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Abstract The current widespread concern with weight reduction rests on at least two assumptions: first, that weight-reduction programs are effective; second, that they are harmless. Recent studies indicate that such programs may be far from harmless.1,2 This report documents their ineffectiveness. The results of treatment, as reported in the medical literature of the past 30 years, are first reviewed. The results of routine treatment of 100 consecutive obese persons in the Nutrition Clinic of the New York Hospital are then reported. Review of the Literature Hundreds of papers on treatment for obesity have been published in the past 30 years. Most, however, do not give figures on the outcome of treatment, and of those that do, most report them in such a way as to obscure the outcome of treatment of individual patients. Some authors, for example, report the total number of patients and the pounds lost without making clear References 1. The present study deals only with outpatient treatment of obesity. Inpatient treatment, with its far greater control over food intake, does not present the same problems. 2. Bruch, H.: The Importance of Overweight , New York, W. W. Norton & Company, Inc., 1957. 3. Stunkard, A. J.: The "Dieting Depression," Am. J. Med. 23:77-86, 1957.Crossref 4. Evans, F. A.: Treatment of Obesity with Low Calorie Diets: Report of 121 Additional Cases , Internat. Clin. 3:19-23, 1938. 5. Feinstein, R.; Dole, V. P., and Schwartz, I. L.: The Use of a Formula Diet for Weight Reduction of Obese Out-Patients , Ann. Int. Med. 48:330-343, 1958.Crossref 6. Fellows, H. H.: Studies of Relatively Normal Obese Individuals During and After Dietary Restriction , Am. J. M. Sc. 181:301-312, 1931.Crossref 7. Gray, H., and Kallenbach, D. C.: Obesity Treatment: Results on 212 Outpatients , J. Am. Dietet. A. 15:239-245, 1939. 8. Harvey, H. I., and Simmons, W. D.: Weight Reduction: A Study of the Group Method , Am. J. M. Sc. 227:521-525, 1954.Crossref 9. McCann, M., and Trulson, M. F.: Long-Term Effect of Weight-Reducing Programs , J. Am. Dietet. A. 31:1108-1110, 1955. 10. Munves, E. D.: Dietetic Interview or Group Discussion-Decision in Reducing? J. Am. Dietet. A. 29:1197-1203, 1953. 11. Osserman, K. E., and Dolger, H. O.: Obesity in Diabetes: A Study of Therapy with Anorexigenic Drugs , Ann. Int. Med. 34:72-79, 1951.Crossref 12. Cecil, R. L., and Loeb, R. F., et al.: A Textbook of Medicine , Ed. 9, Philadelphia, W. B. Saunders Company, 1955. 13. Young, C. M.; Moore, N. S.; Berresford, K.; Einset, B. M., and Waldner, B. G.: The Problem of the Obese Patient , J. Am. Dietet. A. 31:1111-1115, 1955. 14. Dole, V. P.; Schwartz, I. L.; Thaysen, J. H.; Thorn, N. A., and Silver, L.: Treatment of Obesity with a Low-Protein, Calorically-Unrestricted Diet , Am. J. Clin. Nutrition 2:381-390, 1954. 15. Rony, L.: Obesity and Leanness , Philadelphia, Lea & Febiger, 1931. 16. Stunkard, A. J.; Grace, W. J., and Wolff, H. G.: The Night-Eating Syndrome , Am. J. Med. 19:78-86, 1955.Crossref 17. Stunkard, A. J., and Reader, J.: The Management of Obesity , New York J. Med. 58:78-87, 1958. 18. Taylor, J. A.: A Personality Scale of Manifest Anxiety , J. Abnorm. & Social Psychol. 48: 285-290, 1953. 19. Bechtoldt, H. P.: Personal communication to the authors.
A.M.A. Archives of Internal Medicine – American Medical Association
Published: Jan 1, 1959
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