1. I was talking toJulie during her follow-up visit.  Julieis 42 year old single mother and weighs 103 kilos. I saw Julie 10 days ago withknee pain. She got over her pain with analgesics I prescribed and came for herroutine follow up visit. I taught her a few basic knee exercises and thenswitched to the preventive part. I discussed that unless she lost her weighther knees would end up having a replacement surgery very soon.Getting a kneereplacement done before 50 would not be a good idea I told Julie with a seriousface.“Doc, How do I loseweight?” we entered the familiar territory. Julie has 2 kids aged 12 and 15 andwants them to get educated well. To support their education Julie has 2 jobs.When I uttered the word “exercise” Julie got angry “where is the time forexercise? Doc?” Fortunately Julie has no bad habits as far as her diet goes andhas no other illnesses like thyroid or blood pressure or diabetes.Julie then discussedher hectic day and asked me “how does she accomplish the task of exercise”. Icould not answer that question and told Julie I would think about it. As usualshe asked me if there was a weight loss pill, and as usual I shrug my shouldersand smiled.I was reading a bookabout kaizen and suddenly remembered Julie’s problem. Kaizen is Japanese word for"continuous improvement ". In business, kaizen refers to activitiesthat continuously improve allfunctions and involve all employees from the CEO to the assembly line workers.It also talks about small rather than big changes which can improve our lives.I thought about applying Kaizen to Julie’s weight loss problem.Julieused to come home tired at 9pm every day and watch her favorite serial ontelevision for 30 minutes. It was her relaxation time. I suggested to Juliethat she just stands in front of her TV during the commercial break to startwith. After a few days she starts walking in front of the TV during thecommercial break and so on. The idea was to break the habit of “no exercise”.Imet a smiling Julie 2 months down the line. She had brought a rose for me! “Thattrick of yours worked wonders, Doc”! She told me. Julie had started with mysuggestion and gradually started marching in front of her TV during thecommercial breaks. After a few weeks she started watching the serial walkingand the started brisk walks where ever she used to just amble across. Shestarted crossing the roads running! Now she watches her serial sitting but getsup during every commercial break and walks! She has lost 5 kilos already!Lessonlearnt: To break a bad habit you can introduce a small change first and ithelps. Kaizenhas implications in everyone’s life. You want to reduce your shopping bill? Tryremoving one item form your cart just before the check out. Want to quitsmoking? Just reduce one cigarette per day.