Add the ground beef to a large skillet over high heat. Break up the beef, leaving an assortment of crumbly and chunky pieces to mimic a chopped up burger patty.
Stir in garlic; and onion powder. Cook until the beef is browned and slightly charred and transfer to a bowl. Leave juices in skillet.
Reduce heat to medium-high, add the butter and cauliflower rice.
Add the salt and pepper to the rice. Cook until the rice turns slightly charred, about 7 minutes.
Mix the cooked beef back into the skillet until the beef comes back to temperature.
Turn the heat down to low setting and stir in the lettuce and tomatoes. Cook for about 2 minutes - just long enough the heat the vegetables without making them soggy.
Next divide the skillet into 4 equal servings and lay 4 slices of American cheese over the skillet.
Loosely cover with tinfoil for 3-4 minutes until cheese has melted. Remove from heat.
In a small bowl, stir together the mayo and ketchup. Serve this special sauce on the side or spoon it directly onto the skillet.