Robert W. Keeton

Effect of Diets High in Protein but Inadequate in Calories on Weights of Obese Patients.

A patient (L. W.), female, weight 277 lbs., height 63.2 in., surface area 2.25 sq. m., age 21, with basal requirement of 2,000 calories was hospitalized and placed on a diet containing 90 gm. of protein and an inadequate number of calories varying between 802 and 1027. Over a period of 7 months, from Nov. 1, 1925, to June 1, 1926, she lost 65 pounds. All of this time the patient was allowed opportunity for daily walks and during a portion of the period she was given routine light work about the hospital. Then a second period followed in which she lived at home, weighed her food daily, but was actively working. At the opening of this period, June 1, 1926, she weighed 212 pounds and at the close, Feb. 10, 1907, 205 pounds. Thus her weight over this period of 8 months was stationary. Her basal metabolic rates were taken at regular intervals during this reducing period and found to be normal. Her nitrogen excretion showed a slight positive balance, indicating at least a nitrogen equilibrium. This patient was always found to be trustworthy. She was so anxious to lose weight that at times difficulty was experienced in making her eat all the food on her trays. In the hospital the intake did not exceed that shown by the figures. During the eight months when she was not in the hospital she reported at regular intervals and stated that she was following closely the diet. I feel that while she is to be trusted there was more opportunity for error during this period.