Total fasting as a method for weight reduction has been used successfully in non-mental patients and found to produce an elevation in mood. In the present study, this method was explored in mental patients. Twenty-one patients began the fast. Three refused to co-operate from the start; four manifested an exacerbation of symptoms; four were unmotivated to continue more than four days; and ten completed the ten-day fast. the latter ten became relaxed and pleasant after the first few fasting days. Three patients requested a repeat fast. Weight loss ranged from 2.8 to 1.3 pounds per day.
Changes were noted in hemoglobin, hematocrit, plasma unesterified fatty acids, CO2 combining power, urinary acetone, and urine specific gravity.
This may prove to be a satisfactory approach to weight reduction in mental patients.
References
1.
AmdisenA.: Drug-produced obesity — experiences with chlorpromazine, perphenazine, and clopenthixol.Dan. Med. J.2(6), 1964.
2.
AntonisA.: Semiautomated method for the clorimetric determination of plasma free fatty acids.J. Lipid Res.6:307, 1965.
3.
BloomW. L.: Fasting as an introduction to the treatment of obesity.Metabolism. 8:214–220, 1959.
4.
CaffeyE. M.: Experience with large scale inter-hospital co-operative research in chemotherapy.Amer. J. Psychiat., 117: 713–719, 1961.
5.
CaffeyE. M., and KlettC. J.: Side effects and laboratory findings during combined drug therapy of chronic schizophrenics.Dis. Nerv. Sys.22:370–375, 1961.
6.
CrumptonE., WineD. B., and DrenickE. J.: Starvation: Stress or satisfaction?JAMA, 196:108–110, 1966.
7.
DrenickE. J., SwendseidM. E., BlahdW. H., and TuttleS. G.: Prolonged starvation as treatment for severe obesity.JAMA, 187:100–105, 1964.
8.
DuncanG. G., JensonW. K., CristoforiF. C., and SchlessG. L.: Intermittent fasts in the correction and control of intractable obesity.Amer. J. Med. Sci., 245:515–520, 1963.
9.
DuncanG. G., JensonW. K., FraserR. I., and CristoforiF. C.: Correction and control of intractable obesity.JAMA, 181:309–312, 1962.
10.
DuncombeW. G.Colorimetric micro-determination of non-esterified fatty acids in plasma.Clin. Chem. Acta., 9:122, 1964.
11.
GordonH. L., and GrothC.: Weight change during and after hospital treatment.Arch. Gen. Psychiat., 10:187–191, 1964.
12.
GordonH. L., LawA., HohmanK. E., and GrothC.: The problem of overweight in hospitalized psychotic patients.Psychiat. Quart., 34:69–82, 1960.
13.
HansonP. G., JohnsonR. E., and ZaharkoD. S.: Correlation between ketone body and free fatty acid concentrations in plasma during early starvation in man.Metabolism. 14(10): 1037–1040, 1965.
14.
KlettC. J., and CaffeyE. M.: Weight changes during treatment with phenothiazine derivatives.J. Neuropsychiat., 2:102–108, 1960.
15.
KollarE. J., SlaterG. R., PalmerJ. O., DocterR. F., and MandellA. J.: Measurement of stress in fasting man.Arch. Gen. Psychiat., 2:113–125, 1964.
16.
LaszloJ.: Changes in the obese patient and his adipose tissue during prolonged starvation.So. Med. J., 58: 1099–1108, 1965.
17.
MagerM., and IampietroP. F.: The effect of prolonged cold and starvation and subsequent refeeding on plasma lipids and glucose of normal men.Metabolism, 15:9–16, 1966.
18.
MalloyH. T., and EvelynK. A., J. Biol. Chem., 119:480, 1937.
19.
PetersonR. E., KarrerA., and GuerraS. L.: Evaluation of Silber-Porter procedure for determination of plasma hydrocortisone.Analyt. Chem.29:144, 1957.
20.
PlananskyK., and HeilizerF.: Weight changes in relation to the characteristics of patients on chlorpromazine.J. Clin. Exper. Psychopathol., 20:53057, 1959.
21.
SchachnerS. H., WielandR. G., MaynardD. E.KrugerF. A., and HamwiG. J.: Alterations in adrenal cortical function in fasting obese subjects.Metaboism, 14: 1051–1058, 1965.
22.
SchultzA. L., WernerL. A., and KerlowA.: The use of total starvation in the management of chronic obesity.Minn. Med., 48:441–447, 1965.
23.
ScottJ. T., McCallumF. M., and HollowayV. P.: Starvation, ketosis and uric acid excretion.Clin. Sci., 27:209–221, 1964.
24.
SlettenI. W., and GershonS.: The effect of chlorpromazine on water and electrolyte balance.J. Nerv. Ment. Dis., 142:25–31, 1966.
25.
SlettenI. W., MouB., CazenaveM., and GershonS.: The effects of caloric restriction on behavior and body weight in psychiatric subjects on chlorpromazine, Dis. Nerv. Sys. (in Press 1966).
26.
SnedecorG. W.: Statistical Methods.Ames, Iowa, The Iowa State College Press, Fifth Ed., 1957.
27.
SpencerH., LewinI., and SamachsonJ.: Changes in metabolism in obese persons during starvation.Amer. J. Med., 40:27–37, 1966.
28.
Technicon Instruments Corporation, New York, Chauncey, Copyright 1964, Publication No. P 5–3 R 623–1–4.
29.
Van ItallieT.B., and HashimS.A.: Biochemical concomitants of hunger and and satiety in man.Amer. J. Clin. Nutr., 8:587–594, 1960.
