Metabolic observations during starvation and refeeding in massively obese patients.

Treatment of massively obese patients by extended or intermittent starvation has proved to be a relatively benign method for initiating weight reduction programs. Because the problem of obesity is chronic and discouraging, starvation has a certain appeal for many patients, and it has not been difficult to obtain volunteers for metabolic observations. Since massively obese patients do not represent a homogeneous clinical group, this study was designed to determine whether the metabolic response to fasting would help classify these patients in a more precise way. When previously fasted patients are fed a low calorie diet, weight loss usually ceases. Bloom has claimed that the effect is found only when carbohydrate is fed.' The relation of the composition of the refeeding program to the weight course was, therefore, also studied.