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.
'GMA' Grants Food Makeover
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.
Dr. Oz Weighs In
Sue said she didn't have time to plan good meals, and Paul cited his inability to exercise and his dislike of vegetables.
Oz started with Sue, telling her that a woman of her age needed just 1,800 calories per day to maintain her weight, and less if she wanted to lose pounds. On the day "GMA" visited with the family, Sue consumed 2,190 calories.
He told Paul that his total caloric intake for that day was 3,780, noting that a man of Paul's age would need just 2,200 if he were not exercising.
He told Joey that boys in his age group needed about 1,800 calories if they were being active, and between 1,800 and 2,200 if they were moderately active. Joey's total that day was 2,153. Oz told him he would be ok with eating that way if he played sports and remained active.
Oz told Johanna that her total was actually low -- only 1,082 calories for that day. He told her that for her age, she needed between 1,600 and 2,000 calories if she remained active.
Switch toaster waffles and syrup for 100 percent whole wheat bread and 1 teaspoon natural peanut butter. This will provide fiber and protein -- instead of the sugar of waffles – and will help them feel fuller for longer.
Oz said Paul should not skip breakfast. To lose weight, a person has to eat, or run the risk of getting so hungry that he or she will eat whatever is around – no matter how unhealthy it may be, he added.
Oz advised Sue and Paul to eliminate fried foods. Most restaurants are happy to switch fries for salad at no charge, he said. He also advised them to drink 1 or 2 glasses of water before they eat, and also said they should try to eat slowly so they wouldn't eat as much.
Another easy way to cut back would be on the choice of beverage. Oz said they should stick to plain or sparkling water, skim milk, coffee or even iced tea – not the sweetened, flavored kind. Diet soda could be had as a treat – but no more than once a day, he added.
Even though Johanna and Paul don't like vegetables, they can compromise: He suggested pizza with vegetables. At 320 calories for two slices, it's a healthier version of what the family would normally eat.
Because time is an issue for the family, Oz suggested that they consider veggie burgers. Microwave the patty, put it on a whole wheat muffin with lettuce, tomato and marinara sauce instead of ketchup. It's a healthier alternative to a hamburger, and comes in at under 300 calories, he said.
Oz told the family that planning was vital. He urged them to involve their children in planning their daily snacks for one week – his suggestions included almonds, an ounce of dark chocolate or an apple. Giving the children a part to play in healthy meal planning would teach them valuable skills, he added.
He also said that if they had to eat out, they should avoid side dishes, desserts and soda. Those are the calories that can sneak up on a person, he added.
Prevent Unhealthy Snacking
The family can prevent unhealthy snacking by getting rid of all the unhealthy foods that are currently in their kitchen, Oz said.