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Original Contribution
January 11, 1964

Prolonged Starvation as Treatment for Severe Obesity

JAMA. 1964;187(2):100-105. doi:10.1001/jama.1964.03060150024006

Eleven obese, ambulatory patients were starved for periods of 12 to 117 days. Only water and vitamins were consumed. Weight losses averaged 0.91 pounds (0.41 kg) daily. Hunger was virtually absent. Complications which developed during starvation were severe orthostatic hypotension in three cases; severe normocytic, normochromic anemia in one case; and gouty arthritis in two cases. With refeeding all ill effects were promptly reversed. Serum electrolytes, lipids, proteins, and amino acids remained unchanged during starvation. Serum uric acid increased; blood glucose levels fell in some cases. Considerable amounts of body protein and potassium were lost. Prolonged starvation is not advised for obese patients with a history of ischemic cardiovascular or cerebral disease, with history of gout, or with hepatic diseahypo

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