Practical Hints For The Prevention And Treatment Of Obesity
( Originally Published 1913 )
In order to fatten a goose it is kept in a dark place, in a small cage in which it cannot well move about, and stuffed with food, a procedure which is resorted to in Alsace, Belgium, etc. In some places they even go so far as to fasten down the feet so as to prevent all motion. Geese treated in this way get very large, and the liver especially becomes exceedingly fat. When anyone eats a great deal, particularly of very nourishing substances—as is the case with geese, which absorb fats, carbohydrates, and albumin in their corn, and these substances are better assimilated than is the case in man—he will grow fat.
This can be avoided, however, by taking plenty of exercise, and it is not very likely to occur when there is not a predisposition to becoming stout. The foods which contain a great deal of fat not inclosed in cells, but free and ready to be absorbed, are those which chiefly increase the body fat, such as butter, oil, etc. The carbohydrates, sweet foods, candies and sweets of all sorts, are also, fat producers, because large quantities of sugar are absorbed in them. In pastry and farinaceous foods this is especially the case when they can be readily absorbed like tapioca and sago, in which the absorption and the taking up into the blood are not interfered with by any cellulose. The fat formation is increased when carbohydrates and fats are taken together, and particularly when in combination with alcohol. Obesity is sure to occur when plenty of meat is also used. When only a small quantity of meat or of albumin is taken, obesity is not apt to occur. True vegetarians scarcely ever grow fat, but this is more likely to occur, according to my experience, when a milk-egg-vegetable diet is used. No matter how large the quantity of meat, it will probably not cause excessive fat; on the contrary, with a diet consisting largely or, rather, almost entirely of meat, a decrease of fat will occur, as is shown by the obesity cures. When, on the other hand, there is a sufficient quantity of meat, viz., albumin, in the diet, and plenty of starchy foods and fats are also taken, then obesity is apt to occur. This shows that the quantity of albumin, especially that contained in meat and eggs, must be diminished in the diet. When little meat is eaten, more carbohydrates, i.e., farinaceous foods, may be absorbed. Other-wise, they, and especially milk, cheese, fatty foods, and butter, are strictly to be avoided. Sweets and alcohol are never al-lowed. The carbohydrates may be preferably given when ingested in foods containing much cellulose, as, for instance, the leguminous vegetables, as they are then not so well assimilated. In order that there shall be no hunger, and consequently no desire for more nutritious foods, it is customary, at the beginning of the treatment of obesity, to allay the hunger by such foods as contain but little carbohydrate and plenty of cellulose, and are likewise bulky, such as sauerkraut, certain kinds of fruit, all vegetables, rye bread, and pumpernickel. In this way the patient lives upon foods which are not fat producers, and yet has plenty in the stomach. The best dietetic treatment as well as the most certain preventive of excessive fat is, in my opinion, a diet of this kind, without milk or eggs. If this diet is not helpful, as in cases where there is a constitutional obesity, due to alterations in the thyroid gland, the ovaries, or other ductless glands, either acquired or inherited, then the best treatment is by means of tablets o,f thyroid extract and, in the case of women, ovarian extract as well. When the obesity is due to overnutrition I have often seen good results after treatment with thyroid extract, which is, in my opinion, the most satisfactory in obesity. According to, my many observations—even some upon myself—I do not consider it at all injurious, if the patient is carefully watched by a physician who is familiar with the effects of ductless-gland preparations.