Fasting as a means of treating obesity is accompanied by ketosis and anorexia, and results in a precipitous loss of weight. The method may, therefore, be more attractive, to both the patient and the physician, than are the conventional dietary approaches. However, the emphasis on the actual number of pounds lost has obscured two problems, namely, that the object of the treatment is to lose fat and not protein, and that refeeding following the fast is invariably accompanied by fluid and electrolyte gains of 10 to 15 lb.
A communication in a recent issue of the Archives of Internal Medicine presents the results of metabolic studies carried out on 12 fasting, grossly obese patients.1 In these patients, estimated fat losses accounted for about 25% of the weight loss, whereas protoplasmic losses comprised 35%. The remainder of the weight loss was in fluids and electrolytes. Prolongation of the fast resulted