In my practice I work with many male clients, and certainly many of the people who want to take control of their weight these days are men. But when I walk around the city, or take a look around at the airport, I notice that most of the overweight men I see aren’t especially big in their arms or legs; instead, they’re carrying most of their extra pounds around their waists. They don’t need weight management, they need waist management.

I want to talk to the guys here today, and I want to start by making a distinction between your medical waist and what we might call your fashion waist. As far as the medical profession is concerned, if your waist circumference is more than 40 inches you are at risk for heart disease, hypertension, insulin resistance, metabolic syndrome, and, perhaps most urgent of all, reduction in sex drive! When I assess men in this situation, I ask myself — why are they not just gaining weight, but taking on this odd shape? Why are they looking like they are going to deliver a baby at any moment? Ironically, many men blame their wife and kids for the fact that they’ve lost control of what they eat, and for keeping junk food in the house.

But the reality is, what I often see in my practice is that men are more likely than women to skip meals. That leads to overeating — especially when men are stressed out at work, don’t eat throughout the day, and rely on their food environment (which far too often consists of vending machines) to provide emergency fuel. This behavior is exacerbated by age, which decreases metabolism; as time goes on, men sit more and more at work, are less and less physically active at home, and get in the habit of releasing stress with a beer and some chips after work.

Sound familiar? Time to stop blaming the wife or family, and start eating like a man. That doesn’t mean starving yourself, or eating like a bird. It means managing your nutrition, and tackling your stress as well. Here’s what men can do to take control of their waists, and their health:

1) Eat breakfast
A man needs this meal as much as his wife and kids. It jumpstarts the metabolism, and gives you fuel for the morning that prevents unconscious snacking later. And breakfast needs to be substantial — the yogurt your wife is having probably isn’t enough even for her, and it certainly isn’t enough for you. Unless you want to hit the cookie jar at 10 a.m., you need a healthy mix of carbohydrates, fat, and protein for breakfast.

2) Prioritize mealtimes
No matter how busy you are, you need to eat actual meals. No, you don’t need to light candles or get out Grandma’s silver, but you do need to step away from your computer and dedicate some free time to eat your lunch. And lunch should not be just a salad — again, you need actual brain food: protein and carbohydrates mixed.

3) Release stress
Take at least one and preferably two or more two-to-three-minute breaks during the day to practice deep breathing exercises and reduce the stress hormones, such as cortisol, which build fat around your mid-section. The best times for these breaks are at 11 a.m. and 4 p.m. — right in the most intense times of the workday, when your stress is high and mealtimes are near; this is the danger zone for snacking.

4) Moderate alcohol
But what’s moderation? Obviously, that depends on what “normal” is to you — but if you want to get your gut down, it needs to be no more than a serving of alcohol per day, and better yet no more than half that. And let’s be clear about what constitutes a serving: 4 oz. of wine, 12 oz. of beer, 1.5 oz. of hard liquor. Measure your pours.

5) Control servings
Speaking of serving size, you really need to get conscious of this if you want to get control of your waistline. Most people have little idea of just how much food is really in a serving. Here are some simple tips to help you look at a plate of food and be honest about how much is really on it: a serving of meat is about the size of the palm of your hand (5 – 6 oz.); that’s the right amount for dinner. Likewise, a man’s closed fist is usually about a cup to a cup-and-a-half of grain or starch — pasta, rice, potato, beans — and enough for a meal. Those two together should fill about half your plate, and the other half should be full of vegetables that are not doused in butter or cheese.

Finally, guys, it’s time to cook. If you want to know what you’re eating, you have to cook it. Maybe start by preparing the evening meal one day per week — that means both shopping and cooking, so you really know what goes into what you eat. Not only will you have to stop blaming your wife for what you eat, you might find new appreciation for her cooking.