Plasma cholesterol levels during rapid weight reduction.

Twenty-seven obese individuals underwent rapid weight reduction by rigid caloric restriction. During this time there was a slight overall drop in plasma cholesterol levels. Patients undergoing most rapid weight loss showed the greatest drop in plasma cholesterol. Fear of elevating the plasma cholesterol need not deter the physician from subjecting obese patients to rapid weight reduction M ANY writersl-3 have pointed out the serious danger to life of obesity. In spite of general agreement that weight reduction is urgently indicated in overweight individuals there is considerable difference of opinion as to how rapidly it should be accomplished. It has been our experience that rapid weight loss is no more unpleasant for the patient than gradual reduction and is much more likely to succeed, since the tangible results encourage the patient to continue until his desired goal is achieved. Dilatory weight reduction often fails because results are so slowly realized that the patient becomes discouraged and stops after a few weeks trial. Newburghl has advocated rapid weight reduction and reported the case of an unusually obese male who sustained the amazing loss of 286 pounds in a year's time with marked improvement in health. Because of apparent correlation between elevation of plasma cholesterol and the incidence of arteriosclerosis considerable interest has been directed toward learning the effects of nutritional variables on cholesterol levels. Shope4 has reported an early rise in the level of serum cholesterol in both man and experimental animals during fasting, and the concept of "starvation hyperlipemia" has been accepted by some as an established fact. However, many workers have been unable to demonstrate elevation in plasma cholesterol during fasting or starvation in man or experimental animals..'8 Reports are variable and conflicting. Harrison9 seemed to have accepted the concept of starvation hyperlipemia when he stated, "It should be remembered that weight reduction causes 864 the patient to utilize large amounts of his own fat, and hence is equivalent to a high fat diet ... Hence, weight reduction should usually be carried out slowly rather than rapidly." The present study was undertaken for the purpose of determining whether high plasma cholesterol levels resulted during the early stages of rapid weight reduction. STUDY The 27 overweight patients included in the study were placed on reducing diets after their weights had been recorded and a fasting plasma cholesterol had been obtained. Reducing diets of 600 or 800 calories daily were used in …