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Alfred W. Pennington, M.D.
JAMA. 1958;166(17):2214-2215. doi:10.1001/jama.1958.02990170112033.
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To the Editor:—  Dr. Max Wishnofsky (J. A. M. A.166:964-965 [Feb. 22] 1958) is in error in stating "The thesis of Pennington is that when an obese individual is on a high-fat, high-protein ad libitum diet, a substantial loss of weight will occur even when there is no negative caloric balance." Such a statement appears nowhere in any of the papers I have written, nor is it implied in them. On the contrary, my statements on the matter have been very clear. For example: "In the treatment of obesity, the aim of which is to reduce the size of the adipose deposits, it is axiomatic that the caloric expenditure must exceed the intake" (J. Clin. Nutrition1:100-106 [Jan.] 1953). Again: "The overall determinant in weight reduction is the degree to which the caloric expenditure exceeds the intake" (New England J. Med.248:959-964 [June 4] 1953). My


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