There is no definite evidence of any abnormality of intestinal function, fat deposition and mobilization or energy metabolism in simple obesity (Newburgh, 1944;Conn, 1944). The only known means by which an obese person can lose fat, other than by surgical excision, is to convert it into energy, which conversion occurs only when there is a negative calorie balance.The prescription of a low-calorie diet for weight reduction is successful if the patient can be persuaded to adhere to it. It is generally agreed that the lower the calorie intake the faster the loss of weight will be, but the most desirable level of calorie intake is uncertain. Perhaps the greatest difficulty is in constructing a diet that will be both palatable and acceptable, the latter being essential if the patient is to keep to the regimen. In such a subjective matter considerable individual variation is probable. Again, the rate of loss of weight may depend to some extent on the qualitative composition of the diet (Kekwick & Pawan, 1956) and the investigation now reported was designed to test this hypothesis.An experimental design permitting rigorous statistical analysis of the results has been used. It was not possible to carry out balance studies so the loss in body-weight was used as the criterion of effectiveness of the diets. E X P E R I M E N T A LPatients. The personal details and basal metabolic rates of the six women examined are shown in Table I . They all had moderate or severe simple obesity without evidence of endocrine or intracranial disease. Physical examination, radiography of chest and sella turcica, urine composition, blood count, erythrocyte sedimentation rate, serum cholesterol and proteins were normal.The women were unselected except in that they agreed to a prolonged hospital admission and that such an admission was thought justified either because of the degree of obesity or, in patient no. 6, the earnest desire to lose weight. All had made previous attempts at weight reduction and had relapsed. None had borne children except no. 2, who had had six. Three patients admitted to the trial were later rejected. One was found to have hyperadrenocorticism, one was pubertal and the third could not tolerate the diet.Measurements. The patients were weighed each morning after passing urine at about 8.30 a.m. wearing only a nightdress. An Avery seat scale, the accuracy of which was
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