Marcia Upson comes from a family of entrepreneurs. But it was her mother's struggles with weight that sparked Marcia's own entrepreneurial flame. After trying many diets without lasting results, Sandra Breithaupt created a weight-loss system after a "light bulb" moment over lunch with a thin friend.

"She thought, 'I know everything there is to know about dieting, I've been on every diet on the planet. I'm going to quit dieting and start watching thin people,'" Upson says. And so she laid the groundwork for Naturally Slim in 1978.

Like Mother, Like Daughter

Breithaupt saw that naturally slim people, whom Upson calls "true thins," have a good sense of when and how much to eat. The Naturally Slim approach focuses on eating sensibly and paying close attention to hunger. Breithaupt lost almost 50 pounds and has kept it off. She worked with a group of physicians who sought out her services and ended up writing a book, The Dallas Doctors' Diet, in 1984. Upson lost 30 pounds following the program, then had a light bulb moment of her own.

When Upson graduated from Texas Woman's University as a nurse practitioner in 1999, she started seeing patients who needed prescriptions to treat conditions that could be controlled with dietary change. "I'd think, 'If they'd just lose a little weight, they wouldn't need this!'"

She decided to follow her passion and start teaching her mother's Naturally Slim principles. She formalized the principles into a 10-week course and started the business by inviting a few friends over to her home in Garland, Texas. They lost weight and told their friends. Pretty soon Upson had paying clients and a viable business.

The Plan

Naturally Slim stresses the need to keep eating simple. The keys are moderation, mindful eating and awareness of how nutrition affects health. She educates about hidden sugars by creating easy-to-understand comparisons. "I'll say, 'Did you know that for the amount of sugar you drink in one bottled cola a day, you could have three candy bars?'"

She's proud to say she's been recommending reduced sugar intake from the beginning. "Today we're seeing the American Heart Association making the same recommendation."

In a survey of 1,457 clients with a blood sugar of 100 mg/dL or higher at the start, 51% did not have elevated blood sugar after completing the 10-week course.

Clients Shrink, Business Grows

Several key events have helped Upson grow Naturally Slim into a financially successful business. At first, she presented her program in primary care practices where her clients were patients.

"I felt like a drug rep," she says. "Whenever I heard a doctor was interested in what I was doing, I'd call them up and say, 'Hey can I bring you and your staff lunch?'" As a result, physicians started recommending Naturally Slim to patients.

In 2004, a New York company that provides healthcare to business executives contacted Upson. They wanted their executives to follow the Naturally Slim approach. Upson had no way to deliver the program to remote clients, so she created a website, www.NaturallySlim.com.

"I didn't have money for fancy videos to put on it," she says, but clients needed to watch videos of the 10-week course. She borrowed her brother's video camera, set it up in her kitchen and taped herself teaching. "It was fun and humorous - the dog would bark, the doorbell would ring, and I'd have to start all over again."

The City of Garland, Texas, was next. Rick French, the benefits manager, contacted Upson and proposed a project that tracked every participant's progress. He wanted to show the city that wellness saved healthcare costs.

"We ran a pilot class, and the average triglyceride level lowered by 50 points," Upson says. The city's government continues as a client today.

Despite these remarkable successes, Upson still struggled to get the word out about her business. A breakthrough came in 2005 when the city of Garland invited Upson to share the results from the pilot at a national conference for city and state governments. There, she met Wally Gomaa, whose company, Accountable Care, Accountable Patient, works with Sabre Holdings, a large travel-industry corporation. Gomaa offered to help Upson market the business. He proposed a pilot program to Sabre Holdings, in which Naturally Slim and another weight-loss program were tested at the same time.

"I felt like I was in the Pillsbury Bake-off!" Upson says. Results were never tallied, however, because clients in the comparison program dropped out and requested to enter the Naturally Slim group.

Naturally Slim still works with Sabre Holdings. In 2008, Sabre Holdings was named one of America's 15 fittest companies by Men's Fitness magazine. Sabre Holdings also helped Naturally Slim develop an online community called NS Town, which today has 7,500 active members.

The Business Today

Naturally Slim has served more than 100 companies, many of them household names, yet she still offers individual participation for $435 a person. Upson has reinvested much of the money she's made, which has helped her get on track to having a multimillion-dollar business. "We don't mind that sometimes it can just get crazy busy!" she declares.

As far as improvements in client health, the numbers are staggering. With an average weight loss of 10 pounds per person during the 10-week class, Upson and her instructors have helped 34,000 clients lose at least 340,000 pounds. Upson remembers several people who lost 170 pounds or more. A survey she conducted showed that 2.5 years after the program ended, 80% of clients had kept the weight off. Upson often hears from clients who have been able to discontinue hypertension or cholesterol medications as a result of her program. And 45% of people who had metabolic syndrome at the start of the program no longer do afterward.

Natural Evolution

As Americans continue to gain weight, Upson is poised for the challenge of helping them get and stay healthy. She has already filmed videos for a stay-slim plan, which will update clients who are using a continuous (maintenance) plan.

Upson has also talked to grocery store chains about creating smaller-portion foods for a "True Thin" food product line. And she's working on an iPhone app that will allow users to take photos of meals instead of writing down what they ate.

"It's fun and fascinating thinking of new ways to make it easier for people to make lifestyle changes," Upson says.

Jennifer Ford is the associate editor and website editor of ADVANCE for NPs & PAs. Reach her at jford@advanceweb.com.

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