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How to treat and when to treat

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Part of the Current Status of Modern Therapy book series (CSMT, volume 2)

Abstract

In theory it is obvious how to treat or prevent obesity: if it can be arranged that over the lifespan of an individual the total energy intake from food matches total energy expenditure, with suitable allowances for growth in childhood and for the physiological decrease in lean body mass in old age, then that individual cannot become obese. In practice this balance is often very difficult to achieve, and the medical literature is full of jeremiads about the impossibility of successful treatment. Astwood1 said that obesity was due to an inborn error of metabolism, so people who are fat are born fat, and nothing much can be done about it. Kemp2 said there is a point of no return at which the fat organ is so large that it becomes autonomous. Goldrick3 questioned whether refractory obese patients should be treated at all.

Keywords

Obese Patient Anorexia Nervosa Lean Body Mass Eating Binge Total Energy Expenditure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Astwood, E. B. (1962). The heritage of corpulence. Endocrinology, 71, 337.CrossRefGoogle Scholar
  2. 2.
    Kemp, R. (1972). The overall picture of obesity. Practitioner, 209, 654.Google Scholar
  3. 3.
    Goldrick, R. B., Havenstein, N. and Whyte, H. M. (1973). Effect of caloric restriction and fenfluramine on weight loss and personality profile of patients with longstanding obesity. Aust. N.Z.J. Med., 3, 131.CrossRefGoogle Scholar
  4. 4.
    Garrow, J. S. (1976). Upbringing, appetite and adult obesity. In A. W. Wilkinson (ed.). Early Nutrition and Later Development, pp. 219–228. (London: Pitman Medical Publ.).Google Scholar
  5. 5.
    Ashwell, M. A. (1973). A survey investigating patients’ views on doctors’ treatment of obesity. Practitioner, 211, 653.Google Scholar
  6. 6.
    Dwyer, J. T. and Mayer, J. (1970). Potential dieters: who are they? Attitudes towards body weight and dieting behaviour. J. Am. Diet. Assoc, 56, 510.Google Scholar
  7. 7.
    Garrow, J. S. (1978). Energy Balance and Obesity in Man, 2nd edn. (Amsterdam: North Holland Publishing Co.).Google Scholar
  8. 8.
    Olsson, E.-E. and Saltin, B. (1970). Variation in total body water with muscle glycogen in man. Acta Physiol. Scand., 80, 11.CrossRefGoogle Scholar
  9. 9.
    Edholm, O. G., Adam, J. M. and Best, T. W. (1974). Day-to-day weight changes in young men. Ann. Hum. Biol., 1, 3.CrossRefGoogle Scholar
  10. 10.
    MacAdie, D. (1978). Eat your way to better health. (London: Health Education Council).Google Scholar
  11. 11.
    Jolliffe, N. and Alpert, E. (1951). The ‘performance index’ as a method for estimating effectiveness of reducing regimens. Postgrad. Med., 9, 106.Google Scholar
  12. 12.
    Binnie, C. C. (1977). Obesity in general practice. Ten year follow-up of obesity. J. Roy. Coll. Gen. Pract., 27, 492.Google Scholar
  13. 13.
    Young, C. M. (1963). Management of the obese patient. J. Am. Med. Assoc., 186, 903.CrossRefGoogle Scholar
  14. 14.
    Donald, D. W. A. (1973). Mortality rates among the overweight. In R. F. Robertson (ed.), Anorexia and Obesity, pp. 63–70. (Edinburgh: RCP).Google Scholar
  15. 15.
    Leach, R. E., Baumgard, S. and Broom, J. (1973). Obesity: its relationship to osteoarthritis of the knee. Clin. Orthop., 93, 271.CrossRefGoogle Scholar
  16. 16.
    Keys, A., Aravanis, C., Blackburn, H., Buchem, F. S. P., Buzina, R., Djordjevic, B. S., Fidansa, F., Karvonen, M. J., Menotti, V. and Taylor, H. L. (1972). Coronary heart disease: overweight and obesity as risk factors. Ann. Intern. Med., 77, 15.Google Scholar
  17. 17.
    Blair, B. F. and Haines, L. W. (1966). Mortality experience according to build at higher durations. Trans. Act. Soc Amer., 18, 35.Google Scholar
  18. 18.
    Dublin, L. I. (1953). Relation of obesity to longevity. N. Engl. J. Med., 248, 971.CrossRefGoogle Scholar
  19. 19.
    Garrow, J. S. (1976). Underfeeding and overfeeding and their clinical consequences. Proc. Nutr. Soc, 35, 363.CrossRefGoogle Scholar
  20. 20.
    Hirsch, J. (1974). Cell number and size as a determinant of subsequent obesity. In M. Winick (ed.) Childhood Obesity, pp. 15–21. (New York: Wiley).Google Scholar
  21. 21.
    Hirsch, J. and Batchelor, B. (1976). Adipose tissue cellularity in human obesity. Clin. Endocr. Metab., 5, 299.CrossRefGoogle Scholar
  22. 22.
    Ashwell, M. A., Durrant, M. and Garrow, J. S. (1977). How a ‘fat cell pool’ hypothesis could account for the relationship between adipose tissue cellularity and age of onset of obesity. Proc. Nutr. Soc., 36, 111A.Google Scholar
  23. 23.
    Poskitt, E. M. E. and Cole, T. J. (1977). Do fat babies stay fat? Br. Med. J., 1, 7.CrossRefGoogle Scholar
  24. 24.
    Whitelaw, A. G. J. (1971). The association of social class and sibling number with skinfold thickness in London schoolboys. Hum. Biol., 43, 414.Google Scholar
  25. 25.
    Brewer, T. (1967). Human pregnancy nutrition: a clinical view. Obstet. Gynecol., 30, 605.Google Scholar
  26. 26.
    Blackburn, N. W. and Calloway, D. H. (1976). Energy expenditure and consumption of mature, pregnant and lactating women. J. Am. Diet. Assoc., 69, 29.Google Scholar
  27. 27.
    Stein, Z., Susser, M., Saenger, G., and Marolla, F. (1975). Famine and Human Development: the Dutch Hunger Winter of 1944–1945, p. 284. (London: Oxford University Press).Google Scholar
  28. 28.
    Ford, M. J., Scorgie, R. E. and Munro, J. F. (1977). Anticipated rate of weight loss during dieting. Int. J. Obesity, 1, 239.Google Scholar
  29. 29.
    Mellbin, T. and Vuille, J.-C. (1973). Physical development at 7 years in relation to velocity of weight gain in infancy with special reference to incidence of overweight. Br. J. Brev. Soc. Med., 27, 225.Google Scholar
  30. 30.
    Wilkinson, P. W., Parkin, J. M., Pearlson, J., Philips, P. R. and Sykes, P. (1977). Obesity in childhood: a community study in Newcastle upon Tyne. Lancet, i, 350.CrossRefGoogle Scholar

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© MTP Press Limited 1979

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