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Original Contributions |

Prolonged Starvation as Treatment for Severe Obesity

Ernst J. Drenick, MD; Marion E. Swendseid, PhD; William H. Blahd, MD; Stewart G. Tuttle, MD
JAMA. 1964;187(2):100-105. doi:10.1001/jama.1964.03060150024006
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Eleven obese, ambulatory patients were starved for periods of 12 to 117 days. Only water and vitamins were consumed. Weight losses averaged 0.91 pounds (0.41 kg) daily. Hunger was virtually absent. Complications which developed during starvation were severe orthostatic hypotension in three cases; severe normocytic, normochromic anemia in one case; and gouty arthritis in two cases. With refeeding all ill effects were promptly reversed. Serum electrolytes, lipids, proteins, and amino acids remained unchanged during starvation. Serum uric acid increased; blood glucose levels fell in some cases. Considerable amounts of body protein and potassium were lost. Prolonged starvation is not advised for obese patients with a history of ischemic cardiovascular or cerebral disease, with history of gout, or with hepatic diseahypo

REFERENCES

Bloom, W.L.:  Fasting as Introduction to Treatment of Obesity , Metabolism 8:214-220 ( (May) ) 1959;.
Duncan, G.G., et al:  Intermittent Fasts in Correction and Control of Intractable Obesity , Amer J Med Sci 245: 515-520 ( (May) ) 1963;.
CrossRef
Ashley, B.C., and Whyte, H.M.:  Metabolic Studies in Starvation , Aust Ann Med 10:92-113 ( (May) ) 1961;.
Stunkard, A., and McLaren-Hume, M.:  Results of Treatment for Obesity: Review of Literature and Report of Series , Arch Intern Med (Chicago) 103:79-85 ( (Jan) ) 1959;.
Swendseid, M.E.; Griffith, W.H.; and Tuttle, S.G.:  Effect of Low Protein Diet on Ratio of Essential to Non-essential Amino Acids in Blood Plasma , Metabolism 12:96-97 ( (Jan) ) 1963;.
Caraway, W.T.:  Determination of Uric Acid in Serum by Carbonate Method , Amer J Clin Pathol 25:840-845 ( (July) ) 1955;.
Kingsley, G.R., and Schaffert, R.R.:  Direct Microde-termination of Sodium, Potassium and Calcium in Single Biological Specimen , Analyt Chem 25:1738-1741 ( (Nov) ) 1953;.
CrossRef
Dumm, R.M., and Shipley, R.A.:  Simple Estimation of Blood Ketones in Diabetic Acidosis , J Lab Clin Med 31: 1162-1163 ( (Oct) ) 1946;.
Kingsley, G.R.:  Determination of Butterfat in Ice Cream by Dry Extraction with Chloroform , J Ass Off Agric Chem 27:337-338 ( (May) ) 1944;.
Kingsley, G.R., and Schaffert, R.R.:  Determination of Free and Total Cholesterol by Direct Chloroform Extraction , J Biol Chem 180:315-328 ( (Aug) ) 1949;.
Kingsley, G.R., and Getchell, G.:  Direct Ultramicro Glucose Oxidase Method for Determination of Glucose in Biologic Fluids , Clin Chem 6:466-475 ( (Oct) ) 1960;.
Kingsley, G.R., and Dowdell, L.A.:  Direct Iodometric Colorimetric Determination of Blood Chloride , J Lab Clin Med 35:637-639 ( (April) ) 1950;.
Kingsley, G.R.:  Direct Biuret Method for Determination of Serum Proteins as Applied to Photoelectric and Visual Colorimetry , J Lab Clin Med 27:840-845 ( (March) ) 1942;.
Tallen, H.H.; Moore, S.; and Stein, W.H.:  Studies on Free Amino Acids and Related Compounds in Tissues of Cat , J Biol Chem 211:927-939 ( (Dec) ) 1954;.
Blahd, W.H.; Cassen, B.; and Lederer, M.:  Determination of Total Body Potassium by Potassium-40 Measurements in Patients With Muscular Dystrophy and Related Diseases, Whole-Body Counting , Proc Sympos Vienna, 1961 , Vienna: International Atomic Energy Agency, 1962;, p 427-433.
Svendseid, M.E.; Tuttle, S.G.; and Drenick, E.J.: Unpublished data.
Kekwick, A.; Pawan, G.L.; and Chalmers, T.M.:  Resistance to Ketosis in Obese Subjects , Lancet 2:1157-1159 ( (Dec 26) ) 1959;.
CrossRef

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Bloom, W.L.:  Fasting as Introduction to Treatment of Obesity , Metabolism 8:214-220 ( (May) ) 1959;.
Duncan, G.G., et al:  Intermittent Fasts in Correction and Control of Intractable Obesity , Amer J Med Sci 245: 515-520 ( (May) ) 1963;.
CrossRef
Ashley, B.C., and Whyte, H.M.:  Metabolic Studies in Starvation , Aust Ann Med 10:92-113 ( (May) ) 1961;.
Stunkard, A., and McLaren-Hume, M.:  Results of Treatment for Obesity: Review of Literature and Report of Series , Arch Intern Med (Chicago) 103:79-85 ( (Jan) ) 1959;.
Swendseid, M.E.; Griffith, W.H.; and Tuttle, S.G.:  Effect of Low Protein Diet on Ratio of Essential to Non-essential Amino Acids in Blood Plasma , Metabolism 12:96-97 ( (Jan) ) 1963;.
Caraway, W.T.:  Determination of Uric Acid in Serum by Carbonate Method , Amer J Clin Pathol 25:840-845 ( (July) ) 1955;.
Kingsley, G.R., and Schaffert, R.R.:  Direct Microde-termination of Sodium, Potassium and Calcium in Single Biological Specimen , Analyt Chem 25:1738-1741 ( (Nov) ) 1953;.
CrossRef
Dumm, R.M., and Shipley, R.A.:  Simple Estimation of Blood Ketones in Diabetic Acidosis , J Lab Clin Med 31: 1162-1163 ( (Oct) ) 1946;.
Kingsley, G.R.:  Determination of Butterfat in Ice Cream by Dry Extraction with Chloroform , J Ass Off Agric Chem 27:337-338 ( (May) ) 1944;.
Kingsley, G.R., and Schaffert, R.R.:  Determination of Free and Total Cholesterol by Direct Chloroform Extraction , J Biol Chem 180:315-328 ( (Aug) ) 1949;.
Kingsley, G.R., and Getchell, G.:  Direct Ultramicro Glucose Oxidase Method for Determination of Glucose in Biologic Fluids , Clin Chem 6:466-475 ( (Oct) ) 1960;.
Kingsley, G.R., and Dowdell, L.A.:  Direct Iodometric Colorimetric Determination of Blood Chloride , J Lab Clin Med 35:637-639 ( (April) ) 1950;.
Kingsley, G.R.:  Direct Biuret Method for Determination of Serum Proteins as Applied to Photoelectric and Visual Colorimetry , J Lab Clin Med 27:840-845 ( (March) ) 1942;.
Tallen, H.H.; Moore, S.; and Stein, W.H.:  Studies on Free Amino Acids and Related Compounds in Tissues of Cat , J Biol Chem 211:927-939 ( (Dec) ) 1954;.
Blahd, W.H.; Cassen, B.; and Lederer, M.:  Determination of Total Body Potassium by Potassium-40 Measurements in Patients With Muscular Dystrophy and Related Diseases, Whole-Body Counting , Proc Sympos Vienna, 1961 , Vienna: International Atomic Energy Agency, 1962;, p 427-433.
Svendseid, M.E.; Tuttle, S.G.; and Drenick, E.J.: Unpublished data.
Kekwick, A.; Pawan, G.L.; and Chalmers, T.M.:  Resistance to Ketosis in Obese Subjects , Lancet 2:1157-1159 ( (Dec 26) ) 1959;.
CrossRef
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