Clinical Use of a Protein-Sparing Modified Fast

Excerpt

OBESITY is notoriously resistant to treatment. Short-term weight reduction of greater than 18 kg occurs in fewer than 5% of outpatients.¹ Possible explanations for noncompliance and ineffectiveness of conventional diet therapy include hunger and the disappointingly slow rate of weight loss. Total fasting reduces hunger and induces rapid weight loss,² but half the weight loss in the first month and one fourth to one third thereafter is from muscle tissue,³ and hepatic, renal, and endocrine function is affected. For these reasons fasting regimens are generally recommended only for inpatients.

Long-term follow-up of persons who previously fasted has demonstrated a high rate of recidivism⁵ due to obligate regain of lean tissue or the lack of a weight-maintenance program or both. When a fast is supplemented by small amounts of protein in the form of egg albumin,⁶ casein,⁷ casein with glucose,⁸ or amino acids with