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A New Concept in the Treatment of Obesity: Title and subTitle BreakA 48-hour total fast followed by six meals a day and later by stepwise increases in food and calorie intake has permitted patients to lose weight that they show no tendency to regain for periods of up to 6 months. It also promoted spontaneous evolution of good dietary habits. FREE

Edgar S. Gordon, MD; Marshall Goldberg, MD; Grace J. Chosy, BS
[+] Author Affiliations

Madison, Wis.

From the departments of medicine and dietetics, University of Wisconsin Medical School.


JAMA. 1963;186(1):50-60. doi:10.1001/jama.1963.63710010013014
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OBESITY is a problem of affluent society and occurs only in those geographical areas and during those periods of human history that are characterized by an abundance of food available to great masses of people. Conversely, during war, famine, and economic catastrophe, when food becomes scarce, obesity and related diseases rapidly disappear. At mid-20th century Americans have been made acutely aware that, over many huge, underdeveloped areas of the earth representing more than one half of the world's population, a base subsistence level of food supply or actual famine and starvation are still the "normal" ways of life. Among these people obesity is unknown. In other countries, such as the US and those of western Europe, a superabundance of food has led to a high and continuously rising incidence of obesity. There could be no more eloquent testimony to overeating as the basic cause of this problem. Within any

REFERENCES

Gordon, E.S., et al:  Abnormal Energy Metabolism in Obesity , Trans Ass Amer Physicians 75:118, 1962;.
Gordon, E.S., and Goldberg, E.M.: Energy Metabolism in Obesity, in preparation.
Dole, V.P.:  Relation Between Non-Esterified Fatty Acids and Metabolism of Glucose , J Clin Invest 35:150, 1956;.
Gordon, E.S.:  Non-Esterified Fatty Acids in Blood of Obese and Lean Subjects , Amer J Clin Nutr 8:740, 1960;.
Opie, L.H., and Walfish, P.G.:  Plasma Free Fatty Acid Concentrations in Obesity , New Eng J Med 268:757, 1963;.
Goldberg, E.M., and Gordon, E.S.:  Free Fatty Acid Metabolism in Human Obesity , J Lab Clin Med 60:877, 1962;.
Berkowitz, D.:  Metabolic Changes Associated with Obesity Before and After Weight Reduction , Abstract in the Official Program of the 112th Annual Meeting of the American Medical Association , p 89, 1963;.
Kekwick, A.; Pawan, G.L.S.; and Chalmers, T.M.:  Resistance to Ketosis in Obese Subjects , Lancet 2:1157, 1959;.
Gordon, E.S.: Unpublished observations.
Bansi, H.W., and Olsen, J.M.:  Water Retention in Obesity , Acta Endocr 32:113, 1959;.
Elsbach, P., and Schwartz, I.L.:  Salt and Water Metabolism During Weight Reduction , Metabolism 10:595, 1961;.
Roth, J., et al:  Secretion of Human Growth Hormone: Physiologic and Experimental Modification , Metabolism 12:-577, 1963;.
Schteingart, D.E.; Gregerman, R.I.; and Conn, J.W.:  Comparison of Characteristics of Increased Adrenocortical Function in Obesity and Cushing's Syndrome , Metabolism 12:484, 1963;.
Randle, P.J., et al:  Glucose Fatty Acid Cycle , Lancet 1:785, 1963;.
Hales, C.N., and Randle, P.J.:  Effects of Low Carbo-Carbohydrate Diet and Diabetes Mellitus on Plasma Concentrations of Glucose, Non-Esterified Fatty Acid and Insulin During Oral Glucose Tolerance Tests , Lancet 1:790, 1963;.
Grodsky, G.M., et al:  Reduction by Phenformin of Excessive Insulin Levels After Glucose Loading in Obese and Diabetic Subjects , Metabolism 12:278, 1963;.
Stuchlikova, E., et al:  Some Changes in Intermediary Metabolism of Obese Patients , Clin Chim Acta 6:571, 1961;.
Dickerson, V.C.; Tepperman, J.; and Long, C.N.H.:  Role of Liver in Synthesis of Fatty Acids from Carbohydrate , Yale J Biol Med 15:875, 1943;.
Tepperman, J., and Tepperman, H.M.:  Effects of Antecedent Food Intake Pattern on Hepatic Lipogenesis , Amer J Physiol 193:55, 1958;.
Hollifield, G., and Parson, W.:  Metabolic Adaptations to "Stuff and Starve" Program: I. Studies of Adipose Tissue and Liver Glycogen in Rats Limited to Short Daily Feeding Period , J Clin Invest 41:245, 1962;.
Cohn, C., and Joseph, D.:  Effects on Metabolism Produced by Rate of Ingestion of Diet , Amer J Clin Nutr 8:682, 1960;.
Cohn, C., and Joseph, D.:  Influence of Body Weight and Body Fat on Appetite of "Normal" Lean and Obese Rats , Yale J Biol Med 34:598, 1962;.
Bedell, G.N.; Wilson, W.R.; and Seebohm, P.M.:  Pulmonary Function in Obese Persons , J Clin Invest 37:1049, 1958;.
Doorenbos, H.; Cost, W.S.; and Nagelsmit, W.F.:  Effect of Aldosterone Antagonists on Disturbance of Carbohydrate Metabolism in Primary Aldosteronism , Acta Endocr , (suppl 51) , Abstracts, No. (93) , p 185.
Steinberg, A.G.:  Comments on Genetics of Human-Obesity , Amer J Clin Nutr 8:752, 1960;.
Astwood, E.B.:  Heritage of Corpulence , Endocrinology 71:337, 1962;.

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Gordon, E.S., et al:  Abnormal Energy Metabolism in Obesity , Trans Ass Amer Physicians 75:118, 1962;.
Gordon, E.S., and Goldberg, E.M.: Energy Metabolism in Obesity, in preparation.
Dole, V.P.:  Relation Between Non-Esterified Fatty Acids and Metabolism of Glucose , J Clin Invest 35:150, 1956;.
Gordon, E.S.:  Non-Esterified Fatty Acids in Blood of Obese and Lean Subjects , Amer J Clin Nutr 8:740, 1960;.
Opie, L.H., and Walfish, P.G.:  Plasma Free Fatty Acid Concentrations in Obesity , New Eng J Med 268:757, 1963;.
Goldberg, E.M., and Gordon, E.S.:  Free Fatty Acid Metabolism in Human Obesity , J Lab Clin Med 60:877, 1962;.
Berkowitz, D.:  Metabolic Changes Associated with Obesity Before and After Weight Reduction , Abstract in the Official Program of the 112th Annual Meeting of the American Medical Association , p 89, 1963;.
Kekwick, A.; Pawan, G.L.S.; and Chalmers, T.M.:  Resistance to Ketosis in Obese Subjects , Lancet 2:1157, 1959;.
Gordon, E.S.: Unpublished observations.
Bansi, H.W., and Olsen, J.M.:  Water Retention in Obesity , Acta Endocr 32:113, 1959;.
Elsbach, P., and Schwartz, I.L.:  Salt and Water Metabolism During Weight Reduction , Metabolism 10:595, 1961;.
Roth, J., et al:  Secretion of Human Growth Hormone: Physiologic and Experimental Modification , Metabolism 12:-577, 1963;.
Schteingart, D.E.; Gregerman, R.I.; and Conn, J.W.:  Comparison of Characteristics of Increased Adrenocortical Function in Obesity and Cushing's Syndrome , Metabolism 12:484, 1963;.
Randle, P.J., et al:  Glucose Fatty Acid Cycle , Lancet 1:785, 1963;.
Hales, C.N., and Randle, P.J.:  Effects of Low Carbo-Carbohydrate Diet and Diabetes Mellitus on Plasma Concentrations of Glucose, Non-Esterified Fatty Acid and Insulin During Oral Glucose Tolerance Tests , Lancet 1:790, 1963;.
Grodsky, G.M., et al:  Reduction by Phenformin of Excessive Insulin Levels After Glucose Loading in Obese and Diabetic Subjects , Metabolism 12:278, 1963;.
Stuchlikova, E., et al:  Some Changes in Intermediary Metabolism of Obese Patients , Clin Chim Acta 6:571, 1961;.
Dickerson, V.C.; Tepperman, J.; and Long, C.N.H.:  Role of Liver in Synthesis of Fatty Acids from Carbohydrate , Yale J Biol Med 15:875, 1943;.
Tepperman, J., and Tepperman, H.M.:  Effects of Antecedent Food Intake Pattern on Hepatic Lipogenesis , Amer J Physiol 193:55, 1958;.
Hollifield, G., and Parson, W.:  Metabolic Adaptations to "Stuff and Starve" Program: I. Studies of Adipose Tissue and Liver Glycogen in Rats Limited to Short Daily Feeding Period , J Clin Invest 41:245, 1962;.
Cohn, C., and Joseph, D.:  Effects on Metabolism Produced by Rate of Ingestion of Diet , Amer J Clin Nutr 8:682, 1960;.
Cohn, C., and Joseph, D.:  Influence of Body Weight and Body Fat on Appetite of "Normal" Lean and Obese Rats , Yale J Biol Med 34:598, 1962;.
Bedell, G.N.; Wilson, W.R.; and Seebohm, P.M.:  Pulmonary Function in Obese Persons , J Clin Invest 37:1049, 1958;.
Doorenbos, H.; Cost, W.S.; and Nagelsmit, W.F.:  Effect of Aldosterone Antagonists on Disturbance of Carbohydrate Metabolism in Primary Aldosteronism , Acta Endocr , (suppl 51) , Abstracts, No. (93) , p 185.
Steinberg, A.G.:  Comments on Genetics of Human-Obesity , Amer J Clin Nutr 8:752, 1960;.
Astwood, E.B.:  Heritage of Corpulence , Endocrinology 71:337, 1962;.
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