Reducing diets

Abstract

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

Deliberate overfeeding in women and men: energy cost and composition of the weight gain

“…The lack of an influence of type of food consumed is in keeping with the observations of Fletcher et al (1961) who found that type of food had no effect on the magnitude of weight loss in obese subjects on weight-reduction diets. Claims of a sex difference in ease of weight gain or that overweight individuals gain weight more readily than thin individuals cannot be substantiated by the available findings (however, none of the forty-eight subjects was massively obese).…”

Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity

“…Nevertheless, many studies agreed with our data showing greater weight loss with reduced carbohydrate diets (Anderson, 1944; Bell et al, 1969; Bogardus et al, 1981; Bortz et al, 1968; Bortz et al, 1967; Kekwick and Pawan, 1956; Lewis et al, 1977; Olesen and Quaade, 1960; Pilkington et al, 1960; Rabast et al, 1979; Rabast et al, 1981; Werner, 1955; Yang and Van Itallie, 1976). However, several studies did not detect significant differences in weight loss (Fletcher et al, 1961; Golay et al, 1996; Kinsell et al, 1964; Miyashita et al, 2004; Rumpler et al, 1991; Vazquez and Adibi, 1992; Vazquez et al, 1995). Often, the greater weight losses with the low carbohydrate diets were attributed to sodium and water imbalances (Anderson, 1944; Bell et al, 1969; Bortz et al, 1968; Bortz et al, 1967; Lewis et al, 1977; Olesen and Quaade, 1960; Pilkington et al, 1960; Werner, 1955; Yang and Van Itallie, 1976).…”

“…Previous inpatient controlled-feeding studies have employed isocaloric reduced-energy diets with fixed protein and varying in carbohydrate and fat to investigate differences in weight loss (Anderson, 1944; Bell et al, 1969; Bogardus et al, 1981; Bortz et al, 1968; Bortz et al, 1967; Fletcher et al, 1961; Golay et al, 1996; Kekwick and Pawan, 1956; Kinsell et al, 1964; Lewis et al, 1977; Miyashita et al, 2004; Olesen and Quaade, 1960; Pilkington et al, 1960; Rabast et al, 1979; Rabast et al, 1981; Rumpler et al, 1991; Vazquez and Adibi, 1992; Vazquez et al, 1995; Werner, 1955; Yang and Van Itallie, 1976). Only two of these previous studies investigated more subjects per diet group than the present study (Golay et al, 1996; Rabast et al, 1979).…”

The Treatment of Obesity

“…diets in which 90 per cent of the calories were provided by either fat, protein or carbohydrate, and found that those taking the ‘high‐fat’ diet lost weight the most rapidly. However, the effect of each diet was observed for only 8 to 10 days and similar studies over longer periods (Pilkington et al 1960; Oleson and Quaade 1960; Fletcher et al 1961) showed that the final weight loss was determined solely by the caloric value of the daily diet and was uninfluenced by the proportion of fat, protein or carbohydrate in it. The initial greater weight loss in Kekwick's patients taking the ‘high‐fat’ diet has been explained by the temporary greater excretion of water, as was indeed shown 30 years ago by Lyon and Dunlop (1932).…”