Follow-up study of refractory obesity treated by fasting.

MacCuish, A. C.; Munro, James; Duncan, L. J. P.

doi:10.1136/bmj.1.5584.91

Cited by 34 publications

(4 citation statements)

References 8 publications

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“…: Weight Regain after Low Calorie Diet Diabetologia 27,35]. However, Grodsky in particular has pointed out that long-term follow.up studies on metabolic changes after cessation of reducing therapy are sparse [18,29,31]. The weight change of our follow-up patients was consistent with that found by other in-~stigators [25,43], namely a small number of patients returned to or exceeded their initial weight while half of them maintained their weight toss or even reduced further.…”

Section: Discussionsupporting

confidence: 82%

Weight regain after low calorie diet: Long term pattern of blood sugar, serum lipids, ketone bodies and serum insulin levels

et al. 1973

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4 years after controlled clinical treatment with a 1000 calorie mixed diet, 24 patients were reinvestigated to assess (1) whether the improved metabolism, as observed during therapy, is merely the result of starvation and (2) to what extent this improvement continues beyond the time of dietary treatment.-The following tests were carried out: Oral G.T.T. (100 g), immunoreactive insulin, free fatty acids, free glycerol. triglycerides, cholesterol, acetoacetate and beta-hyclroxy: butyrate.-12 patients had been able to maintain their weight or reduce further. They showed a slightly improved glucose tolerance and a more normal secretion kinetic for insulin release. However, 12 individuals who were found to have a 35% weight gain (Broca), returning almost to their initial weight, showed a decreased glucose tolerance compared with previous examination, while insulin levels were slightly elevated, with a typically delayed secretion. Both groups showed a weight-independent elevation of cholesterol and triglyceride levels and a marked decline of plasma FFA, free glycerol and ketone bodies. The parameters of lipid metabolism may possibly be influenced by the composition of the diet, while a change of weight after reduction primarily affects blood sugar levels and, to a lesser extent, insulin levels.

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Section: Discussionsupporting

confidence: 82%

Weight regain after low calorie diet: Long term pattern of blood sugar, serum lipids, ketone bodies and serum insulin levels

et al. 1973

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“…Short-term fasts, although demonstrating to the obese patient his ability to lose weight, have a poor long-term outlook with respect to subsequent weight gain (MacCuish et al, 1968). We have found, like Munro and colleagues (1970), that prolonged supervised therapeutic starvation of the obese patient can be a safe therapy, which is also effective if the ideal weight is reached.…”

Section: Discussionsupporting

confidence: 54%

“…longer than 40 days) has an element of risk attached (Lawlor & Wells, 1971). It is generally agreed that the long-term outlook for the achievement and maintenance of ideal body weight is poor (MacCuish, Munro & Duncan, 1968;Lawlor & Wells 1971) unless a weight close to the ideal is achieved during the supervised phase (Munro et al, 1970), a process which in the majority of cases would involve a prolonged rather than a short-term fast.…”

Section: Introductionmentioning

confidence: 99%

Features of a successful therapeutic fast of 382 days' duration

Stewart

Fleming

1973

Postgraduate Medical Journal

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“…In addition, we believe that starvation is of value only if it results in permanent weight reduction. Previous experience has shown that almost all obese patients starved for a relatively short time and allowed home while still clinically obese soon regain weight (MacCuish et al, 1968). This further study was undertaken to determine if more satisfactory results could be obtained by starving obese patients until they have reduced to 25 % in excess of their ideal weight.…”

Section: Medical Journalmentioning

confidence: 99%