The Energy Exchange in Obesity

Abstract

The problem of obesity, in its many aspects, has been receiving attention in recent years and is becoming important in clinical practice. There are many points needing further examination. The popular prejudice, that fat people are frequently "small eaters" and, therefore, have some mystic power of handling food more economically than normal people, persists in spite of many reports demonstrating basal metabolic rates of the obese within normal limits. The fact that the fat person actually consumes more energy than he would if he were not obese has been emphasized by Labbe and Stevenin (2) and by Lauter (3). Observations have been made repeatedly that the basal calories per day lie between 2000 and 2200 instead of the normal 1400 to 1600. These data lend no support to the conception of a mysterious economy practised by the tissue infiltrated with fat. A long series of cases (1) successfully treated by dietary measures alone also questions the validity of this hypothesis. In this report, the evidence dealing with the caloric exchange of the obese in the basal stater is reexmined and correlated with additional data.Basal heat production is customarily referred to the surface area of the body. The so-called basal metabolic rate expresses the per cent deviation of the basal calories per unit of body surface from the average values for normal persons. A review of the literature (4,5,6,7,8,9) shows that the basal metabolic rates of obese persons fall within normal limits. Our observations are in accord with these data.It is, therefore, established that a pudgy woman of forty-nine years, 5 feet tall, weighing 294 pounds has only 6 per cent less energy exchange in the resting state than a man of the same age, 6 feet 3 inches tall, weighing ideally 205 pounds. The surface is the same in the two cases, namely, 2.22 square meters. It is apparent, however, that there is a fundamental difference in the two cases. The measure of the 277

Reducing diets

“…At first sight it might appear likely that for a given calorie intake a certain weight loss would result but it has been known for many years (cf. Strang, 1959) that the heavier the patient the faster is the loss of weight on a reducing diet. More recently this observation has been confirmed by experiment (Young, Brown, Empey & Turk, 1958; Grossman & Sloane, 1955).…”

The Treatment of Obesity in Patients with Cardiovascular Disease

“…Of the 16 diabetics, 11 had associated arteriosclerotic cardiovascular disease; 5 of these 11 and 1 of the remaining 5 diabetics had associated hypertension. All of these patients were overweight by any standard used.…”

A Theoretical Analysis Examining the Construct of a Pound of Fat Equaling 3,500 Kilocalories

“…Evans undertook another study with James Strang, examining energy exchange in the obese (Strang & Evans, 1928). Strang and Evans (1928) placed participants on a diet of only 600-650 kilocalories a day, equivalent to about 6 kcal/gram of body weight.…”

“…Evans undertook another study with James Strang, examining energy exchange in the obese (Strang & Evans, 1928). Strang and Evans (1928) placed participants on a diet of only 600-650 kilocalories a day, equivalent to about 6 kcal/gram of body weight. The individuals with the large decrease in caloric intake lost weight quickly, as much as 2-4 pounds a day (Strang & Evans, 1928).…”

“…Strang and Evans (1928) placed participants on a diet of only 600-650 kilocalories a day, equivalent to about 6 kcal/gram of body weight. The individuals with the large decrease in caloric intake lost weight quickly, as much as 2-4 pounds a day (Strang & Evans, 1928). Strang and Evans (1928) reported that large amounts of weight loss can be achieved with obese persons.…”