( Originally Published 1929 )
PEOPLE with obesity of the endocrine type appear to have bodies which function with such abnormal efficiency in the creation of fat from carbohydrates that no matter how heroically they adhere to a limited diet they just go on manufacturing excess fat.
These unfortunates had best ignore the usual weight tables and food charts, for calories will mean little in their lives. The cause of their obesity is the storing of fat in the body under conditions which seem largely independent of diet and do not respond effectively to diet control.
Obesity of the endocrine type may have its origin in any one of four glands, namely thyroid, gonadal, pituitary or thymus.
A number of diseases and disorders, all char acterized by imperfect metabolism and all marked by deposits of fat, are included under the endocrine type.
McLester includes in this group the following;
1. Adiposis dolorosa or Dercum's disease.
2. Dystrophia adiposo-genitalis, overgrowth of the skeleton, obesity and disgenitalism.
3. Thyroid obesity, which results from thyroid deficiency, and which usually, though not invariably, begins in early life.
4. Obesity of genital origin, related to disease or developmental defects of the gonads and exhibiting as a rule abnormal distribution of fat.
5. Obesity which is associated with disease of the pineal and suprarenal glands.
6. Other abnormal deposits of fat, circumscribed or diffuse to which the term lipomatosis is applied.
7. Polyglandular types fall within this group.
8. Thyroid and pituitary obesity appear to be-long to the endocrine group although they sometimes appear in conjunction with other diseases and disorders of the body.
While the physician of course must be the final judge, the following may be given as the signs that indicate endocrine types:
Signs Indicating Endocrine Types Thyroidal
The "spade hand" (also seen in the pituitary type).
Extremes of these symptoms are found in advanced thyroid deficiency to which the name myxedema has been applied. Gall stones are very common in these cases of advanced thyroid deficiency.
May have "spade hands."
Fat deposits usually below the waist line. Features of the "Dutch doll" type.
Scant hair on face and trunk though it may be thick and coarse on the scalp.
Absence of half moons on the nails, and thickening of skin at roots of nails.
Pituitary and Gonadal
Skin dotted with black moles.
Women may have menstrual disorders and men may be a sexual.
Spacing between upper front teeth (incisors).
(Found in children whose gonads have not properly developed, in eunuchs and in women whose ovaries have been removed surgically or destroyed by disease.)
In the male
Overgrowth of fatty tissue on hips. Voice heightens.
In the female
Hair appears on the lips.
Masculine characteristics develop.
A very rare type of obesity, for which no definite indications need be listed. The thymus gland is antagonistic to the sex glands and if this gland, which normally atrophies at birth, persists into childhood it produces many complications such as asthma, obesity or sudden death.
Many of the symptoms listed under Thyroidal can be improved or made to disappear by the intelligent use of thyroid. But thyroid is a dangerous drug in the hands of the laity and should only be used under the direction of a physician. Thyroid medication properly given is one of the greatest reducing and rejuvenating agents at our command but recklessly taken it has tremendous potentiality for harm.
Failures from thyroid medication may be due to underdose or overdose.
The thyroid may have deteriorated on the drug-gist's shelves or the dosage may have been insufficient. Although the products on the market have been standardized, errors in dosage may creep in. This is due to the fact that some manufacturers make tablets of the whole dried thyroid gland and others use an extract of the gland, the latter being ten times the strength, weight for weight, of the former. A two-grain tablet of the extract equals twenty grains of the dried gland. The danger in refilling prescriptions or in buying thyroid over the counter must be obvious.
The symptoms of overdosage are nervousness, sweating, tremor of the fingers, aching of the long bones of the body and palpitation. Patients taking thyroid should be seen by a physician every few days, a pulse record kept and the urine examined at stated intervals. If a patient is carefully watched while taking thyroid no possible harm can result because withdrawal of the treatment for a few days at the first sign of overdosage will check the condition.