pers 1 12 3 3 13 1400 1883 60 11 82.562057 ounce)5 1 12 3 3 14 1468 1880 49 13 96.654533 rather4 1 12 3 4 0 766 1905 748 21 -1 5 1 12 3 4 1 766 1911 37 12 81.078850 than5 1 12 3 4 2 812 1908 26 14 93.879517 reds 1 12 3 4 3 847 1910 41 11 68.093124 meats 1 12 3 4 4 898 1909 20 12 68.093124 tat5 1 12 3 4 5 931 1905 28 16 89.711662 1005 1 12 3 4 6 968 1905 68 16 89.711662 calones5 1 12 3 4 7 1045 1909 26 14 96.724983 pers 1 12 3 4 8 1080 1909 64 11 57.722240 ounces,5 1 12 3 4 9 1159 1905 14 16 77.371033 “I5 1 12 3 4 10 1184 1905 30 16 91.602043 sull5 1 12 3 4 11 1223 1909 23 12 94.734558 eats 1 12 3 4 12 1256 1906 37 20 96.374207 high5 1 12 3 4 13 1303 1905 20 15 85.330971 fats 1 12 3 4 14 1333 1905 46 16 96.081810 foods5 1 12 3 4 15 1388 1906 30 15 96.682182 ands 1 12 3 4 16 1429 1905 3 16 71.162338 |5 1 12 3 4 17 1441 1905 73 19 49.268913 certainty4 1 12 3 5 0 765 1932 640 22 -1 5 1 12 3 5 1 765 1939 46 15 41.067425 enios5 1 12 3 5 2 822 1933 58 17 93.664314 them.”5 1 12 3 5 3 888 1934 27 15 95.134689 she5 1 12 3 5 4 923 1937 36 16 55.222290 sass5 1 12 3 5 5 973 1932 40 16 40.232132 “But5 1 12 3 5 6 1021 1936 34 11 40.232132 now5 1 12 3 5 7 1066 1932 4 15 84.960518 |5 1 12 3 5 8 1078 1933 45 15 90.425858 knows 1 12 3 5 9 1134 1933 39 15 82.073006 what5 1 12 3 5 10 1183 1936 9 11 93.500229 it5 1 12 3 5 11 1200 1933 43 15 95.924942 takes5 1 12 3 5 12 1251 1936 15 12 93.596237 to5 1 12 3 5 13 1273 1933 65 15 94.925964 balances 1 12 3 5 14 1347 1932 58 16 56.386433 them.”3 1 12 4 0 0 764 1959 753 104 -1 4 1 12 4 1 0 793 1959 723 22 -1 5 1 12 4 1 1 793 1961 70 20 93.093811 Physical5 1 12 4 1 2 871 1964 60 16 94.728378 activity5 1 12 4 1 3 942 1965 12 10 76.223419 1s5 1 12 4 1 4 962 1964 18 11 93.728333 an5 1 12 4 1 5 989 1963 81 16 0.000000 important5 1 12 4 1 6 1078 1963 93 16 96.724190 components 1 12 4 1 7 1180 1959 16 16 96.824707 of5 1 12 4 1 8 1203 1960 23 15 96.689674 thes 1 12 4 1 9 1236 1959 45 16 93.261414 HMR5 1 12 4 1 10 1291 1959 59 21 28.979866 Fasung5 1 12 4 1 11 1360 1960 76 20 96.262520 Program.5 1 12 4 1 12 1444 1959 43 16 94.328064 After5 1 12 4 1 13 1495 1965 21 10 94.608917 six4 1 12 4 2 0 766 1986 751 22 -1 5 1 12 4 2 1 766 1989 61 16 4.006378 T.nths5 1 12 4 2 2 835 1993 14 11 93.667297 in5 1 12 4 2 3 857 1989 24 15 96.644455 thes 1 12 4 2 4 889 1992 76 16 93.306221 program.5 1 12 4 2 5 973 1987 66 16 91.326347 Jeanene5 1 12 4 2 6 1049 1986 25 16 83.877472 ieft5 1 12 4 2 7 1083 1987 25 15 92.523415 hers 1 12 4 2 8 1116 1987 92 15 68.751732 wheeichair5 1 12 4 2 9 1215 1991 15 11 81.779648 to5 1 12 4 2 10 1237 1987 46 20 95.820381 begins 1 12 4 2 11 1291 1988 66 19 90.239746 walking5 1 12 4 2 12 1366 1988 35 14 93.105095 with5 1 12 4 2 13 1412 1992 4 11 93.105095 a5 1 12 4 2 14 1425 1987 56 16 95.116745 walker5 1 12 4 2 15 1488 1988 29 14 96.735100 anda 1 12 4 3 0 765 2014 746 21 -1 5 1 12 4 3 1 765 2021 33 11 39.718941 now5 1 12 4 3 2 812 2020 35 12 87.572517 uses5 1 12 4 3 3 856 2020 8 11 87.572517 a5 1 12 4 3 4 874 2019 37 13 92.261124 cane5 1 12 4 3 5 922 2018 16 13 96.344704 to5 1 12 4 3 6 948 2019 23 16 87.680771 gets 1 12 4 3 7 982 2016 63 14 94.403091 around.5 1 12 4 3 8 1065 2014 73 16 96.605354 Between5 1 12 4 3 9 1148 2015 72 20 36.188469 walling.5 1 12 4 3 10 1230 2019 79 15 80.229454 stavonary5 1 12 4 3 11 1323 2015 50 20 71.884796 buung5 1 12 4 3 12 1384 2016 29 14 93.067116 ands 1 12 4 3 13 1423 2019 88 16 56.873222 swumming4 1 12 4 4 0 764 2041 705 22 -1 5 1 12 4 4 1 764 2044 68 15 66.964272 Jeanette5 1 12 4 4 2 839 2043 73 20 75.478493 currenuy5 1 12 4 4 3 922 2043 46 16 95.497894 burns5 1 12 4 4 4 975 2042 120 20 95.459709 approximately5 1 12 4 4 5 1105 2041 46 17 93.290833 3.0005 1 12 4 4 6 1157 2042 65 16 92.756050 calones5 1 12 4 4 7 1228 2046 26 16 96.618942 pers 1 12 4 4 8 1262 2043 42 15 95.519623 weeks 1 12 4 4 9 1312 2047 14 10 94.392914 in5 1 12 4 4 10 1333 2043 69 19 96.372307 physical5 1 12 4 4 11 1409 2046 60 16 63.461567 activity3 1 12 5 0 0 766 2069 752 75 -1 4 1 12 5 1 0 791 2069 726 20 -1 5 1 12 5 1 1 791 2071 41 15 91.488129 “Thes 1 12 5 1 2 838 2074 38 12 66.604454 moss 1 12 5 1 3 883 2073 79 16 23.620056 imponant5 1 12 5 1 4 968 2071 41 18 96.809914 things 1 12 5 1 5 1015 2065 22 28 96.228256 for5 1 12 5 1 6 1046 2065 17 28 95.664391 me5 1 12 5 1 7 1073 2073 11 11 80.268814 1s5 1 12 5 1 8 1092 2065 13 28 73.904129 lo5 1 12 5 1 9 1110 2070 91 19 96.339348 keeps 1 12 5 1 10 1155 2065 17 28 94.858009 up5 1 12 5 1 11 1181 2065 17 28 92.636940 my5 1 12 5 1 12 1208 2070 105 19 17.493759 acovity.””5 1 12 5 1 13 1290 2065 22 28 93.889961 she5 1 12 5 1 14 1320 2074 37 15 66.368835 says.5 1 12 5 1 15 1368 2065 60 28 42.391655 “That's5 1 12 5 1 16 1438 2065 79 28 30.172485 somevung4 1 12 5 2 0 766 2096 752 20 -1 5 1 12 5 2 1 766 2099 3 15 65.919212 I5 1 12 5 2 2 778 2092 43 28 76.683578 never5 1 12 5 2 3 827 2092 71 28 92.897316 realized.5 1 12 5 2 4 907 2097 2 16 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18 11 95.766197 so5 1 12 6 2 8 1054 2178 38 17 73.379425 far.”5 1 12 6 2 9 1099 2183 35 15 79.177032 says5 1 12 6 2 10 1142 2179 69 15 92.558594 Jeanene5 1 12 6 2 11 1228 2178 40 16 84.506973 “But5 1 12 6 2 12 1277 2179 29 15 46.314564 I’m5 1 12 6 2 13 1313 2174 44 30 95.318710 proofs 1 12 6 2 14 1364 2174 33 30 93.586472 that5 1 12 6 2 15 1405 2179 26 15 61.164860 11's5 1 12 6 2 16 1438 2183 47 11 94.359390 never5 1 12 6 2 17 1492 2182 27 12 51.943878 (004 1 12 6 3 0 766 2205 754 22 -1 5 1 12 6 3 1 766 2210 28 14 59.125854 Jae5 1 12 6 3 2 817 2208 3 16 69.775101 15 1 12 6 3 3 829 2208 45 16 72.873802 don't5 1 12 6 3 4 883 2208 31 15 91.331055 feels 1 12 6 3 5 922 2206 83 21 80.172806 sixty-five5 1 12 6 3 6 1025 2206 56 15 61.942844 That's5 1 12 6 3 7 1090 2206 23 16 95.780045 for5 1 12 6 3 8 1121 2211 34 10 93.746429 sure.5 1 12 6 3 9 1177 2205 95 16 96.144066 Sometimes5 1 12 6 3 10 1282 2206 3 15 70.337288 |5 1 12 6 3 11 1294 2211 40 11 96.567215 even5 1 12 6 3 12 1342 2206 31 16 87.862686 feels 1 12 6 3 13 1382 2207 42 19 95.772827 goods 1 12 6 3 14 1432 2206 63 19 96.740105 enough5 1 12 6 3 15 1504 2210 16 11 95.284073 to4 1 12 6 4 0 766 2233 754 23 -1 5 1 12 6 4 1 766 2240 21 16 10.025414 fo5 1 12 6 4 2 798 2236 38 15 93.694923 backs 1 12 6 4 3 849 2239 16 12 95.792549 to5 1 12 6 4 4 876 2235 50 16 92.653801 work!5 1 12 6 4 5 947 2234 60 20 92.653801 Losing5 1 12 6 4 6 1019 2235 30 14 95.844955 this5 1 12 6 4 7 1061 2235 58 19 96.706940 weights 1 12 6 4 8 1131 2234 27 16 96.602379 has5 1 12 6 4 9 1169 2238 48 16 94.506569 given5 1 12 6 4 10 1228 2238 24 11 93.314148 me5 1 12 6 4 11 1264 2238 7 11 90.901176 a5 1 12 6 4 12 1284 2238 45 11 90.901176 senses 1 12 6 4 13 1341 2234 30 15 95.724876 that5 1 12 6 4 14 1384 2233 4 15 58.863964 15 1 12 6 4 15 1399 2238 30 12 85.387001 cans 1 12 6 4 16 1440 2233 46 20 93.731033 really5 1 12 6 4 17 1499 2234 21 15 96.159126 do4 1 12 6 5 0 766 2261 754 22 -1 5 1 12 6 5 1 766 2264 91 19 95.021896 something5 1 12 6 5 2 880 2262 49 16 70.120865 And]5 1 12 6 5 3 940 2262 26 15 92.078148 did5 1 12 6 5 4 976 2265 10 12 62.038551 15 1 12 6 5 5 995 2261 24 16 92.080956 for5 1 12 6 5 6 1028 2265 32 12 93.367363 me.5 1 12 6 5 7 1069 2265 26 11 96.277733 not5 1 12 6 5 8 1105 2261 23 16 96.356895 for5 1 12 6 5 9 1138 2262 71 19 88.786667 anybody5 1 12 6 5 10 1222 2263 31 14 89.391121 else.5 1 12 6 5 11 1276 2261 4 16 86.994011 |5 1 12 6 5 12 1291 2262 52 15 96.509720 would5 1 12 6 5 13 1354 2262 102 15 96.444855 recommends 1 12 6 5 14 1466 2261 29 16 96.656761 this5 1 12 6 5 15 1505 2265 15 11 90.467728 to3 1 12 7 0 0 766 2289 1077 44 -1 4 1 12 7 1 0 777 2289 348 17 -1 5 1 12 7 1 1 777 2296 17 10 64.139618 ay5 1 12 7 1 2 949 2293 4 11 0.000000 Of5 1 12 7 1 3 986 2289 70 15 94.158485 weights 1 12 7 1 4 1051 2285 15 29 95.241028 to5 1 12 7 1 5 1076 2289 23 15 0.000000 lose4 1 12 7 2 0 766 2289 1077 44 -1 5 1 12 7 2 1 766 2289 213 21 77.907089 anyone5 1 12 7 2 2 837 2285 30 30 96.916214 who5 1 12 7 2 3 877 2285 28 30 95.217606 has5 1 12 7 2 4 912 2285 10 30 92.301224 a5 1 12 7 2 5 929 2285 51 30 39.784653 lotof5 1 12 7 2 6 1012 2293 14 16 95.949669 weights 1 12 7 2 7 1058 2293 10 12 92.637756 to5 1 12 7 2 8 1101 2293 7 12 92.637756 loses 1 12 7 2 9 1703 2297 140 36 56.518517 4939942 1 13 0 0 0 773 1857 23 11 -1 3 1 13 1 0 0 773 1857 23 11 -1 4 1 13 1 1 0 773 1857 23 11 -1 5 1 13 1 1 1 773 1857 23 11 95.000000 2 1 14 0 0 0 765 2397 1150 19 -1 3 1 14 1 0 0 765 2397 1150 19 -1 4 1 14 1 1 0 765 2397 1150 19 -1 5 1 14 1 1 1 765 2397 1150 19 95.000000 2 1 15 0 0 0 1714 2421 207 17 -1 3 1 15 1 0 0 1714 2421 207 17 -1 4 1 15 1 1 0 1714 2421 207 17 -1 5 1 15 1 1 1 1714 2421 33 16 95.625404 For5 1 15 1 1 2 1755 2422 40 16 95.625404 Yours 1 15 1 1 3 1801 2421 54 17 77.407928 Bester5 1 15 1 1 4 1862 2421 59 16 57.889179 Heaith HEALTH MANAGEMENT RESOURCES CORPORATION from FEASTING, first page If you're tired of “diet plates” with 2 hamburg patty, cottage cheese. and a peach half, try ordenng a large turkey sandwich with lettuce. tomato, mustard.

and a side order of coleslaw. You'll get more food and less than half the calones If you're an incurable nibbler or realls enjoy mghttime snacking. there's no need to change your eating habits, just sour food. In choosing what to snack on. remember that fned foods are higher in fat than their baked or broiled counterparts: that ait-popped popcorn 1s a lower. calome snack than peanuts. which have 36 umes the calones: and that a turkes sandwich has half the calories of pastrami and cneese Irs not when vou eat. t's how much fat and calones you eat that counts.

A little walking goes 8 long way In addinon to limiting calones. you can hum them upas well Exercise caneven “hus you some extra calories. If sou want to eal some higher calone foods.

then work those calones off We're not suggesting that you turn yourself into a world-class athlete. just that sou become more acuve You might get off the bus afew stops early and walk of OD Pan ag in the back of the lot Another quick Inck 15 fo use the stairs instead of taking the eles ator Got a few spare minutes at lunch”

You can sneak in some exercise and give sourself a change of pace by walking 10 minute. away from + rh olace and 10 minutes back each day If vou weigh 180 Ibs., you'll burn off about: 100 calones. a ten pound weight loss in one year.

Physically active people have fewer situggles with extra pounds than sedenian people. so it’s a good idea 10 make your activities a regular pan of every day If you keep 1 up even after you've hit your goal weight. you Il increase your Complaint EXHIBIT B-3 chances of staying there The key to regular exercise is to build unght into your daily routine. [t's easier to stick (0 an acuvity when it fits into your lifestyle and you enjoy doing it.

The trick to holiday treats You can change some of your food choices to keep those excess calones down. For example. take a fook at the traditional turkes dinner Nuts are much higher in fat than raw ve,elables. so vou could munch more carrots and celery without piling up the calones you would with the nuts Dark meat has more fat than white meat. If sou want to cut the meal’s fat content. remove the skin. Putting gravy through a skimmer, reduces the calones by 80% Stuffing baked outside of the bird saves even more. Candied sweet potatoes have five times as many calones as baked squash And you can have (wo pieces of pumpkin or apple pie for the sane nu of calones as one piece of pecan pre — i$ your choice As you decide what to put on your plate. sou can make some tadeoffs. If the holiday ust wouldn't be a holiday without your fasonte food that is high in wae APLy balance wt by cutung calones elsewhere Then round up the family.

and enjoy a walk around the neighberhood:

Recipe for success So if vour holiday celebrations leave you with unwanted extra pounds. you can lose weight sensibly And permanently When vou know where the calones and fats really are. you can make educatonal diet choices You'll know how to Jower the fats you ea while increasing your carbohydrates. Add regular physi cal acuvity. and you'll be able to enjoy the festivities as well as contro} your weight: Enjoy’ HMR Health Foundation:

The American Indians Obesity and its complicauons arc well-known to Amencan indian com.

mumuues and reservanons where |;

styles have changed dramauca!ls o the past 100 years. A decreasc in acpvity and a diet higher in {31 content has led to an incidence of obesity bee tween two and five umes US averages.

The Supai reserva’.

dorem of ne Gra has a special' sucpieme"

carries Through the Indian Health Senace HMR has esuibbshed 1 (programs or:

Indian reservauions in Nevass.

Anzona and Califoma HMR sp pons program services through i non-profit branch, the HMR Health Foundauon. for a population which might not have had the opporunity tc panicipaie in a high-nsk program bee cause of costs and availabiliy:

Through the song commuymcn:

of the staff of the HMR Fasung Programs on the Indian restr avons pavents are receiving the hi quality Care.

Health Management Resources Ourponent Healir Program 59 Temple Piace Suite 704 Boston. MA 02741 (617) 357-9876 € 1989 Heath Managemen: Resources. Boston. MA 103995, For Your Benter Heal:t Complaint 116 F.T.C.

EXHIBIT B-4 Old Road to Nine Acre Corner Concord MA 01742-4166 (508) 369-1400 FOR IMMEDIATE RELEASE CONTACT: MICHELE CORKERY 357-9876 Emerson Hospital in Concord will hold a FREE EDUCATIONAL ORIEN- TATION on “Lifetime Weight Management” on January 5th from 5:30 to 7:30 p.m. The orientation will introduce participants to a medically-supervised fasting and weight management program to begin in late January at the hospital. Emerson Hospital internist and endocrinologist, Dr. Melvyn Kramer, M.D., Medical Director for the new program, will discuss the risk factors associated with being overweight and the medical implications of weight loss. Anita Cohen, Behavioral Health Educator, will explain why traditional diets fail over the long term and why once weight loss is achieved many people fail to maintain it. Studies show that of the three percent of dieters who reach their goal weight, more than 90 percent regain that weight in six to twelve months. “To be successful, people need to learn new behavioral skills and procedures to both lose weight and maintain it over the longterm,” said Dr. Kramer. The HMR Fasting Program combines effective medical, behavioral and educational methods for achieving and maintaining significant weight loss. HMR patients lose an average of 2.5-5 pounds per week. Every patient must be screened to determine medical eligibility. Then the patient is placed on a 520 calories a day nutritionally complete dieting supplement . . . reaches goal weight. To ensure the patient’s health and well-being during the “fasting” stage of the program, medical monitoring is done weekly and lab tests are performed by-weekly. Throughout the program, patients are required to attend weekly educational/ behavioral group meetings where they learn to make simple lifestyle changes that reduce the amount of fat in their diets and increase their levels of physical activity. When patients reach goal weight, they join an 18 month maintenance program, where the lifestyle changes are reinforced. “Unlike traditional weight loss programs, HMR realizes that patients all have individual eating styles,” added Cohen. “You can be a snacker, weekend eater, night eater or binger and til! maintain your weight. In addition, during the maintenance phase we do not have lists of forbidden or restricted foods. Instead we teach a calorie-balancing system where people learn to make their food choices in conjunction with their individual eating styles.” HEALTH MANAGEMENT RESOURCES CORPORATION 817 799 Complaint Since 1979, more than 150,000 patients have used the HMR supplement in over 400 medically-supervised programs in hospitals, medical schools, and medical practices across the U.S. Staff is comprised of physicians, nurses, dietitians and behavioral educators, who have expertise in developing and implementing high quality programs in behavioral medicine. For more information or to make reservations for the free orientation at Emerson Hospital, call (508) 369-4211 or (617) 357-9876. Complaint LI6E.T.C.

EXHIBIT C-1 HMR ORIENTATION FOR PROSPECTIVE NEW PATIENTS In a very real sense, the orientation is the most important part of your program. The goals are to present accurate information about the treatment you are offering and to convince attendees that this is the right program for them to lose weight and learn how to keep it off. Therefore, a major function of the orientation presentation is to sell the program. Remember: If the people attending the orientation do not join your program, you will not be able to help them. Free orientations, held frequently, are the most efficient and effective way of enrolling patients who are interested in learning more about your program. If orientations are scheduled frequently, prospective patients will not have to wait to start the program. We have found that when patients are ready to join a weight loss program, they often become discouraged if they are required to wait. Thus, we recommend that you schedule a formal orientation each week. At least once each month arrange to have the medical director (or other program physician) take part in the orientation. At other times the R.N. can present the medical section. The weekly orientations are flexible and can be held for large groups, small groups, or individuals, as circumstances dictate. We recommend that the responsibility of presenting a comprehensive orientation be shared by the physician/nurse and an experienced health educator. A typical orientation for a large group will last approximately one and one-half hours. A small group or individual orientation will last approximately one hour.

The orientation should be seen as the first integral step in the treatment plan and not as an option that can be missed. It is a time when you are beginning to lay foundations that will increase patient compliance and success after they have joined. Although we always try to consider flexibility in accommodating patient needs, attendance is not a commitment to negotiate freely. To have a patient start the program with the sense that attendance is somewhat optional will undermine their commitment to this critical procedure. Therefore, we recommend serious discussion about how to rearrange their schedules to meet this commitment. Strongly address the issue of weekly attendance in the orientation. Problem-solve with prospective patients to avoid problems later on (e.g., patients can reschedule their vacations so that they do not miss the core groups, or patients who planned to be out of town before they knew the class schedule can sign up, join the program, get scheduled for their clinical and physical exams (if that is appropriate) and begin the program in the next clinic group that will start after they return.). As we mentioned, since the orientation is the first integral step in the treatment plan, HEALTH MANAGEMENT RESOURCES CORPORATION 819 799 Complaint a clinic staff member talking to a prospective patient on the phone should explain to the individual who says, I'm5 1 3 1 2 7 1070 669 116 38 96.236832 already5 1 3 1 2 8 1198 670 65 29 93.282532 sold5 1 3 1 2 9 1274 687 11 4 93.197052 -5 1 3 1 2 10 1293 670 61 38 96.819305 just5 1 3 1 2 11 1365 676 67 25 96.822914 starts 1 3 1 2 12 1442 680 47 21 96.971413 me5 1 3 1 2 13 1502 671 28 30 96.335320 in5 1 3 1 2 14 1542 672 47 29 96.335320 thes 1 3 1 2 15 1600 678 68 24 96.921738 next5 1 3 1 2 16 1678 673 116 38 95.655098 group, why the orientation is necessary and the benefit of hearing the entire program overview. All patients should attend an orientation, or they will miss program foundations and information.

The orientation should be informative and upbeat. The Presenters should be enthusiastic, convincing, and professional. The emphasis should be on what makes this program different from others and why this program is more likely to succeed for them than their past efforts. The style of all staff who are presenting should be relaxed and friendly, and those attending should be encouraged to ask questions at the end after they have heard the basic information. Even if a patient decides not to join the program, it is still our goal that they will leave the orientation better equipped to manage their weight by having learned at least some relevant information. Also remember that the more concrete, exciting, and hopeful you make the examples and facts in your orientation, the more likely it is that patients will join the program. Even those who do not join immediately will be more likely to join the program at a later date and talk positively about the program to others.

An outline of a typical patient orientation follows: BEHAVIORAL OUTLINE/SCRIPT FOR PATIENT ORIENTATION I. INTRODUCTION Welcome everyone. Introduce yourself and other staff. (include why you do this work) My job tonight is to convince you that this is the only program you should join: Why? How many of you have lost weight before? How many of you have gained your weight back? One Time? Two times or more? This is not unusual. People have regained their weight sometimes 3 or 4 times before they come to us.

What we'll tell you tonight is that long term weight maintenance is “doable,” We have the only successful program which teaches people the skills to lose weight and to keep it off.

Complaint 116 F.T.C.

Tonight we'll talk about:

Who we are, who is HMR Why diets fail We'll give you an overview of the program and answer questions We'll explain the cost We'll discuss the medical safety issues We'll tell you what you need to do to start the program ll. HMR *HMR is a National Health Care Company with over 300 programs in hospitals, medical schools and large medical practices. *Unlike commercial programs, we offer close, competent medical supervision for those patients who require it.

*Our staff is full time. We're doctors, nurses, behavioral health educators, administrators.

*All staff receive intensive on-going training. For example, a BHE has over 200 hours of training per year.

* All staff work together on a team to support you during your visit each week as well as between your visits.

*In all article written for the Journal of the American Medical Association, (one of the most prestigious medical journals in the world), by three well-known and respected authorities on the treatment of obesity, it was stated the medically supervised very-low-calorie diets--combined with behavioral education and supervised by trained professionals--are recognized as one of the most effective forms of treatment for high-risk obesity. Of all such programs, HMR has data that are clearly superior to those published by others in the field. And HMR is the only provider of VLCD programs that gives ongoing training to all professional staff involved in the treatment of patients.

*Describe your own clinic site: How long have you been doing this program at your site.

*We are data based: we monitor our effectiveness and improve the program using national data.

HEALTH MANAGEMENT RESOURCES CORPORATION 821 799 Complaint II]. HOW WE'RE DIFFERENT AND WHY DIETS FAIL I'm going to talk about why your other diets have failed, and how we're different from other diet programs.

A. DATA In commercial programs over 90% of people gain back all the weight they lose. Often they lose fewer than 15 Ibs.

In our programs, less than 15% of our patients gain back all the weight they lose. Our average weight loss is 52.6 Ibs, counting every patient who starts in the program.

B. WHY DIETS FAIL They don't teach you how to keep weight off. They ask you to make changes which are unnecessary and irrelevant to your weight maintenance.

For example they recommend:

Eat small portions Eat 3 meals a day Don't snack “What other recommendations have been made to you by other programs? that may not be doable or are not necessary?" (Get participation from the group.) Patients often tell us that they are told to: Reduce stress in your life Stop eating compulsively Use small plates Just push5 1 11 4 1 3 733 2148 100 37 93.043777 away from the table Never eat chocolate Just eat when you're hungry These are not the kind of changes you need to learn to make. In fact, How5 1 12 1 1 17 1784 2353 87 29 96.707130 many4 1 12 1 2 0 552 2387 926 40 -1 5 1 12 1 2 1 552 2387 35 29 96.792145 of5 1 12 1 2 2 596 2396 59 29 94.993164 you5 1 12 1 2 3 668 2388 89 29 96.662788 knows 1 12 1 2 4 769 2388 98 29 96.579697 THIN5 1 12 1 2 5 880 2389 108 38 96.579697 peoples 1 12 1 2 6 1001 2389 67 30 96.895958 who5 1 12 1 2 7 1082 2390 90 29 96.788879 snacks 1 12 1 2 8 1186 2399 33 20 96.160706 or5 1 12 1 2 9 1230 2395 46 24 96.160706 eats 1 12 1 2 10 1288 2391 190 29 93.704628 chocolate? So, to lose weight and keep it off you need to learn something else. Not only are the above recommendations not relevant, but they also can set you up to fail because they are not realistic for most people. Complaint 116 F.T.C.

IV. WHAT WE WILL TEACH YOU A. WE WILL TEACH YOU ABOUT FOOD CALORIES Why? So you can learn how to keep off the weight you lose. Weight maintenance is a calorie issue (calorie-balancing and -X). Can I have a volunteer? How much weight do you hope to lose. Possible answer: 50 Ibs.

Women get 11 cals/Ib/day 50 x 11=550 cals = calorie change needed to maintain lower weight.

Men get 12 cals/lb/day 50 x 12=600 cals = calorie change needed to maintain lower weight.

How5 1 4 1 1 2 740 1286 60 30 95.537178 will5 1 4 1 1 3 814 1295 58 29 96.565948 you5 1 4 1 1 4 886 1286 87 28 96.563660 makes 1 4 1 1 5 986 1285 82 29 96.535820 these5 1 4 1 1 6 1081 1283 164 38 90.131233 changes? We have a simple calorie system to help you make the changes that are easiest for you -- changes that will reduce fat and reduce calories but NOT reduce the amount of food you can eat.

Examples: (possible changes) *Snacks: 35 cups of air popped popcorn vs. 1 cup peanuts *Lunch: 2 turkey sandwiches vs. | pastrami sandwich 3 x week=22 Ibs. kept off a year *Dinner Valle's Steak House example Goal: Not eat less Not change eating style Eat more food for fewer calories Doable for a lifetime B. WE'LL TEACH YOU ABOUT PHYSICAL ACTIVITY CALORIES Fit into lifestyle, not become athletes Example: *10 min. walk out of your house, 10 min. walk back 3 x per day =31 lbs. in a year kept off. HEALTH MANAGEMENT RESOURCES CORPORATION 823 799 Complaint *2000 cals. per week (approximately 45 min.-hour per day) and records keep 76.6% of weight off after 18 months. SUMMARY:

Overeating is normal.

People often may feel discouraged. We understand this. We'll work with you throughout the hard times to keep you attending, to lower your fats and increase your physical activity through learning calories, record keeping.

We'll teach you weight maintenance long-term! V. PHASES OF THE PROGRAM Induction Phase Weight loss phase Transition Weight Maintenance A. Induction Phase: There are two parts to this phase *HMR has always offered medical screening and quality medical supervision. *Commercial programs do not provide this. *The importance of having a program with a medical screening is that it enables you to find out what the appropriate program is for you to participate in. First step: Patient orientation - you5 1 7 8 1 7 1168 1725 47 20 95.695023 ares 1 7 8 1 8 1228 1716 94 29 95.672661 here. Second step: Medical screening to determine status. Unsupervised Body Mass Index (BMI) less than 30 (ratio of height & weight). This is the technical measure we use. It generally means someone with less than 40-50 pounds to lose, depending on height.

No current risk factors.

Minimum of 800 calories/day.

*All three of the above must be satisfied to qualify the patient for the unsupervised program.

Supervised BMI greater than or equal to 30.

Current risk factors.

520 calories/day.

*If any one of the above are present, the appropriate program is the medically supervised program.

Complaint 116 F.T.C.

B. Weight Loss Phase:

1. Our diet provides complete nutrition in a structure which helps people lose weight successfully.

There are two options for you.

The Very Low Calorie Diet (VLCD) and the Low Calorie Diet (LCD). The Very Low Calorie Diet (VLCD):

*Minimum of 520 calories per day including supplement only (chocolate, vanilla, chicken soup) *Medically supervised *HMR has more than 10 years of experience with this diet *Supplement only=No decisions (this is easier for many patients) *This option has the least number of calories with complete nutrition The Low Calorie Diet (LCD):

*Minimum of 800 calories per day in supplement only or supplement with HMR entrees *Medical supervision to be determined *Offers dinner entrees *Limits decisions-no grocery food (keeps it simple and easier than other food diets) Both Diets are:

TIME-LIMITED-NOT FOREVER SAFE/NUTRITIONALLY SOUND: 100 -150% OF RDAs SIMPLE: Few decisions to be made Hot or cold Large volume or small volume CONVENIENT: Glass, blender, microwave, boiling water EFFECTIVE: 52.6 Ibs average weight loss Taste is excellent Guaranteed weight loss on the diet Sometimes patients are not sure which option they should choose. They should be advised to be less concerned with the option and more concerned with the use of basic program procedures (e.g., are you coming in, keeping records, working with your health educator, etc.). It is the use of procedures which correlates with success.

HEALTH MANAGEMENT RESOURCES CORPORATION 825 799 Complaint 2. HOW THE WEIGHT LOSS PHASE LOOKS Attendance weekly and why this is important 90 minute behavioral group (starts you on the diet and keeps you on the diet) Continuous support and phone follow-up We're available evenings, weekends, hard times 3. WHAT IF YOU BREAK THE DIET? It's not a failure. We won't judge you.

We'll help you get back on the diet. You don't need to drop out. C. TRANSITION PHASE:

The time between the VLCD or LCD and the Maintenance Phase. A gradual increase in calories and food choices D. MAINTENANCE PHASE:

The most important phase The time for skill development, practice for long term success. Sixty minute groups Flexible times 18 months to practice: successful weight management is a skill acquisition (like learning a sport) Examples: Tennis example Golf-swing example Next: Medical Orientation: (Usually presented by the physician or nurse, see accompanying outline) Next: Maintenance Patient Speaks:

Select a successful and articulate maintenance patient. Coach him/her to speak about: what skills (s)he has learned in the program: how this program has been different from other weight loss programs in his/her experience; how (s)he experienced the fast; how critical maintenance is for success; and how supportive the staff has been. Maintenance patients often present their sincere, heartfelt experiences which can be credible and convincing to prospective patients. In some cases, an experienced ongoing faster can take the place of a maintenance patient. Complaint 116 F.T.C.

Next: Fees, Class Times: (Presented by the health educator, see accompanying script) Next: Summary: Why Join VI. SUMMARY:

WHY JOIN OUR PROGRAM ASK WHY5 1 4 2 2 3 819 1058 120 29 95.323792 JOIN? *We have a dedicated, full time continually trained staff whose only job is to support you to lose your weight and keep it off. *We're data based so that we continue to improve our program. *If you need medical supervision:

Our medical staff monitors your health and as you heard from Dr. , Many patients have reduced their coronary risk factors, lowered their blood pressure and decreased their need for blood pressure and diabetes medications. *We have a program available for everyone, no matter how little or how much weight you wish to lose.

*What you can expect from us: our commitment to you: We care about the longevity and quality of your life. By losing weight now, you can increase both of these.

*What we will ask of you: THE THREE COMMITMENTS (Note to educators: Refer to the What, Why, and How expansion on Attendance, Record Keeping, and Maintenance in Thes 1 12 1 2 7 1300 2165 125 29 96.604576 General5 1 12 1 2 8 1438 2165 139 38 96.782433 Programs 1 12 1 2 9 1588 2165 200 33 95.877174 foundations,5 1 12 1 2 10 1800 2164 118 38 96.749710 Fasting4 1 12 1 3 0 598 2214 412 35 -1 5 1 12 1 3 1 598 2214 199 30 96.516052 Foundations5 1 12 1 3 2 811 2214 34 29 95.006584 of5 1 12 1 3 3 855 2214 93 29 95.006584 Weeks 1 12 1 3 4 966 2214 44 35 95.286041 1) 1, Attend Weekly (and why this is important) A. To obtain the information you need B. For support C. For medical supervision, if necessary D. To obtain your supplement/entrees E. The data shows that people must attend in order to be successful HEALTH MANAGEMENT RESOURCES CORPORATION 827 799 Complaint (Note: It is important that you spend enough time on this commitment so that patients understand how critical attendance is for their success). Please be sure to repeat the following sentence verbatim:

WEEKLY5 1 3 1 1 2 784 824 275 29 95.923500 ATTENDANCE5 1 3 1 1 3 1071 824 33 29 96.631088 IS5 1 3 1 1 4 1119 824 239 29 96.293762 IMPORTANT5 1 3 1 1 5 1371 824 171 29 95.129692 ENOUGH5 1 3 1 1 6 1555 824 109 29 95.129692 THAT5 1 3 1 1 7 1676 824 62 29 96.384369 WE5 1 3 1 1 8 1751 824 112 29 71.785248 HAVE5 1 3 1 1 9 1876 824 27 29 71.785248 A4 1 3 1 2 0 583 871 1320 31 -1 5 1 3 1 2 1 583 872 146 30 96.359756 POLICY5 1 3 1 2 2 748 872 240 30 96.218864 REGARDING5 1 3 1 2 3 1007 871 88 30 96.551857 THIS5 1 3 1 2 4 1115 872 87 29 96.129189 ANDS 1 3 1 2 5 1222 872 93 29 96.173248 MAY5 1 3 1 2 6 1333 872 108 29 96.173248 NEEDS 1 3 1 2 7 1459 871 54 30 96.228012 TO5 1 3 1 2 8 1531 872 276 30 96.228012 DISCONTINUE5 1 3 1 2 9 1825 872 78 29 96.525421 THEA 1 3 1 3 0 583 920 937 30 -1 5 1 3 1 3 1 583 920 199 30 96.062347 PROGRAMS 1 3 1 3 2 795 920 78 30 96.609276 FOR5 1 3 1 3 3 886 920 191 29 96.085472 PATIENTS5 1 3 1 3 4 1090 920 97 29 95.892944 WHO5 1 3 1 3 5 1200 920 121 29 95.225586 DON'T5 1 3 1 3 6 1333 920 187 29 80.966125 ATTEND.”2 1 4 0 0 0 583 1016 1318 87 -1 3 1 4 1 0 0 583 1016 1318 87 -1 4 1 4 1 1 0 583 1016 775 38 -1 5 1 4 1 1 1 583 1017 26 28 96.509560 2.5 1 4 1 1 2 634 1017 115 28 96.855835 Records 1 4 1 1 3 763 1016 136 38 96.579384 Keeping5 1 4 1 1 4 913 1017 70 35 96.720642 (ands 1 4 1 1 5 997 1016 67 38 96.153618 why5 1 4 1 1 6 1078 1016 56 29 96.368149 this5 1 4 1 1 7 1147 1016 25 29 96.368149 is5 1 4 1 1 8 1186 1016 172 38 96.428398 important)4 1 4 1 2 0 584 1064 1317 39 -1 5 1 4 1 2 1 584 1065 83 30 76.520164 “This5 1 4 1 2 2 680 1065 24 29 96.253433 is5 1 4 1 2 3 717 1074 16 20 96.178940 a5 1 4 1 2 4 744 1065 60 29 96.178940 tools 1 4 1 2 5 817 1071 30 23 96.784134 to5 1 4 1 2 6 859 1074 52 20 96.726112 uses 1 4 1 2 7 923 1065 59 29 96.984055 that5 1 4 1 2 8 994 1064 59 30 96.969307 will5 1 4 1 2 9 1066 1065 69 38 96.817093 helps 1 4 1 2 10 1147 1074 58 28 96.831398 you5 1 4 1 2 11 1218 1065 79 29 96.417267 learns 1 4 1 2 12 1310 1064 278 39 96.695801 self-management5 1 4 1 2 13 1600 1065 58 30 96.482834 ands 1 4 1 2 14 1669 1065 64 30 96.734215 also5 1 4 1 2 15 1745 1065 68 38 95.638176 helps 1 4 1 2 16 1825 1074 34 21 95.840004 us5 1 4 1 2 17 1872 1070 29 25 95.840004 to2 1 5 0 0 0 581 1114 1173 135 -1 3 1 5 1 0 0 581 1114 1173 135 -1 4 1 5 1 1 0 581 1114 190 38 -1 5 1 5 1 1 1 581 1114 93 29 96.771126 coach5 1 5 1 1 2 688 1114 83 38 92.055756 you. (Note: No further expansion on this commitment is really necessary.) 3. Attend Maintenance (and why this is important; very little expansion is necessary, because attendance has already been discussed.) *CLOSING THE ORIENTATION:

1. Those who are ready to make your appointment, we have clinical times available; please see RN to make your first appointment. 2. Ifyou have any questions or concerns before making your appointment, we will be happy to meet with you individually and address them. 3. Thank you for coming.

MEDICAL OUTLINE/SCRIPT FOR PATIENT ORIENTATION I. Introduction - introduce yourself and include information about your practice area and experience. Include your personal reasons for doing this type of work, e.g. frustration with trying to help patients in private practice lose weight and not having an effective method. II. The health risks of obesity. Why lose weight? NOTE: Remember that the people attending the orientation may present a range of weight loss needs from 10-100+ Ib. The HMR program options offer an effective prevention and treatment for the health consequences of being overweight.

II.

*ear prod *tod Complaint 116 F.T.C.

The associated health risks include hypertension, diabetes, orthopedic problems, increased risk of developing cardiovascular disease, increased risk of stroke, complications with surgery and childbirth, cancers, and gout. Being 40 or more pounds overweight increases the risk of sudden death in the under age 65 population by 1200%.

Two thirds of all diabetics are overweight. With weight loss, two thirds of diabetes would be eliminated.

Hypertension develops up to 5-10 times more often in individuals who are 20% or more over ideal body weight.

(Flipside) For those of you who have a smaller amount to lose, you may not have these health risks now. However, people tend to gain weight as they get older, and we recommend taking the weight off now to prevent these problems from developing.

Medical safety and effectiveness of the Very Low Calorie Diet Why is it safe? The quality of the VLCD Evolution: *early - total fasting or starvation which was unsafe; patients did not feel well and had no energy ly 1970's - progressed to fasting with supplement but the quality of the ucts was inferior ay - high quality supplements associated with medical supervision and effective education for people with 40-50 or more pounds to lose; high quality supplements at a higher calories level or combined with food entrees for people with b.

1.

2.

smaller amounts of weight to lose.

The VLCD is the treatment of choice if the following criteria are met: The program is medically supervised.

The program includes an intensive and effective educational component. The program uses a high quality dietary supplement which provides protein with a superior amino acid profile and meets al] of the Recommended Daily Allowances for nutrients.

HEALTH MANAGEMENT RESOURCES CORPORATION 829 799 Complaint c. Nutritional content 1. High quality protein derived from milk and egg white with a superior amino acid profile.

2. 79 grams of carbohydrate, more than any of the leading, supplements, preserves muscle tissue and reduces nutrient loss; keeps energy level up. 3. 150 % of the RDA for most nutrients.

4. Taste is preferable to other products. 2. The medical supervision makes it safe. a. Some people will not be able to be on the low calorie diet right now because of contraindications - pregnancy or lactation. Some medical conditions will need to be evaluated individually such as recent heart attacks or strokes, recent surgeries, kidney disease, etc. but individuals with these conditions probably can participate on the diet.

b. Every individual receives initial screening including blood tests and health history to determine if he/she needs medical supervision. Anyone who is more than 40-50 Ib. overweight will need medical supervision, but people who have less weight to lose may not need medical supervision if they do not have health risks.

c. If you do not require medical supervision, you will be taking a minimum of 800 calories a day of the supplement or the supplement and HMR entrees. You will have an appointment with the nurse for baseline lab work and a health history review and the physician and nurse will review these and make the decision that you can diet without medical supervision. d. If you need medical supervision because of your weight or medical conditions, you will receive a complete physical exam before starting and will see the physician and nurse weekly, have blood drawn every 2 weeks and periodic EKGs done.

e. Each individual must take the recommended amount of supplement or supplement and entrees in order to get adequate nutrition and be medically safe. So that we know that you always have enough supplement to take the recommended amount, we require that you purchase 2 boxes each week if you are on the VLCD.

f. Each individual must attend every week for the Behavioral class and medical supervision. As has been mentioned before in this orientation we cannot aor Complaint 116 F.T.C.

stress enough how critical your attendance is whether you are medically supervised or not.

The staff are on call for any medical problems that are related to the diet. We will work cooperatively with your primary care physician and send periodic letters with lab test results.

Why is it effective? Safe, rapid weight loss (3-6 Ibs. per week for people on VLCD) (2-4 lbs. per week for people on LCD) Significant health benefits Decrease blood pressure and reduce or eliminate medicines. Decrease blood glucose and reduce or eliminate insulin. Reduce risk of heart disease by reducing cholesterol and triglyceride levels. Improve arthritis by reducing stress on joints. IV. Possible Side Effects (The major side effect is becoming healthier!) A.

BRONP> Intro statement: Benefits of losing weight and keeping it off far outweigh the risk of developing any of the possible sides effects I'm about to present. You can always expect some physical changes whenever you diet, and you may have experienced some of these in the past. The most common are fairly simple to prevent or manage: Bowel changes - constipation or diarrhea Dizziness Headache Fatigue These physical changes are fairly simple to prevent or manage by taking plenty of fluids (2-3 quarts/day) and taking additional fiber in the form of bran or metamucil.

C.

1, Less common Temporary hair thinning may occur after more than 40 lbs. of weight loss and will reverse after refeeding.

Gallbladder problems (Suggested Statement To Make): There is a short term increased risk for developing gallbladder problems. People who are overweight are at increased risk for gallbladder disease and HEALTH MANAGEMENT RESOURCES CORPORATION 831 799 Complaint when people are dieting (no matter what kind of diet) they experience an increased risk of developing gallstones. However, by losing the weight, the overall risk of developing gallbladder disease is much reduced. We manage this possible side effect by recommending careful, supervised refeeding, slow introduction to foods, and caution about eating foods with high fat. Vv. Summary A. Obesity carries significant medical risks. B. The VLCD is the treatment of choice and it is safe and effective with medical screening and supervision. The VCLD and LCD programs are successful because they combine complete nutrition with lifestyle change and risk factor management education.

C. What makes this program different is how effective it is in teaching you how to keep the weight off.

OPERATIONS SCRIPT FOR PATIENT ORIENTATION Many people are not aware of their medical risk factors when they go on a diet. HMR performs an assessment of your medical condition as a part of the induction to the program. As you know, commercial programs do not generally do any screening or medical tests prior to enrollment nor do they provide ongoing medical monitoring of their clients. Many of those people do not even know they have a serious medical condition. This is one of the reasons many of the commercial programs are under investigation by the congressional subcommittee in Washington, D.C.

Insert a similar story: For example, one of our clients female, 30 years old, 60 pounds overweight, discovered diabetes on induction. She was cleared by our medical director to start the Very Low Calorie Diet with medical supervision. No medications were required, she lost the weight and is doing fine HMR HAS TWO DISTINCTIONS: (USE THE CHARTS IF AVAILABLE) MEDICALLY SUPERVISED MEDICALLY UNSUPERVISED Min. 520 cal/day Min. 800 cal/day Supplement or Suppl/Entrees Supplement or Supp]/Entrees Complaint 116 F.T.C.

INDUCTION You will have a medical screening tailored to your specific medical needs. If you are over 30% BMI, you will have a complete blood chemistries, EKG, comprehensive physical examination. If you are below 30% BMI, you will have blood chemistries done. The fees will be based on the services rendered. Above 30% BMI $190.00 Induction, below 30% BMI $235.00 induction with Services included. More of the fees are paid up front in the $235.00 charge. I'll explain more fully:

WEIGHT LOSS PHASE The weight loss phase includes weekly weigh-in, and weekly 90 minute educational group. Medically supervised patients are seen by the program RN and MD weekly and have blood chemistries every other week, EKG's approximately every 35 Ibs. of weight loss/or/12 weeks.

Insurance coverage is also a factor for most people (medically monitored) reducing the cost of the program. According to a recent survey 63.5% of our people in the program are receiving insurance reimbursement (from 80-100%). Some insurance companies provide reimbursement for patients with medical diagnoses such as diabetes or hypertension. Insurance carriers are inconsistent regarding claim payments for weight management. Due to the wide variety of insurance coverages, each patient is responsible for obtaining insurance reimbursement from his/her insurance company. HMR will help by providing necessary letters, reports and physician referral letters. Submission of the charges is really the only way to find out if you will receive insurance reimbursement. (STORY) I had two patients who both had the same insurance and same diagnosis. One was covered, one was not. We made several submissions of letters and information and finally they did cover the patient. Often it can take time and patients should be viable for several weeks in waiting for insurance reimbursement to occur. We do not accept Medicaid patients at this time. We also have a national agreement with Travelers as a weight management provider. However, all the same requirements must be met. (i.e. Diagnosis, contract differs from individual to individual.) The weekly visit (including blood work) is $65.00 per week. This is paid monthly (or our 4 week cycle we call it). This system is set up to aid with attendance. As you may have guessed, attendance in any weight management program is critical for successful weight loss and weight management. It is for that reason, missed HEALTH MANAGEMENT RESOURCES CORPORATION 833 799 Complaint visits are not credited and no medical receipts are given. This can effect your being reimbursed since you will have paid for the service. It is HMR’s attendance practice and we are firm about it. Missed visits must be made up within the week. Serious medical absences will be accepted. HMR can get these successful statistics and one of the reasons is the commitment around attendance. DIET Average cost per meal is $1.40-3.50 depending on if you are taking supplement or entrees, about $7-14.00 per day. All supplement and entrees are purchased and dispensed weekly. That $1.40-3.50 per meal is your complete diet. That makes it convenient, no additional shopping and they travel with you great for work or travel. You will be spending less on food on this program than you are now. According to the USDA, the average working adult spends about $72.00 per week on food and food related items. This may be subject to regional difference, but when you start to add up the 3 dinners out, lunches, wine with dinner, etc. you can see where it is not surprising some of our groups tell us they actually saved money during the weight loss phase.

MAINTENANCE Our maintenance phase of 18 months is designed for your long term success in weight management. The maintenance phase of the program is critical, especially for those with significant amounts of weight to lose and keep off. If you are transitioning from the medically monitored weight loss to maintenance (goal weight) you will be paying $250.00 per month (every 4 weeks). You pay that fee for 4 months and then you are totally paid up for the remaining 14 months. In this way you can attend as often as you like. According to recent patient surveys most patients have tried at least 3 other programs and may have been unsuccessful in keeping all the weight off. We are sure that with our coaching and support and individual focus we can help you become successful in keeping your weight off. We will work with you on teaching you how to keep the weight off and practice some simple lifestyle changes. You learn about shopping in grocery stores, reading labels, calculating your physical activity, etc. Weight management is a skill acquisition. The unsupervised maintenance phase is a minimum of six months. We offer an incentive for the unsupervised maintenance patient $100 off the regular $300.00 fee if the amount is paid in full at the induction phase. Again, the unsupervised maintenance term is 6 months. Having worked with hundreds (or whatever your local experience is) of patients we are confident that we have a maintenance Complaint 116 F.T.C.

program that can be tailored to your needs. Some patients want to have a longer term commitment and we can accommodate that. In Summary, the HMR program can cost less than commercial programs who offer less services. We have successful patient data unrivaled by any other program. In addition, as I mentioned, HMR can often be covered by insurance companies. RECOMMENDATIONS:

1. Offer discounts to multiple family members 2. Offer discounts to hospital/center you work with 3. Note tax deduction discount can often apply See the orientation packet materials.

HEALTH MANAGEMENT RESOURCES CORPORATION 835 799 Decision and Order DECISION AND ORDER The Federal Trade Commission having initiated an investigation of certain acts and practices of the respondent named in the caption hereof and the respondent having been furnished thereafter with a copy of a draft of complaint, which the Bureau of Consumer Protection proposed to present to the Commission for its consideration and which, if issued by the Commission, would charge respondent with violation of the Federal Trade Commission Act and, The respondent, its attorneys, and counsel for the Commission having thereafter executed an agreement containing a consent order, an admission by the respondent of all the jurisdictional facts set forth in the aforesaid draft of complaint, a statement that the signing of said agreement is for settlement purposes only and does not constitute an admission by respondent that the law has been violated as alleged in such complaint, and waivers and other provisions as required by the Commission’s Rules; and The Commission having thereafter considered the matter and having determined that it had reason to believe that the respondent has violated the said Act, and that a complaint should issue stating its charges in that respect, and having thereupon accepted the executed consent agreement and placed such agreement on the public record for a period of sixty (60) days, and having duly considered the comment filed thereafter by an interested person pursuant to Section 2.34 of its Rules, now in further conformity with the procedure prescribed in Section 2.34 of its Rules, the Commission hereby issues its complaint, makes the following jurisdictional findings and enters the following order: 1. Respondent Health Management Resources Corp., is a corporation organized, existing and doing business under and by virtue of the laws of the State of Nevada, with its office and principal place of business at 59 Temple Place, Boston, MA. 2. The Federal Trade Commission has jurisdiction of the subject matter of this proceeding and of the respondent, and the proceeding is in the public interest.

Decision and Order 116 F.T.C.

ORDER DEFINITION For purposes of this order, “competent and reliable scientific evidence” shall mean those tests, analyses, research, studies, surveys or other evidence conducted and evaluated in an objective manner by persons qualified to do so, using procedures generally accepted in the relevant profession or science to yield accurate and reliable results.

It is ordered, That respondent HMR, a Nevada corporation, its successors and assigns, officers, representatives, agents, and employees, directly or through any corporation, subsidiary, division or other device, in connection with the advertising, promotion, offering for sale, or sale of any weight loss or weight control product, program or service, in or affecting commerce, as “commerce” is defined in the Federal Trade Commission Act, do forthwith cease and desist from:

A. Making any representation, directly or by implication, regarding the safety of any very-low-calorie diet (““WLCD”’) program (providing 800 calories or less per day), unless respondent clearly and prominently discloses in close proximity to any such representation that physician monitoring is required to minimize the potential for health risks;

B. Misrepresenting any health risk of any VLCD diet program; C. Making any representation that the HMR VLCD program is widely accepted by the medical profession as a whole or is considered to be the preferred treatment by most medical experts, or making any other representation regarding the extent to which a diet program, or any aspect thereof, is accepted, recognized or preferred by medical experts unless, at the time of making any such representation, respondent possesses and relies upon a reasonable HEALTH MANAGEMENT RESOURCES CORPORATION 837 799 Decision and Order basis consisting of competent and reliable evidence substantiating any such representation;

D. Misrepresenting the likelihood that patients in any of respondent’s diet programs will regain all or any portion of lost weight; E. Making any representation, directly or by implication, about the success of patients on any diet program to achieve or maintain weight loss or weight control unless, at the time of making any such representation, respondent possesses and relies upon a reasonable basis consisting of competent and reliable scientific evidence substantiating the representation, provided, however, that for any such representation that:

1) Any weight loss achieved or maintained through any diet program is typical or representative of all or any subset of patients using the program, said evidence shall, at a minimum, be based on a representative sample of: (a) all patients who have entered the program, where the representation relates to such persons; or (b) all patients who have completed a particular phase of the program or the entire program, where the representation only relates to such persons, and 2) Any weight loss is maintained long-term, said evidence shall, at a minimum, be based upon the experience of patients who were followed for a period of at least two years after completion of respondent’s program (including any periods of participation in active maintenance); and 3) Any weight loss is maintained permanently, said evidence shall, at a minimum, be based upon the experience of patients who were followed for a period of time after completing the program that is either: (a) generally recognized by experts in the field of treating obesity as being of sufficient length to constitute a reasonable basis for predicting that weight loss will be permanent or (b) demonstrated by competent and reliable survey evidence as being of sufficient duration to permit such a prediction;

F. Representing, directly or by implication, that any patients of any diet program have successfully maintained weight loss, unless Decision and Order 116 F.T.C.

respondent discloses, clearly and prominently, and in close proximity to such representation:

(1) The following information:

(a) The average percentage of weight loss maintained by those patients, (b) The duration, over which the weight loss was maintained, measured from the date that patients ended the active weight loss phase of the program, provided, however, that if any portion of the time period covered includes participation in respondent’s maintenance program(s) that follows active weight loss, such fact must also be disclosed, and (c) If the patient population referred to is not representative of the general patient population for that program, the proportion of the total patient population in respondent’s programs that those patients represent, expressed in terms of a percentage or actual numbers of patients, or the statement: “HMR makes no claim that this [these] result[s] is [are] representative of all patients in the HMR program;” and (2) The statement:

“For many dieters, weight loss is temporary.” Provided, however, that, respondent shall not represent, directly or by implication, that the above-quoted statement does not apply to dieters in respondent's diet programs; G. Making any representation about the efficacy of any other diet program or programs, unless at the time of making such representation, respondent possesses and relies upon a reasonable basis for making such representation. Such reasonable basis shall consist of a competent and reliable scientific study or studies of such other diet program or programs substantiating the representation; H. Making comparisons between the efficacy of respondent’s diet program or programs and the efficacy of any other diet program or programs, unless at the time of making such representation, respondent possesses and relies upon a reasonable basis for making HEALTH MANAGEMENT RESOURCES CORPORATION 839 799 Decision and Order such representation. Such reasonable basis shall consist of a competent and reliable scientific study or studies substantiating the representation in terms of both the efficacy of respondent’s diet program or programs and the efficacy of the diet program or programs with which the comparison is made. II.

It is further ordered, That respondent shall notify the Commission at least thirty (30) days prior to the effective date of any proposed change in the corporate respondent such as dissolution, assignment, or sale resulting in the emergence of a successor corporation(s), the creation or dissolution of subsidiaries, the filing of a bankruptcy petition, or any other change in the corporation(s) that may affect compliance obligations arising out of this order.

Il.

It is further ordered, That respondent shall maintain for a period of three (3) years after the date the representation was last made, and make available to the Federal Trade Commission staff upon request for inspection and copying, all materials possessed and relied upon to substantiate any claim or representation covered by this order, and all test reports, studies, surveys or information in its possession or control or of which it has knowledge that contradict, qualify or call into question any such claim or representation. IV.

It is further ordered, That respondent and its successors or assigns, shall forthwith distribute a copy of this order to each of its officers, agents, representatives, independent contractors and employees, including participating hospitals or clinics, that are engaged in the preparation and placement of advertisements or promotional materials, who communicate with patients or prospective patients, or who have any responsibilities with respect Decision and Order 116 F.T.C.

to the subject matter of this order, and, for a period of ten (10) years from the date of entry of this order, distribute same to all of respondent’s future officers, agents, representatives, independent contractors and employees having said responsibilities. V.

It is further ordered, That respondent and its successors or assigns shall, within thirty (30) days after service of this order, advise physicians, hospitals and clinics using the HMR diet program that advertising previously furnished by respondent for their use, and brochures, pamphlets, booklets and other materials previously provided by respondent to physicians, hospitals and clinics for dissemination to patients and prospective patients, shall not be further used by those physicians, hospitals and clinics where that advertising or other materials would violate this order. If, after providing the notification required by the first sentence in this paragraph, respondent becomes aware that any physician, hospital or clinic using the HMR diet program, uses advertising or other materials previously furnished by respondent that would violate this order, respondent shall again communicate with that physician, hospital or clinic in an attempt to ensure that such advertising or other materials shall not be further used by said physician, hospital or clinic.

VI.

It is further ordered, That respondent and its successors or assigns shall, within sixty (60) days after service of this order, file with the Commission a report, in writing, setting forth in detail the manner and form in which they have complied with this order. Commissioner Owen dissenting with respect to the numerical disclosure requirements for short radio and television advertisements.

DEMERT & DOUGHERTY, INC. 84] 841 Complaint