For the Lettera family of Pennsylvania, eating healthy and losing weight is a constant struggle.
Sue Lettera, 47, is a working mom who is also attending graduate school. She has battled weight all her life. Even though she had gastric bypass surgery in 2004 – losing 160 pounds as a result – she's regained 50 pounds.
Paul Lettera needs to have both hips replaced, but because he's overweight, he can't have the surgery he needs. He has difficulty walking and until he gets the hip replacements, he says, "Exercise isn't really an option for me," the 47-year-old said.
With their schedules, the couple admits that food preparation has taken a back seat to other priorities.
Samantha Heller, a registered dietitian and author of the book "Get Smart: Samantha Heller's Nutrition Prescription for Boosting Brain Power and Optimizing Total Body Health," agreed to evaluate everything the family ate for a day to determine how many calories they consumed.
He listened to their story and learned a lot about their eating habits:
The Letteras' meals aren't planned in advance, and the children – 8-year-old Johanna and 10-year-old Joey – frequently weigh in on mealtime decision-making.
Sue is a nibbler – drinking coffee while grazing on eggs, tomatoes, grapes and her children's leftovers.
For breakfast, Sue's son drinks whole chocolate milk and eats two French toast waffles with syrup and a side of pineapple. That's about 672 calories.
For lunch, Joey's buys his meal at the cafeteria. He chooses a meatball sub with a side of fruit, a fruit snack and chocolate milk. That's 921 calories.
Johanna drinks skim milk, and has two blueberry waffles and a side of pineapple. Her tally? Around 362 calories. She packs her lunch: yogurt, Capri Sun juice, a fruit snack and a rice cake – but not just any rice cake. This one has Nutella spread on top.
"Our eating habits are, I would say, poor at best," Paul acknowledged.
He works night shifts as a security officer for bars and restaurants and his eating habits certainly reflect his job and schedule.
"They give you free food, so it's a burger, chicken wings … I'm eating at strange hours and not really putting a lot of thought into it," he said.
His first meal is typically at 11 a.m., and the pair frequently has lunch at a restaurant.
On the day "GMA" visits, Sue chooses a tuna melt for lunch, while Paul selects French onion soup and a steak sandwich. Instead of tavern fries, applesauce or coleslaw for a side, he upgrades to corn fritters. When his soup arrives, he removes the cheese and gives it to Sue.
His entire lunch, plus a regular Coke, tips the scales at 3,149 calories. Sue's tuna sandwich runs more than 1,000 calories, and the cheese from Paul's soup adds another 150 -- for a total of 1,219 calories.
She doesn't eat the fries that are served with her meal, though.
Dinner is at 5 p.m. Paul makes it four nights a week, and admits that many times he makes meals that are easy to prepare but which may not necessarily be the most nutritious.
Tonight, dinner is frozen ravioli with canned tomato sauce and garlic bread. There are no vegetables.
"I'm not eating vegetables, why should I make them?" Paul said. "This is a typical daddy dinner -- starch, starch and tomato sauce on top of it."
He added: "There are 1,001 reasons people overeat, and we have them. We just never really put that monster effort into it, and it shows."
Before Oz gave the family his recommendations, he asked Paul and Sue to identify their biggest nutritional challenges.