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December 22, 1956


Author Affiliations


From the Department of Medicine, Western Reserve University, and the Benjamin Rose Hospital.

JAMA. 1956;162(17):1511-1513. doi:10.1001/jama.1956.02970340001001

• Systematic observations of 500 patients admitted to a hospital for long-term illness over a period of three years showed that disturbances of nutrition seriously impeded recovery in 35 instances. In 15 there was severe inanition unexplained by either poverty or possible cachexia-producing disease. The causes included physical, psychiatric, and sociologic factors. When patients were induced to eat a sound diet, there resulted gratifying gains in weight in many and the disappearance of avitaminotic symptoms; in about one-third of the cases, however, inanition continued despite vigorous measures. In 20 patients there was overnutrition serious enough to hamper rehabilitation. Obesity not only made exercise laborious and hazardous, but also at times made it impossible for the patient to stand, walk, and develop significant self-sufficiency. When weight-reduction succeeded, the results were striking, but it involved breaking patterns of eating that had existed for decades. Some patients were so upset emotionally by it that the effort had to be abandoned. Malnutrition is more difficult to treat in the aged man than in the young. Obesity proved to be as important as inanition.