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JAMA. 1963;186(7):43-56. doi:10.1001/jama.1963.03710070005002.
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The Cardiologist  What is the usefulness of fasting in the treatment of obesity?Traditionally, total starvation—particularly without supervision by a physician—has been heartily disapproved by the medical profession. More recently, due principally to the work of Garfield Duncan, MD, of Philadelphia, there has been renewed interest in the technique of total starvation in the treatment of obesity. I believe the usefulness of this procedure is as follows:

  • For the initiation of hospital treatment of an extremely obese patient;

  • For its psychological value in initiating treatment as demonstration to a patient that weight loss is possible;

  • Its use on a maintenance basis (eg, 1-2 day episodes interspersed in the course of a low calorie diet, such as 1,000-1,500 daily).

Initially, total starvation is usually employed for 8 to 14 days with observation in the hospital along with careful examination of urine and plasma acetone levels, for it is probably the


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