Some of the reasons why so many severely obese patients fail to reach normal weight with moderate dietary restriction are the disappointingly slow weight loss and persistent hunger. Consequently, many physicians have been resorting to dietary regimens supplying 200 to 600 calories. The result is rapid and extensive weight loss without much hunger.
The purpose of this communication is to emphasize the advantages of a "semistarvation" regimen and to suggest some measures which enhance the chances of success while minimizing the hazards inherent in such treatment. Severe dietary restriction does result in major physical and biochemical changes, and these can, in certain patients, cause serious complications.
Patient Selection.—
Most patients with uncomplicated obesity will easily tolerate prolonged semistarvation. Children and adolescents who are still growing and pregnant women should be excluded because of possible impairment of growth. In the older-age group, the risk of complications would seem to be excessive