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Max Wishnofsky, M.D.
JAMA. 1960;173(1):85. doi:10.1001/jama.1960.03020190087024.
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To the Editor:—  The article by Dr. W. L. Bloom entitled "Fasting as an Introduction to the Treatment of Obesity" (Metabolism8:214 [May] 1959) which was summarized in The Journal, Jan. 23, page 328, prompts me to say that the subject of caloric equivalents of gained or lost weight under varying conditions has hardly been explored by workers in the field of metabolism. Knowledge of the following facts is essential. Carbohydrate and protein cannot be stored dry but retain with them three or more parts of water, while fat can be stored in an almost pure state. One gram of adipose tissue gives the body 8.3 calories of reserve energy, while retention of 1 Gm. of water-soaked glycogen or protein provides only about one calorie. These factors are basic for the determination of the caloric equivalents of gained or lost weight.The average obese patient who is placed on


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